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Employee Cigna 2017-2018 Vision Plan

The 2017-2018 Vision Plan becomes effective Saturday, July 1, 2017.

The chart is only a brief summary. Please see the Summary of Benefits for the Cigna Vision Plan for a thorough description of its benefits, limitations, exclusions and conditions of coverage.

Coverage

In-Network
Benefits

Out-of-Network
Benefits
 

Frequency Period**

Exam Copay

$10

 N/A 12 months
Exam Allowance
(once per frequency period)

Covered 100% after copay

Up to $45

12 months

Material Copay

$20

N/A

12 months

Eyeglass Lenses Allowances:
one pair per frequency period)
     
      Single Vision Lenses

Covered 100% after Copay 

 Up to $32

12 months
      Lined Bifocal

Covered 100% after Copay 

Up to $55

12 months
      Lined Trifocal 

Covered 100% after Copay 

 Up to $65

12 months

      Lenticular 

Covered 100% after Copay 

 Up to $80

12 months

Contact Lenses Allowance:
(one pair or single purchase per frequency period)

 
   
      Elective

 Up to $110

Up to $98

12 months

      Therapeutic

Covered 100%

Up to $210

12 months

Frame  Retail Allowance
(one per frequency period)

Up to $120 

Up to $66

24 months


** Your Frequency Period begins on the 1st of your plan renewal month, July 1, 2017.