Vision Benefits

Name: Class LTD
Address: United States

Vision insurance offers coverage for the routine care of your eyes and may provide coverage for eyeglasses and contact lenses. Your employer offers both a standard plan and an enhanced plan in the VSP Choice network. Be sure to check your plan certificate for details.

VSP provider Network: VSP Choice Benefit	Description	Copay
WellVision Exam	Focuses on your eyes and overall wellness Every 12 months	$10
Prescription Glasses		$25
Frames	$130 allowance for a wide selection of frames $150 allowance for featured frame brands 20% savings on the amount over your allowance $70 Costco® frame allowance Every 24 months	Included in Prescription Glasses
Lenses	Single vision, lined bifocal, and lined trifocal lenses Polycarbonate lenses for dependent children Every 12 months	Included in Prescription Glasses
Lens Enhancements	Standard progressive lenses Premium progressive lenses Custom progressive lenses Average savings of 20-25% on other lens enhancements Every 12 months	$0 $95 - $105 $150 - $175
Contacts (instead of glasses)	$130 allowance for contacts; copay does not apply Contact lens exam (fitting and evaluation) Every 12 months	Up to $60

Your Coverage with Out-of-Network Providers
Exam	up to $45
Frames	up to $70
Single Vision Lenses	up to $30
Lined Bifocal Lenses	up to $50
Lined Trifocal Lenses	up to $65
Progressive Lenses	up to $50
Contacts	up to $105

	Extra Savings
Glasses and Sunglasses	Extra $20 to spend on featured frame brands. Go to vsp.com/specialoffers for details 20% savings on additional glasses and sunglasses, including lens enhancements, from any VSP provider within 12 months of your last WellVision Exam
Retinal Screening	No more than a $39 copay on routine retinal screening as an enhancement to a WellVision Exam
Laser Vision Correction	Average 15% off the regular price or 5% off the promotional price; discounts only available from contracted facilities

	Standard Plan Per Pay Period Cost (26)
Employee	$4.09
Employee + Spouse	$6.54
Employee + Child(ren)	$6.68
Employee + Family	$10.77

Downloads

Summary of Benefits

VSP provider Network: VSP Choice Benefit	Description	Copay
WellVision Exam	Focuses on your eyes and overall wellness Every 12 months	$10
Prescription Glasses		$25
Frames	$200 allowance for a wide selection of frames $150 allowance for featured frame brands 20% savings on the amount over your allowance $70 Costco® frame allowance Every 12 months	Included in Prescription Glasses
Lenses	Single vision, lined bifocal, and lined trifocal lenses Polycarbonate lenses for dependent children Every 12 months	Included in Prescription Glasses
Lens Enhancements	Progressive lenses Scratch-resistant coating Tints/Photochromic adaptive lenses Average savings of 20-25% on other lens enhancements Every 12 months	$0 $95 - $105 $150 - $175
Contacts (instead of glasses)	$130 allowance for contacts; copay does not apply Contact lens exam (fitting and evaluation) Every 12 months	Up to $60

Your Coverage with Out-of-Network Providers
Exam	up to $45
Frames	up to $70
Single Vision Lenses	up to $30
Lined Bifocal Lenses	up to $50
Lined Trifocal Lenses	up to $65
Progressive Lenses	up to $50
Contacts	up to $105
Tints	up to $5

	Extra Savings
Glasses and Sunglasses	Extra $20 to spend on featured frame brands. Go to vsp.com/specialoffers for details 20% savings on additional glasses and sunglasses, including lens enhancements, from any VSP provider within 12 months of your last WellVision Exam
Retinal Screening	No more than a $39 copay on routine retinal screening as an enhancement to a WellVision Exam
Laser Vision Correction	Average 15% off the regular price or 5% off the promotional price; discounts only available from contracted facilities

	Enhanced Plan Per Pay Period Cost (26)
Employee	$8.39
Employee + Spouse	$13.43
Employee + Child(ren)	$13.71
Employee + Family	$22.10

Downloads

Summary of Benefits

Provided By

VSP

Provider Website

https://vsp.com

Customer Service

800.877.7195

Resources

Frequently Asked Questions