Vision Care Summary
Our group vision care plan is offered to all eligible employees and their eligible dependents. As of January 1, 2007, Vision Service Plan (VSP) will administer the employer-paid vision benefits and all service claims.
To receive the full plan benefits you must obtain services from a participating provider. You may obtain services from a non-participating provider, however, at a reduced benefit. To view a list of participating VSP Doctors go to www.vsp.com or call 800-877-7195.
| Item | Basic Benefits |
|---|---|
| Co-payment: | $10.00, payable at the time of service. |
| Comprehensive Examination: | Once every calendar year. |
| Lenses: | One pair every other calendar year or every year if a prescription change (as defined in the Group Master Policy) is indicated. |
| Frames: | One frame every other calendar year. |
| Contact Lenses: | One pair of contact lenses for cosmetic reasons when provided in lieu of other eyewear once every other calendar year or every year if a prescription change (as defined in the Group Master Policy) is indicated. Medically necessary contact lenses when required for anisometropia or keratoconus, or following cataract surgery, or when visual acuity cannot be corrected to 20/70 in the better eye, except through the use of contacts. |
Video Display Terminal (VDT) Benefit
All active employees who utilize a video display terminal for at least 4 hours per day on a regular basis as provided in their CSU job description shall be eligible for the VDT program as follows:
| Item | Benefit |
|---|---|
| Co-payment |
$10.00 payable at the time of examination. This deductible is separate from the Basic Benefit co-payment. |
| Supplemental Examination |
Provider shall perform additional tests during the examination to determine visual needs in relation to the use of a VDT. |
| Lenses |
Lenses One pair once every other calendar year or every calendar year if a prescription change (as defined by the Group Master Policy) is indicated. |
| Frames |
New frames will be provided once every other calendar year. |
Examination
| Service | Participating Provider | Non-Participating Provider |
|---|---|---|
| Comprehensive Opthalmologic | Covered | $50.00 |
| Comprehensive Optometric | Covered | $50.00 |
Frames & Lenses
| Product | Participating Provider | Non-Participating Provider |
|---|---|---|
| Single Vision Lenses | Covered | Up to $45.00 |
| Bifocal Lenses | Covered | Up to $65.00 |
| Trifocal Lenses | Covered | Up to $85.00 |
| Aspheric Monofocal | Covered | Up to $125.00 |
| Aspheric Multifocal | Covered | Up to $125.00 |
| Lenticular Monofocal | Covered | Up to $125.00 |
| Lenticular Multifocal | Covered | Up to $125.00 |
| Frame | $95.00 | Up to $60.00 |
| Contact Lenses- Cosmetic | $120.00 | Up to $110.00 |
| Contact Lenses- Medically Necessary | $250.00 | Up to $250.00 |
Extra Discounts and Savings
Laser Vision Correction
Savings averaging 15% off laser vision correction surgery (PRK, LASIK and Custom LASIK) through VSP contracted center.
Contact Lens
15% off cost of contact lens exam (fitting and evaluation).