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ASEBP Benefit Plan Summary

Vision Care

Benefit Details (Online Document)

 Vision Care Benefit Details 2010

Submitting Claims

 Extended Health Care /Vision Claim Form

Coverage Summary

Vision Care is designed to provide coverage of expenses incurred for vision care only. Depending on which plan you are enrolled in, covered persons can include:

  • yourself
  • your spouse and other dependents - for the purposes of this plan your spouse is considered a dependent

Plan Options

Vision Care Plan 1
  • eye examinations (for people between the ages of 19 to 64), eyeglass frames, prescription sunglasses, repairs/maintenance and contact lens fitting fees, lenses and contact lenses and corrective eye surgery to a combined maximum of $150 every two years per covered person from date of service. Note: Eye examinations are limited to $50 per person per calendar year, which is then subtracted from your $150 plan maximum.
Vision Care Plan 2
  • eye examinations (for people between the ages of 19 to 64), eyeglass frames, prescription sunglasses, repairs/maintenance and contact lens fitting fees, lenses and contact lenses and corrective eye surgery to a combined maximum of $250 every two years per covered person from date of service. Note: Eye examinations are limited to $50 per person per calendar year, which is then subtracted from your $250 plan maximum.

 

Vision Care Plan 3
  • eye examinations (for people between the ages of 19 to 64), eyeglass frames, prescription sunglasses, repairs/maintenance and contact lens fitting fees,lenses and contact lenses and corrective eye surgery to a combined maximum of $350 every two years per covered person from date of service. Note: Eye examinations are limited to $50 per person per calendar year, which is then subtracted from your $350 plan maximum.

 

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