9
Vision
Eye Exam
100% after $10 copay
VSP Kids Care Plan
Basic lenses 100% covered
Every plan year, children receive:
• Two comprehensive eye exams
• One pair of frames
100% covered
after $20 copay
(Team Member only)
Diabetic Eyecare
100% covered
after $20 copay
• Two pairs of lenses (with an Rx change)
Coverage amounts based on in-network providers. If you use
Lenses
Approved Laser
Vision Correction
$250 allowance per eye
Safety Glasses
Team Member
an out-of-network provider, you may pay more.
$150 allowance
20% off amount
after allowance
Eligibility: All Team Members and dependents
only
Team Member
+ Child(ren)
Team Member
+ Spouse
Frames
Contacts
(instead of glasses)
$150 allowance
Program
Family
Weekly Cost of Vision Coverage
$2.35 $4.22 $3.97 $6.68