Vision - Active Employee
There are no plan design or premium changes for the vision plans for 2017-2018. You may change plans or add/drop dependents during Annual Enrollment. For more information, click here.
Fully insured Vision Care benefits are offered by Superior Vision Services. You have two vision plan options to choose from:
- Superior Vision (Standard Plan)
- Superior Vision Plus (Enhanced Plan)
Both plans feature the following copayments:
- Exam: $35
- Materials: $0
- Contact Lens Fitting: $35
Plan differences are highlighted in the table below.
VISION PLAN COMPARISON
|SUPERIOR VISION PLUS
|Exam (MD)||Covered in full 1||Up to $42||Covered in full 1||Up to $42|
|Exam (OD)||Covered in full 1||Up to $37||Covered in full 1||Up to $37|
|Frames||$140 retail allowance||Up to $53||$150 retail allowance||Up to $53|
|Contact Lens Fitting (standard 2 )||Covered in full 1||Not covered||Covered in full 1||Not covered|
|Contact Lens Fitting (specialty 2 )||$50 retail allowance 1||Not covered||$50 retail allowance 1||Not covered|
|Lenses (standard) per pair:|
|Single Vision||Covered in full||Up to $32||Covered in full||Up to $32|
|Bifocal||Covered in full||Up to $46||Covered in full||Up to $46|
|Trifocal||Covered in full||Up to $61||Covered in full||Up to $61|
|Polycarbonate for dependent children only (up to age 25)||Not Covered||Not Covered||Covered in full||Not Covered|
|Scratch Coat (factory, single sided)||Not Covered||Not Covered||Covered in full||Not Covered|
|Ultraviolet Coat||Not Covered||Not Covered||Covered in full||Not Covered|
|Progressive Lens||See description 3||Up to $61||$120 retail allowance 5||Up to $61|
|Elective Contact Lenses 4||$125 retail allowance||Up to $100||$150 retail allowance||Up to $100|
1 After co-pays. Co-pays apply to in-network benefits only.
2 See your benefits materials for definitions of standard and specialty contact lens fittings
3 Covered at the provider's in-office retail price for a standard lined trifocal; member pays difference between the progressive and the trifocal, plus applicable co-pay
4 Contact lenses are in lieu of eyeglass lenses and frames benefit
5 Overages on standard progressive lenses will be the member’s responsibility.
Services/Frequency limits for both plans:
- Exam: 1 per plan year
- Frames: 1 per plan year
- Contact Lens Fitting: 1 per plan year
- Lenses: 1 per plan year
- Contact Lenses: 1 per plan year
Additional discounts are available on LASIK, lens options and upgrades and mail-order contacts.
All costs and allowances are retail; you are responsible for any charges in excess of the retail allowances. All final determinations of benefits,administrative duties, and definitions are governed by the certificate of insurance for your specific benefits.
- Superior Vision Plan Guide
- Superior Vision Plus Plan Guide
- Superior Vision Plans Video
- Find a Vision Provider
- Superior Vision Website
Superior Vision CUSTOMER SERVICE (800) 507-3800
P.O. Box 967
Rancho Cordova, CA 95741-0949