Vision Benefits
The VSP vision program provides eligible employees access to a national network of participating providers. Using an in-network provider gives you the maximum vision benefit. Visit VSP.com for a list of participating providers. Please note: You won’t receive a Vision ID card. Let your provider know you’re covered by VSP, and supply your Social Security number and the group number: 30022223
| Coverage Tier | In-Network | Out-of-Network |
|---|---|---|
| Well Vision Exam (One Exam Per 12-Month Period) | ||
| $10 copay | $45 | |
| Spectacle Lenses (One Pair Per 12-Month Period) | ||
| Single Vision | $25 copay | $30 |
| Bifocal | $25 copay | $50 |
| Trifocal | $25 copay | $65 |
| Frames (Per Pair, One Pair Per 12-Month Period) | ||
| $200 allowance 20% discount on amount over allowance |
$70 | |
| Elective Contact Lenses (One allowance and One Exam Every 12 Months, Contacts In Lieu of Frames) | ||
| $200 allowance for contact lenses Contact lens exam not to exceed $60 copay |
$105 | |
