
PLAN RATES
| MEMBER PLAN | 3 MONTHS | 6 MONTHS | 12 MONTHS |
| Member | $13.29 | $26.58 | $53.16 |
| Member + 1 | $23.94 | $47.88 | $95.76 |
| Member + Family | $41.34 | $82.68 | $165.36 |
Benefits Summary
| NETWORK PROCEDURES | MEMBERS CO-PAYMENTS |
BENEFITS |
| Eye Exam | $4.00 | One exam every 12 months |
| Single Lenses | $10.00 | One standard pair (plastic or clear glass) every 12 months |
| Bifocal Lenses | $10.00 | |
| Trifocal Lenses | $10.00 | |
| Lens Options (tint, UV, anti-scratch coat, anti-reflective, progressive, polycarbonate, hi-index, photogray, transitions, polaroid) |
20% Discount | None |
| Frames* | $79.00 Retail allowance after $10.00 co-payment |
Frames every 12 months |
| Contact Lenses* | $85.00 Allowance** | Contact lenses every 12 months |
| Medically Necessary Contact Lenses | Paid In Full |   |
| * Once a year benefit for either frames OR
contacts. ** Allowance is for exam, fitting, evaluation, follow-up care and materials. |
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Discount Prescription Program (at no additional cost to you): Our prescription drug benefit offers substantial savings on brand prescriptions and generic drugs through a network of over 65,000 retail pharmacies nationwide, including all major retail chains. Your physician’s choice of prescribed medications and your preference for brand generic prescriptions will always be honored. |
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Your Discount Prescription Program includes:
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To ensure that we meet your every need we also offer flexible
payment options which includes, pay by check, pay by credit card or automatic payments quartly, semi-annully and annually. |
Enroll Using Our Downloadable Form |