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    The Choice Program vision care plan provides benefits including eye examinations once per 12 months, lenses including single vision, bifocal, and trifocal once per 12 months, standard progressive lenses, and frames up to $100 retail value once per 12 months. Contact lenses are also covered up to $100 retail value once per 12 months in lieu of lenses and frames. The plan covers these benefits with copays for in-network services and reimbursement for out-of-network services. The monthly costs for the plan are $10.29/€9.20 for individual coverage and $25.60/€22.89 for family coverage.

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    The Choice Program vision care plan provides benefits including eye examinations once per 12 months, lenses including single vision, bifocal, and trifocal once per 12 months, standard progressive lenses, and frames up to $100 retail value once per 12 months. Contact lenses are also covered up to $100 retail value once per 12 months in lieu of lenses and frames. The plan covers these benefits with copays for in-network services and reimbursement for out-of-network services. The monthly costs for the plan are $10.29/€9.20 for individual coverage and $25.60/€22.89 for family coverage.

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    Download as DOCX, PDF, TXT or read online from Scribd
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    37 views1 page

    Vision 1

    Uploaded by

    api-296940651
    The Choice Program vision care plan provides benefits including eye examinations once per 12 months, lenses including single vision, bifocal, and trifocal once per 12 months, standard progressive lenses, and frames up to $100 retail value once per 12 months. Contact lenses are also covered up to $100 retail value once per 12 months in lieu of lenses and frames. The plan covers these benefits with copays for in-network services and reimbursement for out-of-network services. The monthly costs for the plan are $10.29/€9.20 for individual coverage and $25.60/€22.89 for family coverage.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
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    of 1

    Vision Care Plan

    The Choice Program


    Benefits
    Eye Examinations
    1 per 12 months
    Lenses
    Single Vision (1/12
    mo)
    Bifocal (1/12 mo)
    Trifocal (1/12 mo)
    StandardProgressive
    Lens Options
    Scratch Resistant
    Coating
    Ultraviolet Coating
    Gradient Tint
    Anti-Reflective
    Coating
    Frames @ 1 per 12 mo.
    Up to $100 retail
    value
    Contact Lenses @ 1
    per 12 mo.
    In lieu of lenses &
    frames up to $100
    retail value

    In Network

    $12/10.73Copay

    Up to $30

    $10/8.87 Copay
    $10/8.87 Copay
    $10/8.87 Copay
    $75/66.54 Copay

    Up
    Up
    Up
    Up

    $15/13.41 Copay

    $15/13.41 Copay
    $15/13.41 Copay
    $45/40.24 Copay

    Not
    Not
    Not
    Not
    Not

    Covered in Full

    Up to $50/44.71

    $10/8.94 Copay

    Up to $60/53.66

    Monthly Cost:
    Employee Only
    Employee and Family

    Out of Network
    Reimbursement

    $10.29/9.20
    $25.60/22.89

    to
    to
    to
    to

    $20/17.89
    $30/26.83
    $40/35.77
    $40/35.77

    Covered
    Covered
    Covered
    Covered
    Covered

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