Vision Plan

Dolores Nehlig, Manes, Kristen

Vision Chart

The Vision Plan is offered through UnitedHealthcare. UnitedHealthcare does not require members to use an ID card, nor do they send ont out. When you visit an in-netowrk vision provider, tell the provider that you have vision insurance through UnitedHealthcare and they will be able to locate you in their online system. If you prefer to have an ID card, one can be printed directly from the UnitedHealthcare website,

This is a primary vision care benefit and is intended to cover eye examinations and corrective eye wear. Watch this VIDEO explaining the benefits of the vision plan. Click on the "attachment" tab to view more information.
UnitedHealthCare Customer Service: 1.800.638.3120
Policy #903022
UnitedHealthCare Provider Location: 1.800.839.3242

Forms and Resources

Eligibility for Enrollment

Employees appointed for more than 120 days and 75% of full-time or greater are eligible for enrollment.

Effective date of Coverage

  • New Employees have 30 days to either enroll or waive coverage. Coverage is effective on the first day of the month after completion of one full calendar month of employment.
  • Employees who do not enroll within the first 30 days may elect to enroll during the Annual Enrollment period.

Vision Plan

Monthly Premiums for Vision Plan

Level of Coverage Premium 12 month employee Premium 9 month employee
Employee Only $7.39 $9.85
Employee + Spouse $12.45 $16.60
Employee + Children $12.72 $16.96
Family $20.50 $27.33

Enrollment for new employees will be done through the Workday system. Enrollment for existing employees may be done during Annual Enrollment, unless you experience a Qualifying Family Event.

Plan Highlights
  • Members are allowed to obtain one vision exam and one pair of eyeglasses or contact lenses every 12 months.
  • Benefits are greater if an in-network physician/clinic is visited.

In-Network Vision Benefits at a Glance

Comprehensive Eye ExamEvery 12 monthsNo co-pay
Pair of eyeglasses lensesEvery 12 monthsNo co-pay
Single vision, lined, bi-focal, lined tri-focal or lined
lenticular lenses, Standard and Deluxe Progressive
and Oversized Lenses
Every 12 monthsNo co-pay
Standard scratch coating, Solid and Gradient Tint,
ultraviolet Glass and Plastic Coating
Covered in fullCovered in full
FramesEvery 12 months$130 allowance
Lens OptionsSee Benefit Summary for details
Covered selection of Contact Lenses (lens fitting
Every 12 monthsNo co-pay
Up to 4 boxes
Elective Contact Lenses

Contact Lenses that fall outside the covered
selection. (Co-pay does not apply)
Every 12 months$130 allowance
Additional Materials20% off

Additional Member Benefits

If you wish to nominate a particular ophthalmologist, optometrist or optician as a Vision Network Provider, click here to access the Provider Nomination Form.

3/29/2006 12:45:51 AM
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