Quick facts
Eye Exam Copay
$10
Frame Allowance
$130 allowance, 20% off balance over $130
Bifocal Lens Copay
$15
Contact Lens Allowance (Conventional)
$150 allowance, 15% off balance over $150
Contact Lens Allowance (Out-of-Network)
$150 allowance
Premium Contact Lens Fit and Follow-up
10% off retail
Standard Contact Lens Fit and Follow-up
Up to $55
Examination Frequency
Once every 12 months
More details (10)
Eye Exam Reimbursement (Out-of-Network)
Up to $39
Frame Allowance (Out-of-Network)
$50 allowance
Frame Frequency
Once every 24 months
Lenses or Contact Lenses Frequency
Once every 12 months
Lenticular Lens Copay
$15
Single Vision Lens Copay
$15
Trifocal Lens Copay
$15
Monthly Rate - Retiree + Family
$18.25
Monthly Rate - Retiree Only
$4.62
Monthly Rate - Retiree + 1
$13.64
Carrier contact
877-398-2980 — member services
Your member ID card: check the carrier website or app, or ask HR for a copy.
Plan documents
Confirm details with your carrier for current plan information.