Vision Benefits
We provide quality vision care for you and your family through MetLife.
VISION BENEFITS
Vision Plan Premiums — Monthly Contributions
| Coverage Tier | Monthly Contribution |
|---|---|
| Employee Only | $6.18 |
| Employee + Spouse | $12.37 |
| Employee + Child(ren) | $14.18 |
| Employee + Family | $21.86 |
Employee Only
- Monthly Contribution
- $6.18
Employee + Spouse
- Monthly Contribution
- $12.37
Employee + Child(ren)
- Monthly Contribution
- $14.18
Employee + Family
- Monthly Contribution
- $21.86
Service Frequencies
| Service | Frequency |
|---|---|
| Exams | Every 12 months |
| Lenses | Every 12 months |
| Contacts | Every 12 months |
| Frames | Every 12 months |
Exams
- Frequency
- Every 12 months
Lenses
- Frequency
- Every 12 months
Contacts
- Frequency
- Every 12 months
Frames
- Frequency
- Every 12 months
Coverage Details
| In-Network | Out-of-Network | |
|---|---|---|
| Exams - Copay | $10 | Reimbursed up to $45 |
| Lenses - Single Vision | $10 copay | Reimbursed up to $30 |
| Lenses - Bifocal | $10 copay | Reimbursed up to $50 |
| Lenses - Trifocal | $10 copay | Reimbursed up to $65 |
| Lenses - Lenticular | $10 copay | Reimbursed up to $100 |
| Contacts (In Lieu of Lenses and Frames) - Fitting and Evaluation* | $30 copay Standard | Applied to contacts lens allowance |
| Contacts (In Lieu of Lenses and Frames) - Elective | $175 allowance; 20% off amount over allowance | $105 allowance |
| Contacts (In Lieu of Lenses and Frames) - Medically Necessary | Covered in Full | $210 allowance |
| Frames - Allowance | $175 allowance, 20% off amount over allowance | $70 allowance |
Exams - Copay
- In-Network
- $10
- Out-of-Network
- Reimbursed up to $45
Lenses - Single Vision
- In-Network
- $10 copay
- Out-of-Network
- Reimbursed up to $30
Lenses - Bifocal
- In-Network
- $10 copay
- Out-of-Network
- Reimbursed up to $50
Lenses - Trifocal
- In-Network
- $10 copay
- Out-of-Network
- Reimbursed up to $65
Lenses - Lenticular
- In-Network
- $10 copay
- Out-of-Network
- Reimbursed up to $100
Contacts (In Lieu of Lenses and Frames) - Fitting and Evaluation*
- In-Network
- $30 copay Standard
- Out-of-Network
- Applied to contacts lens allowance
Contacts (In Lieu of Lenses and Frames) - Elective
- In-Network
- $175 allowance; 20% off amount over allowance
- Out-of-Network
- $105 allowance
Contacts (In Lieu of Lenses and Frames) - Medically Necessary
- In-Network
- Covered in Full
- Out-of-Network
- $210 allowance
Frames - Allowance
- In-Network
- $175 allowance, 20% off amount over allowance
- Out-of-Network
- $70 allowance
- *Fitting and Evaluation fee applied to contact lens allowance.
Plan Notes
- Vision premium contributions are deducted from your paycheck on a pre-tax basis.
- Your tier of coverage determines your monthly premium.