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Vision
All full-time, regular employees are eligible to sign up for vision coverage, which allows participants to
get an eye examination, lenses, frames, and contact lenses
(in lieu of frames & lenses)
every 12
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.
Benefits Description
In-Network
Benefit
Out-of Network
Benefit
Frequency Period (calendar
year beginning Jan. 1)
Exam Copay
$0
N/A
12 months
Exam Allowance
Covered 100% after Copay
Up to $45
12 months
Materials Copay
$20
N/A
12 months
Eyeglass Lenses Allowances:
(one pair per frequency period)
Single Vision
Bifocal
Trifocal
Lenticular
Covered 100% after Copay
Covered 100% after Copay
Covered 100% after Copay
Covered 100% after Copay
Up to $32
Up to $55
Up to $65
Up to $80
12 months
12 months
12 months
12 months
Contact Lenses Allowances:
(one pair or single purchase per frequency period)
Elective
Therapeutic
Up to $130
Covered 100%
Up to $105
Up to $210
12 months
12 months
Frame Wholesale Allowance
(one per frequency period)
$50 Wholesale after copay
($100-$150 retail value)
Up to $71
12 months
www.avesis.com