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GROUP NUMBER

12146841

NETWORK

VSP Signature Network

CARRIER WEBSITE

CUSTOMER SERVICE

Glasses & Sunglasses

• Extra $20 to spend on featured frame brands. Go to vsp.com/special offers for details.
• 30% savings on additional glasses and sunglasses, including lens enhancements, from the same VSP provider on the same day as your WellVision Exam. Or get 20% from any VSP provider within 12 months of your last WellVision Exam.

Retinal Screening

• No more than a $39 copay on routine retinal screening as an enhancement to a WellVision Exam.

Laser Vision Correction

• Average 15% off the regular price or 5% off the promotional price; discounts only available from contracted facilities.
• After surgery, use your frame allowance (if eligible) for sunglasses from any VSP doctor.

VISION PLANS

Vision Base Plan
Description
Base Plan
WellVision Exam
Focuses on your eyes and overall wellness, every calendar year
$15 Copay
Prescription Glasses
Frames
Allowance for a wide selection of frames
$150 Allowance
Allowance for featured frame brands
$170 Allowance
Glasses
Every other calendar year
Lenses
Single vision, lined bifocal, and lined trifocal lenses
Included
Polycarbonate lenses for dependent children
Included
Lenses
Every calendar year
Lens Enhancements
Standard Progressive Lenses
$0
Premium Progressive Lenses
$80-$90
Custom Progressive Lenses
$120-$160
Anti-reflective coating
N/A
Contacts (Instead of Glasses)
Allowance for contacts
$150 Allowance
Contact Lens Exam (fitting and evaluation)
Up to $60
Vision Base Plan
Bi-Weekly Cost
Employee
$6.46
Employee + Spouse
$9.19
Employee + Child(ren)
$11.13
Family
$17.72
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