Benefits at a Glance

Vision Benefits are offered to Dependent Children to the age of 26.  Coverage will end at the end of the month that a covered dependent turns 26 years of age.

Getting an eye exam is beneficial to your health! – Getting an eye exam is more than just testing your vision. Eye exams can assist in the early detection of vision conditions and health conditions such as: Glaucoma, Diabetes, Cataracts, High Blood Pressure, and Astigmatism. That’s why it’s important to get an eye exam on a regular basis. Children need eye exams, too! Did you know the American Optometric Association recommends that children receive an eye exam as early as six months of age? Our nationwide provider network will be happy to assist you in servicing your vision care needs.

This plan is insured and administered by EyeMed.

Plan Details

Create a member account at

Everything is right there in one spot. Check claims and benefits, see special offers and find an eye doctor – search for one with the hours, location and brands you want. For maximum mobility, try the EyeMed Members App (Google Play or App Store).

For plan details, review the Vision Benefit Flyer


Coverage Tier Weekly  Semi-Monthly
Employee Only $1.60 $3.46
Employee + 1 Dependent $2.86 $6.19
Employee + 2 or More Dependents $4.25 $9.20

Schedule of Benefits

EyeMed Vision Care’s Network consists of private practicing optometrists, ophthalmologists, and opticians.

Summary of Benefits

Covered Persons have the right to obtain vision care from the Provider of their choice. However, payment of the Benefit varies depending on the type of Provider chosen. Benefits are payable as shown in the following schedule:

Service Preferred Provider Non-Preferred Provider Reimbursement
Eye Examination $10 co-pay Up to $40
Standard Single Vision $25 copay Up to $30
Standard Bifocal $25 copay Up to $50
Standard Trifocal $25 copay Up to $70
Standard Lenticular $25 copay Up to $70
Standard Progressive Lenses $80 copay Up to $50
Lens Options
Basic Polycarbonate $0 copay $10.00
Tints $0 copay $4.00
Scratch Coat $0 copay $5.00
UV Coating $0 copay $6.00
Anti-Reflective Coating $0 copay $24.00
Frames $0 copay; 20% off balance
over $150 allowance
Up to $105
Contact Lenses In lieu of frame & lenses
Conventional $0 copay; 15% off balance
over $130 allowance
Up to $91
Disposable $0 copay; 100% of balance
over $130 allowance
Up to $91
Medically Necessary $0 copay; paid-in-full Up to $300
Eye Examinations $10 Up to $40
(Frames & Lenses)
$0 copay; 20% off balance
over $150 allowance
Up to $105
Exams Once every plan year
Frames Once every other plan year
Lenses Once every plan year
Contact Lenses in lieu of Standard Lenses Once every plan year

Certificate of Coverage