• Vision Care for Self-Managed Plans - Available to groups with these medical plans: Innova^SM and HSA Healthplan 2.0^SM
• Vision Care Plans I, II, III - Available to groups of 15 or more enrolled employees (for the Revive health plan only)
• Vision Care Plan IV - Available to groups of 1-14 enrolled employees (for the Revive health plan only)

Vision Care for Self-Managed Plans

• 100% coverage for annual eye exam (Category 1 & 2, Category 3 may be subject to balance billing)
• Up to $150 in hardware annually
• Not subject to deductible
• Available only with these medical plans: Innova and HSA Healthplan 2.0

Vision Care Plans I, II, III (for the Revive health plan only)

Vision Care plans I, II and III are available to groups with 15 or more enrolled employees. Benefits will be provided at 100% of the allowable charge for participating and nonparticipating physicians and/or optometrists. Enrolled employees and eligible dependents will receive benefits for a routine eye refraction once every calendar year as outlined below:

Frames, Lenses & Contacts
In addition to a routine eye refraction, enrolled employees and eligible dependents will receive benefits for the cost of frames, lenses, or contacts. Benefits for frames, lenses, or contacts shall be provided each calendar year according to the schedule of the vision plan selected.

Vision Care Plan IV (for the Revive health plan only)

Plan IV is available to groups of 1-14 enrolled employees. Benefits will be provided at 100% of the allowable charge for participating and nonparticipating physicians and/or optometrists. Enrolled employees and eligible dependents will receive benefits for a routine eye refraction once every calendar year as outlined below:

Frames, Lenses & Contacts
In addition to a routine eye refraction, enrolled employees and eligible dependents will receive benefits for the cost of frames, lenses, or contacts. Benefits for frames, lenses, or contacts shall be provided each calendar year according to the schedule of the vision plan selected.