Vision Plan

The vision plan provides coverage for routine eye exams and pays for all or a portion of the cost of glasses or contact lenses. You can choose any provider; however, you always save money if you see in-network providers. We offer two vision plan choices through UnitedHealthcare.

RESOURCES

Vision Summary - Low Plan

Vision Summary - High Plan

How to get Vision ID card

Plan Provisions	High Plan	Low Plan
Exam	$10 copay	$15 copay
Materials	$10 copay	$30 copay
Frames	$130 allowance plus 30% off balance over $130	$130 allowance plus 30% off balance over $130
Lenses • Single Vision Lenses • Bifocal Lenses • Trifocal Lenses • Lenticular Lenses	Covered at 100% Covered at 100% Covered at 100% Covered at 100%	Covered at 100% Covered at 100% Covered at 100% Covered at 100%
Elective Contact Lenses • Covered Formulary Contacts* • Non-Formulary Contacts* • Medically Necessary Contact Lenses	Up to 4 boxes Up to $105 Covered at 100%	Up to 4 boxes Up to $105 Covered at 100%
Frequency • Exam • Lenses • Frames • Contact Lenses	Every 12 months Every 12 months Every 12 months Every 12 months	Every 12 months Every 12 months Every 24 months Every 12 months

*If a member chooses an in-network provider they’ll receive 4 boxes of contacts. However, if the provider is non-network they have an allowance of $105.

There is no physical ID card for vision insurance. To use your benefits simply let your provider know you have coverage through United Healthcare Care Vision (UHC Vision) and provide your SSN. See “How to get a Vision ID Card” in the Resource Box for additional information.

Vision	Employee Cost Per Pay	Employee Cost Per Month	Full Invoiced Amount Per Month
LowPlan
Employee Only	$2.10	$4.20	$4.20
Family	$5.26	$10.52	$10.52
High Plan
Employee Only	$2.84	$5.67	$5.67
Family	$7.09	$14.17	$14.17