Carrier

Vision Service Plan

Network

VSP’s Nationwide Network

Eye Exam Co-Pay

$10

Materials Co-Pay

$25

Lens/Frame Frequency

Every 12 months

Exam Frequency

Every 12 months

Basic Lenses

Covered in full

Contact Lenses

15% off exam & $130 annual allowance in lieu of glasses

Frames

$130 retail allowance.  20% discount on amount exceeding allowance

Discounts on addt’l pairs of prescription glasses

20%

Primary Eye Care: supplemental coverage for medical eye conditions

Included

Laser Vision Correction

Average of 15% of usual and customary fee price or 5% off promotional offer

Safety Eye Care Plan:  provides glasses that meet ANSI standards for impact protection.  Includes exam, prescription lenses and allowance for frames.

Included

Computer Vision Care Plan:  helps alleviate symptoms of computer vision syndrome.  Includes exam, prescription glasses and patient education.

Included

Rates:

Monthly

Weekly

Employee Only

$14.02

$3.24

Employee + 1

$22.43

$5.18

Employee + Children

$22.90

$5.28

Employee + Family

$36.92

$8.52