Health and Welfare Benefit Summaries

The Vision Plan is available to all active and retired members and their eligible dependents.

This benefit helps pay for annual vision examinations and for glasses and contact lenses, subject to the rules of the Plan. The Plan uses a network of opticians, optometrists, and ophthalmologists called Vision Service Plan (VSP) to provide these benefits in an efficient and cost-effective way. Reduced benefits are available when you use a provider outside the VSP network. How often you can use the benefit and your copayment are shown in the benefit schedule below.

Benefit	Frequency	Your Copayment
Well Vision Examinations	once every 12 months	$15
Contact Lens Examination	once every 12 months	not to exceed $60
Frames	once every 24 months if needed	$25 (for both lenses and frames)
Lenses	once every 24 months if needed
Lenses – Second Pair Benefit (For employee only)	once every 24 months if needed	$60 (for both lenses and frames)
Frames – Second Pair Benefit (For employee only)	once every 24 months if needed
Lens Enhancements	once every 24 months if needed	$50 (standard progressive lenses) $80-90 (premium  progressive lenses) $120-$160 (custom progressive lenses)
Contacts	24 months	$0 (subject to $150 allowance)
Diabetic Eyecare Plus Program	As needed.*	$20

*Limitations and coordination with medical coverage may apply. Ask your VSP doctor for details.

Website:  www.vsp.com
Phone Number: 1-800-877-7195
Monday – Friday 5 a.m. to 8 p.m., Pacific Time
Saturday 7 a.m. to 8 p.m., Pacific Time
Sunday 7 a.m. to 8 p.m., Pacific Time

Closed: Major Holidays

Hearing impaired customers may call 800.428.4833 for assistance.