Vision Plan

General Info
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General Info

Certificated and Management employees scheduled to work at least 50% and classified employees scheduled to work more than 30 hours per week are eligible for VSP PPO coverage at no cost. VSP does not provide members with an ID card. When verifying coverage, your VSP vision provider will ask for the last four digits of your Social Security number. However, it is District policy to enroll all members with their employee ID number in lieu of their Social Security number. Please provide your employee ID number to your vision provider in the form of a SSN in order to verify coverage. For example:

Employee ID: 1234
VSP ID: 000-00-1234

For plan overview and coverage information, click on the "Benefits Summary" tab below.

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Below are summaries of the benefits and coverages for the vision plan.

Benefits Summary

Benefits Summary

Benefits Summary

WellVision Exam:

Description	Copay
Focuses on your eyes and overall wellness Every 12 months	$25 for exam and glasses

Prescription Glasses:

Benefit	Description	Copay
Frame	$140 allowance for a wide selection of frames ($75 at Costco) $160 allowance for featured frame brands 20% savings on the amount over your allowance Every 24 Months	Combined with exam
Lenses/Contacts	Single vision, lined bifocal, and lined trifocal lenses Polycarbonate lenses for dependent children Or contact lenses in place of Glasses - $105 allowance Every 12 Months	Combined with exam
Lens Enhancements	Tints/Photochromic adaptive lenses Standard progressive lenses Premium progressive lenses custom progressive lenses Average savings of 35-40% on other lens enhancements Every 12 Months	$0 $50 $80-$90 $120-$160
Covered Contact Lenses (in addition to glasses)	Annual supply of contacts Contact lens exam (fitting and evaluation) Every 12 months	$50
Diabetic Eyecare Plus Program	Services related to diabetic eye disease, glaucoma and age -related macular degeneration (AMD). Retinal screening for eligible members with diabetes. Limitations and coordination with medical coverage may apply. Ask your VSP doctor for details. As needed	$20

Extra Savings:

Benefit	Savings
Glasses and Sunglases	Extra $20 to spend on featured frame brands. Go to www.vsp.com/specialoffers for details. 30% savings on additional glasses and sunglasses, including lens enhancements, from the same VSP provider on the same day as your WellVision Exam. Or get 20% from any VSP provider within 12 months of your last WellVision Exam.
Retinal Screening	No more than a $39 copay on routine retinal screening as an enhancement to a WellVision Exam
Laser Vision Correction	Average 15% off the regular price or 5% off the promotional price; discounts only available from contracted facilities After surgery, use your frame allowance (if eligible) for sunglasses from any VSP doctor

Your Coverage with Out-Of-Network Providers:

Benefit	Plan Pays
Exam	Up to $50
Frame	Up to $70
Single Vision Lenses	Up to $50
Lined Bifocal Lenses	Up to $75
Lined Trifocal Lenses	Up to $100
Progressive Lenses	Up to $75
Contacts	Up to $250
Tints	Up to $5

Using your VSP benefit is easy.

Create an account at www.vsp.com. Once your plan is effective, review your benefit information.
Find an eye care provider who's right for you. The decision is yours to make - choose a VSP doctor, a participating retail chain, or any out-of-network provider. To find a VSP provider, visit www.vsp.com or call 800-877-7195
At your appointment, tell them you have VSP. There's no ID card necessary. If you'd like a card as a reference, you can print one on www.vsp.com

That's it! We'll handle the rest - there are no claim forms to complete when you see a VSP provider.

Best Eye Care

You'll get the highest level of care, including a WellVision Exam - the most comprehensive exam designed to detect eye and health conditions. Plus, when you see a VSP provider, you'll get the most out of your benefit, have lower out-of-pocket costs, and your satisfaction is guaranteed.

Choice in Eyewear

From classic styles to the latest designer frames, you'll find hundreds of options. Choose from featured frame brands like bebe, Calvin Klein, Cole Haan, Flexon, Lacoste, Nike, Nine West, and more. Visit www.vsp.com to find a Premier Program location that carries these brands. Prefer to shop online? Check out all of the brands at www.Eyeconic.com, VSP's online eyewear store.

Plan Information

VSP Coverage Effective Date: 07/01/2017
VSP Provider Network: VSP Signature