CSM 2017-18 Benefit Overview

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B E N E F I T S P L A N O V E R V I E W P A G E 6
VISION BENEFITS
All full-time employees are eligible to sign up for vision coverage, which allows participants to get an examination
annually; lenses and contact lenses (in lieu of frames & lenses) every 12 months; and frames every 24 months.
Participants have the option of receiving care from a network or out-of-network provider; however, if you use a non-
network provider you will incur higher out-of-pocket expenses.
You have access to the VSP — one of the nation’s largest eye care networks. Employees pay the entire cost of this
coverage.
Per Pay (24 Pays)
Employee $5.32
Employee & Spouse $8.96
Employee & Child $9.13
Family $14.89
Employee Contributions
Vision In-Network Out-of-Network Frequency
ExamCopay $10 Copay 12 months
ExamAllowance 100% $46 12 months
Materials Copay $25 Plan Allowance
Base Lenses
- Single Vision Allowance $25 Copay $47 Allowance after Copay 12 months
- Bifocal Allowance $25 Copay $66 Allowance after Copay 12 months
- Trifocal Allowance $25 Copay $85 Allowance after Copay 12 months
- Lenticular Allowance $25 Copay $125 Allowance after Copay 12 months
Contact Lenses
- Elective Allowance $130 Allowance $120 Allowance 12 months
- Therapeutic Allowance 100% $210 Allowance 12 months
Frame Retail Allowance $130 Allowance,
20% off balance $47 Allowance after Copay 24 months
Materials Allowance Not applicable Not applicable