| Plan Features | VSP Vision Plan | |
| In-Network | Out-of-Network | |
| Exam (once per plan year) | $10 copay | Plan reimburses up to $50 |
| Lenses (once per plan year) Single Vision Bifocal Trifocal | No charge to you after you pay materials copay | Plan reimburses: Up to $50 Up to $75 Up to $100 |
| Frames (once every 24 months) | Plan pays up to $150 plus 20% discount on any additional cost | Plan reimburses up to $70 |
| Contact Lenses (once every 12 months; in lieu of glasses) | Plan pays up to $150 | Plan reimburses up to $105 |
| Benefit Plan | VSP Vision Plan |
|---|---|
| Vision | |
| Employee Only | $0.46 |
| Employee + Spouse/Domestic Partner | $2.91 |
| Employee + Child(ren) | $2.97 |
| Employee + Family | $4.79 |