Vision Plans


Vision coverage is provided through Block Vision.  The plan pays benefits for annual exams and corrective lenses.  You pay a co-payment for exams, and the plan pays benefits for frames and lenses up to certain limits.  Under this plan, you may use in network or out of network vision care providers, but you receive greater benefits when you use in network providers.

 
Vision Plan
 Coverage Level

 Monthly
Premium


 Employee Only

 $6.00

 Employee + Spouse  $10.20
 Employee + Child(ren)  $10.80

 Employee + Family

 $16.20





 Plan Features

 

 In Network

 Out of Network

Comprehensive Exam (Optometrist)
Comprehensive Exam (Ophthalmologist) 
 Covered in full after $10 copayment
Covered in full after $10 copayment
$35 allowance 
 Lenses:
  • Single
  • Bifocal
  • Trifocal
After $15 copay
After $15 copay
After $15 copay
$25 allowance 
$40 allowance
$50 allowance
Contact Lenses:
  • Medically necessary
  • Cosmetic (elective)*

*Contact lenses are in lieu of eyeglass lenses and frames benefit.
$10 copay up to $150
*The insured is responsible for paying any charges in excess of this allowance.
 $150 allowance
$80 allowance

Frames:

  • Standard*

*Frames are in lieu of contact lenses and contact lens benefit.

Up to $150

$70 allowance