Benefit
Coverage
Vision Plan – High
Vision Plan – Low
Exam copay
$10 (annual)
$10 (annual)
Materials copay
$25 (annual)
$25 (bi-annual)
Retail Frame Allowance
$200 (annual)
$150 (bi-annual)
Contacts Allowance
$$150 (bi-annual)
$150 (bi-annual)