Sound Plan
SoundPlus Plan
Medical Vision Dental
Retirees

For PPO Plan Participants - Vision Service Plan (VSP)

  • Exam: 100% at a VSP provider, up to $35 at a non-VSP provider after a $10 co-pay, once each 12 consecutive months
  • Lenses: 100% at a VSP provider, from $30 to $90 at a non-VSP provider; once each 12 consecutive months
  • Frames: 100% at a VSP provider up to $30 at a non-VSP provider; once each 24 consecutive months
  • Contact lenses: Up to $130 at a VSP provider, up to $55 at a non-VSP provider; once each 12 consecutive months

For Group Health Options Participants

  • Exam: 85% for Group Health (In Network) Providers / 60% for Out of Network Providers, not subject to deductible or coinsurance; once each 12 consecutive months
  • Lenses, frames and contact lenses: Up to $150; once each 12 consecutive months
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