7 VISION Protect your sight and enjoy those sunsets even more with vision insurance. Receive both preventive and materials coverage. Hover over the insurance terms below to learn what they mean. EXAMS $10 Copay Up to $45 LENSES Single: No cost after $25 eyewear copay Bifocal: No cost after $25 eyewear copay Trifocal: No cost after $25 eyewear copay Lenticular: No cost after $25 eyewear copay Single: Up to $30 Bifocal: Up to $50 Trifocal: Up to $65 Lenticular: Up to $100 FRAMES $130 after $25 eyewear copay Up to $70 CONTACT LENSES Elective: $130 allowance Medically Necessary: No cost after $25 eyewear copay Elective: Up to $105 Medically Necessary: Up to $210 FREQUENCY OF SERVICES Exams: 1 X 12 Months Lenses: 1 X 12 Months Frames: 1 X 12 Months Contact Lenses: 1 X 12 Months SEMI-MONTHLY RATES Employee: $3.70 Employee + Spouse: $7.43 Employee + Children: $6.29 Family: $10.37 VSP CHOICE NETWORK DENTAL PLAN In Network Out of Network The benefits and rates in this guide are for illustrative purposes only. To the extent the rates or the benefit plan information summarized herein differs from the underlying plan details specified in the insurance documents that govern the terms and conditions of the plans of insurance described in this guide, the underlying insurance documents will govern in all cases. Review Plan Summary Vision Find A Provider

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