Vision
Healthy eyes and clear vision are an important part of your overall health and quality of life. You may enroll yourself and your eligible dependents or you may waive vision coverage. You do not have to be enrolled in medical coverage to elect vision coverage or cover the same dependents under medical and vision.
Although vision care services and supplies are covered in-network and out-of-network, your benefits are generally greater when you use in-network providers. Your costs are based on the family members you choose to cover.
Vision Choice
Plan Information
Plan Name: Vision PPO Plan
Policy Number: 30076094
Effective Date: 07/01/2025
Provider Network: VSP Choice
Benefit Highlights
In-Network Only
Exams
$25
Single Vision Lenses
Combined with exam
Bifocal Lenses
Combined with examÂ
Trifocal Lenses
Combined with examÂ
Frames
Combined with exam; $200 frame allowance
Contacts (in lieu of glasses)
$130 allowance; Fitting and Evaluation: up to $60
Frequency
Exams
Once every 12 months
Lenses
Once every 12 months
Frames
Once every 24 months
Contacts
Once every 12 months