Vision
Healthy eyes and clear vision are an important part of your overall health and quality of life. You may enroll yourself and your eligible dependents or you may waive vision coverage. You do not have to be enrolled in medical coverage to elect vision coverage or cover the same dependents under medical and vision.
Although vision care services and supplies are covered in-network and out-of-network, your benefits are generally greater when you use in-network providers. Your costs are based on the family members you choose to cover.
VSP Vision Plan Through Sun Life
Plan Information
Plan Name: VSP Vision Plan Through Sun Life
Policy Number: 918424
Effective Date: 10/01/2024
Provider Network: VSP
In-Network Benefit Highlights
Deductible (Individual/Family)
$XX/$XX
Out-of-Pocket Max (Individual/Family)
$XX/$XX
Preventive Care
$XX
Primary Care Visit
$XX
Specialist Visit
$XX
Urgent Care
$XX
Emergency Room
$XX
Benefit Highlights
In-Network
Exams
$0
Covered Services
$10 Copay
Single Vision Lenses
Covered in full
Bifocal Lenses
Covered in full
Trifocal Lenses
Covered in full
Frames
$150 allowance
Contacts (in lieu of glasses)
$150 allowance
Frequency
Exams
Once every 12 months
Lenses
Once every 12 months
Frames
Once every 12 months
Contacts
Once every 12 months
Out-of-Network Reimbursement
Exams
Up to a $45 allowance
Covered Services
N/A
Single Vision Lenses
Up to $30 allowance
Bifocal Lenses
Up to $50 allowance
Trifocal Lenses
Up to $60 allowance
Frames
Up to $70 allowance
Contacts (in lieu of glasses)
Up to $105 allowance
Frequency
Exams
Once every 12 months
Lenses
Once every 12 months
Frames
Once every 12 months
Contacts
Once every 12 months