Vision Service Plan
Your Vision Plan through VSP offers coverage for you and your eligible dependents for eye exams, lenses, frames and contact lenses.
 
VSP pays for the majority of expenses for a number of services when you use a participating provider. Providers can be found on VSP’s website, www.vsp.com.
 
Vision Service Plan benefits include:
  • Exam
    Once every 12 months
  • Frames
    Once every 24 months.
  • Eyeglass Lenses
    Once every 12 months
  • Contact Lenses
    Once every 12 months. Contact lenses benefit is not available in the same year lenses are purchased
  • Laser Vision Surgery discounts available through network providers.  See VSP website for more information.
  • Discounts are available for frames, lenses and contacts if purchased in-network more often than benefit frequency.  See VSP website for more information.
Vision Benefits Summary

In-Network Provider

Eye Exam (every 12 months)

Plan pays 100% (after $15 copay)

Eyeglass Lenses

100% for single vision, lined bifocal, or lined trifocal lenses (after $25 copay)

Contact Lenses — Evaluation and fitting (every 12 months)

Plan pays up to $150 after $25 copay

Eyeglass Frames (every 24 months)

Plan pays up to $150 allowance after $25 copay

Laser Correction Surgery

Plan provides discount

Out-of-Network Provider

Eye Exam (every 12 months)

Plan pays up to $35 allowance

Eyeglass Lenses

Plan pays up to $25 for single vision
Plan pays up to $40 for lined bifocal
Plan pays up to $55 for lined trifocal

Contact Lenses — Evaluation and fitting

Plan pays up to $105

Eyeglass Frames

Plan pays up to $45 allowance

Laser Correction Surgery

Not covered
 
2009 Vision Service Plan Rates Per Month (Full/Part-Time Employees)

VSP Plan

Employee Cost

Employee Only

$10.94

Employee + Spouse/Domestic Partner*

$17.18

Employee + Child(ren)

$17.51

Family

$28.25
 
*For plan purposes, a Domestic Partner means:
•
 Two adults at least 18 years of age of the same or opposite sex that are not related by blood that have lived together for more than six months in a exclusive committed relationship of mutual caring and financial support.
   
•

Your share of coverage for your domestic partner will be deducted on an after-tax basis and the portion of the employer subsidy attributable to your domestic partner will be reported on your W-2 as taxable income.