Vision Plan
Vision benefits are provided through Davis Vision. Davis Vision maintains a provider network to provide you with innovative eye care solutions. Your benefits will differ if you choose an eye care provider who is not associated with the Davis Vision network.
In-Network Provider Benefits Frequency: Each 12 month period
Eye examamination -- $25 CopaymentEyeglasses (lenses and/or frames) -- $25 CopaymentStandard pair of soft, daily-wear contacts(two multi-packs of lenses)-- $25 Copayment orDisposable and planned replacement lenses (four multi-packs of lenses) -- $25 Copayment |
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Out-of-Network Provider Benefits
If you choose to receive services from an out-of-network provider, you must pay the provider directly for all charges and then submit a claim for reimbursement to Davis Vision.
You will be reimbursed up to $32 for an eye exam
$32 for single lenses
$48 for bifocals
$64 for trifocals
$50 for frames
$92 for contact lenses
Use the Documents link on the left side of our webpage to download an Out-of-Network Claims Form. |
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| Davis Vision Brochure Download the Davis Vision brochure by clicking on Documents at the left side of our webpage. This brochure describes the benefits of the Plan and includes frequently asked questions. To contact Davis Vision call 1-800-999-5431 or visit their website. |
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Get in-depth information here.
Summary Plan Description