2017 Benefit Guide Hand Family

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Voluntary Vision Benefits
Your vision plan at Hand Family Companies is also through BCBST. The Plan
covers routine eye care, including eye exams and eyeglasses (lenses and
frames) or contacts.
With this plan, you can choose any provider you want, but you will receive the
most benefits when you choose providers that are within the network. To find
a provider, go to .
Employee Payroll Deductions
Bi-Weekly Payroll Deduction
Employee Only $2.93
Family $7.61
Plan Benefits In-Network Provider Out of Network Provider (Allowance)
Copayments
Exam
Lenses and/or Frames
$20
$55/$0
Up to $35
Up to $0/Up to $60
Exam (every 12 months) 100% after $20 copay Up to $45
Lenses (every 12 months)
Single
Bifocal
Trifocal
100 % after $20 Copay
100 % after $20 Copay
100 % after $20 Copay
Up to $30
Up to $45
Up to $60
Contact Lenses (every 12 months)
Instead of lenses and frames
Elective (fitting, follow-up & lenses)
Medically necessary
Up to $120, 15% off balance
Covered in Full
Up to $96
Up to $96
Frames (every 24 months) Up to $120 Up to $60
Customer Service: (800)-565-9140
Websites:
Network: VisionBlue
Group Number: 81196
Standard Polycarbonate: $40 Copayment
Standard Polycarbonate (under age 19): $0
Standard and Premium Progressive Lenses:
(add on to Bifocal) $65 Additional Copayment
Std. Polycarbonate $40
Tint (solid and gradient) $15
Scratch Resistant Coating $15
Anti-Reflective Coating $45
Ultraviolet Coating $15
Lens Options
(member cost)