Vision Indemnity Plan Summary

Vision Indemnity Option 1
  Plan Benefit Frequency Options
A B C D
Yearly Deductible Options $0, $10 or $25        
Annual Eye Exam $60 allowance 12 12 12 12
Frames $80 allowance 12 24 24 24
Lenses          
Single $35 allowance 12 12 12 24
Bifocal $55 allowance
Trifocal $65 allowance
Contacts          
Elective $125 allowance 12 12 24 24
Medically Necessary $200 allowance 12 12 24 24
Vision Indemnity Option 2
  Plan Benefit Frequency Options
A B C D
Yearly Deductible Options $0, $10 or $25        
Annual Eye Exam $60 allowance 12 12 12 12
Frames $100 allowance 12 24 24 24
Lenses          
Single $45 allowance 12 12 12 24
Bifocal $65 allowance
Trifocal $75 allowance
Contacts          
Elective $125 allowance 12 12 24 24
Medically Necessary $200 allowance 12 12 24 24
Vision Indemnity Option 3
  Plan Benefit Frequency Options
A B C D
Yearly Deductible Options $0, $10 or $25        
Annual Eye Exam $60 allowance 12 12 12 12
Frames $115 allowance 12 24 24 24
Lenses          
Single $55 allowance 12 12 12 24
Bifocal $75 allowance
Trifocal $85 allowance
Contacts          
Elective $125 allowance 12 12 24 24
Medically Necessary $200 allowance 12 12 24 24
Available in AK, AL, AR, AZ, CA, CO, DC, FL, GA, HI, ID, IL, IN, KS, KY, LA, MD, MI, MO, MS, MT, NC, ND, NE, NM, NV, OH, OK, OR, PA, SC, SD, TN, TX, UT VA, WA and WY.