Vision
Healthy eyes and clear vision are an important part of your overall health and quality of life. You may enroll yourself and your eligible dependents or you may waive vision coverage. You do not have to be enrolled in medical coverage to elect vision coverage or cover the same dependents under medical and vision.
Although vision care services and supplies are covered in-network and out-of-network, your benefits are generally greater when you use in-network providers. Your costs are based on the family members you choose to cover.
Vision Plan
Benefit Highlights
In-Network
Exams
$10 copay
Materials
$20 copay
Single Vision Lenses
No charge after applicable copay
Bifocal Lenses
No charge after applicable copay
Trifocal Lenses
No charge after applicable copay
Frames
80% of balance over $120 allowance
Contacts (in lieu of glasses)
Balance over $120 allowance
Frequency
Exams
Once every 12 months
Lenses
Once every 12 months
Frames
Once every 24 months
Contacts
Once every 12 months
Out-of-Network Reimbursement
Exams
Up to $50
Materials
Up to benefit schedule after $20 copay
Single Vision Lenses
Up to $50 after applicable copay
Bifocal Lenses
Up to $75 after applicable copay
Trifocal Lenses
Up to $100 after applicable copay
Frames
Up to $70
Contacts (in lieu of glasses)
Up to $105 (exam + contact lenses)
Frequency
Exams
Once every 12 months
Lenses
Once every 12 months
Frames
Once every 24 months
Contacts
Once every 12 months
Semi-Monthly Per-Pay-Period Plan Costs
Cigna CDHP + VSP Vision
Employee Only: $0.00
Employee and Spouse/DP: $107.50
Employee and Child(ren): $90.50
Employee and Family: $227.00
Cigna PPO + VSP Vision
Employee Only: $104.00
Employee and Spouse/DP: $342.00
Employee and Child(ren): $272.50
Employee and Family: $563.50
Kaiser HMO + VSP Vision — CA & OR, Cigna EPO + VSP Vision
Employee Only: $40.50
Employee and Spouse/DP: $212.50
Employee and Child(ren): $166.00
Employee and Family: $373.00