VSP Vision Plan
Keep an eye on your vision. You can select from two Vision Plan options that offer a range of coverage for all your vision care needs.
How the Vision Plan Works
- You’ll get the best value when you visit a VSP provider.
- VSP guarantees service from VSP network providers only.
- If you choose to see a provider who is out-of-network, you’ll receive a lesser benefit and typically pay more out of pocket.
- The copay will still apply, and you are required to pay the provider in full at the time of your appointment, then submit a claim to VSP for partial reimbursement.
- If you see a provider who is not in the VSP network, call VSP first.
Vision Plan Options
| Highlights | Plan 1 | Plan 2 | ||
|---|---|---|---|---|
| In Network | Out of Network | In Network | Out of Network | |
| Calendar Year Deductible | None | None | None | None |
| WellVision Exam | $10 copay (once every calendar year). | $10 copay (once every calendar year).Maximum allowance applies. | $10 copay (once every calendar year). | $10 copay (once every calendar year).Maximum allowance applies. |
| Eyeglass Lens Enhancements Tints/Photochromic adaptive lenses, scratch-resistance coating, UV protection and standard progressive lenses | $0 (No additional cost.) | Copays apply as applicable (once every calendar year). Maximum allowance applies. | $0 (No additional cost.) | Copays apply as applicable (once every calendar year). Maximum allowance applies. |
| Premium progressive lenses | $95 - $105 | $95 - $105 | ||
| Custom progressive lenses | $150 - $175 | $150 - $175 | ||
|
Contact Lens Care – Elective
Provided in lieu of all other lens and frame benefits available. If you choose contact lenses, you will be eligible for a frame 12 months from the date the contact lenses are obtained. |
$200 annual allowance;copay does not apply (once every calendar year). Contact lens exam (fitting and evaluation) up to $60 allowance. | $125 annual allowance.Maximum allowance applies. | $250 annual allowance;copay does not apply. (Once every calendar year. Contact lens exam (fitting and evaluation) up to $60 allowance. |
$125 annual allowance. Maximum allowance applies. |
| Frames Frames covered up to specified allowance, plus 20% off any out-of-pocket costs. $100 Walmart/Sam's Club/Costco allowance. | $15 copay (once every 2 calendar years).$250 featured frame brands allowance;$200 frame allowance. | $15 copay (once every 2 calendar years).Maximum allowance applies. | $15 copay (once every calendar year).$300 featured frame brands allowance;$250 frame allowance. | $15 copay (once every calendar year). Maximum allowance applies. |
| KidsCare Provides eye care and eyewear for active and growing children by providing two WellVision exams and one pair of glasses every year. Covers children up to age 26. | N/A | N/A | $10 copay for annual WellVision exam. Frames fully covered up to annual allowance; Additional lenses fully covered when needed (minimum prescription change required). | Copays apply as applicable (once every calendar year). Maximum allowance applies. |
| LightCare Use vision benefits without a prescription to defend against the effects of UV or blue light that can cause digital eye strain. The frame allowance may be used for ready-to-wear, non-prescription blue-light filtering glasses or non-prescription sunglasses (instead of prescription eyewear). | $15 copay (once every 2 calendar years).$200 frame allowance in lieu of prescription glasses or contacts. | $15 copay (once every 2 calendar years).Maximum allowance applies. | $15 copay (once every calendar year).$250 frame allowance in lieu of prescription glasses or contacts. | $15 copay (once every calendar year).Maximum allowance applies |
Extra Savings through Vision Service Plan YourVSP program provides additional savings when you use network providers, such as:
Vision Correction
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| Weekly Payroll Deduction Amount | ||||
| Employee Only | $1.87 | $3.20 | ||
| Employee + Spouse | $2.82 | $4.84 | ||
| Employee + Child(ren) | $2.88 | $4.95 | ||
| Employee + Family | $4.65 | $7.97 | ||
NOTE: See the Summary Plan Descriptions for all details, including plan limits, conditions and exclusions.