Other Coverage Options
VISION BENEFITS
Vision care is also provided to eligible plan participants. Your vision benefits are provided through Vision Service Plan (VSP).
|
|
|
| Network |
You may visit any provider. However, your benefits are greater when you visit a provider who is contracted with Vision Service Plan. |
| Deductible |
$10 |
| Benefits – In Network |
| Exam |
every 12 months |
| Lenses |
every 12 months |
| Frames |
every 24 months |
There is a $120 allowance toward frames. Contact lenses, in lieu of glasses, also have a $120 allowance. |
| Benefits – Out of Network |
Please refer to your Evidence of Coverage provided by Vision Service Plan |
ALCOHOL AND DRUG DEPENDENCY TREATMENT
Benefits for alcohol and drug dependency, including detoxification and rehabilitation, are available through the Beat It! program only. Care must be arranged by Beat It! and obtained at Beat It!- contracted facilities. These benefits are for active employees and their dependents only.
| Inpatient Benefits for Detoxification |
| First Confinement |
85% of contracted rate |
| Second Confinement |
80% of contracted rate |
| Inpatient Benefits for Rehabilitation after Detoxification |
| First Confinement without prior outpatient treatment under the Beat It! Program |
| Employee |
100% of contracted rate |
| Dependent |
80% of contracted rate |
| First Confinement with prior outpatient treatment under the Beat It! Program |
| Employee |
80% of contracted rate |
| Dependent |
50% of contracted rate |
| Second Confinement |
| Employee |
80% of contracted rate |
| Dependent |
50% of contracted rate |
| Benefits for inpatient confinement are limited to two per person per lifetime. |
| Outpatient Benefits |
| Lifetime maximum benefit – per person |
40 hours of counseling in a consecutive 12-week period |