Breads of the World 2017-2018 Benefits Guide

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9
Voluntary Vision Insurance
EyeMed is the vision carrier for 2017-2087. The vision plan offers coverage both in-network and out-of-network. It is to your
advantage to utilize a network provider to take advantage of the established contract rates and benefits. If you go out-of-network, your
benefit is based on a reimbursement schedule. Also, if you are considering Lasik Surgery, there is a discount available with particular
providers. To find a participating provider, go to
Out-of-Network Services: You can choose to receive care
outside of the EyeMed Vision network. You simply get an
allowance toward services and you pay the rest. (In-Network
benefits and discounts will not apply.) Just pay in full at the
time of service and then file a claim for reimbursement.
EyeMed - Plan Design
Features In-Network Out-of-Network
Examination Co-pay $10 Co-pay $40 reimbursement
Frequency of Service:
Exams
Lenses
Frames
Contacts
Every 12 months
Every 12 months
Every 24 months
Every 12 months
Lenses
Single
Bifocal
Trifocal
Lenticular
100%
100%
100%
100%
Reimbursement
$30
$50
$70
$70
Frames
$120 allowance;
20% off remaining
balance
$84
Contacts
Necessary
Elective
$120 allowance;
15% off remaining
balance
Reimbursement
$210
$120
Laser Vision Correction Discount Available N/A
Vision Plan Semi-Monthly Cost
Type of Coverage Employee
Employee $2.77
Employee & Spouse $5.26
Employee & Child(ren) $5.54
Employee & Family $8.14
To find a EyeMed vision provider in your
area, visit the website at
■ Click “Find a Provider” at the top right
of the webpage
■ Enter your zip code and hit the “Get
Results” button
■ The search will generate a report of the
Search Results, listing the providers
closest to your zip code first
■ Your refine your search even more under
the “Filter Search Results” on the left
side of the webpage.
■ OR, you can call 866.939.3633 to speak
with a Customer Service representative
You can also use this website for practical
tools and personalized information for your
vision care.
■ Learn about vision wellness to manage
your vision health and wellbeing
■ Check your in-network and out-of-
network vision benefits and how to use
them.
FIND A PROVIDER
Please note there has been no change to your per paycheck cost
for the new plan year!