Benefits Options
What to Expect with Vision Care
Below are the features of the VSP plan. LightCare coverage allows members without a need for prescription eyewear to apply the materials coverage towards non-prescription sunglasses or non-prescription blue light filtering glasses.
While you have a choice of what provider to see, we recommend finding an in-network provider to maximize your benefit.
Under the plan, when you select an out-of-network provider the benefits are limited. For out-of-network reimbursement, you pay the entire bill when services are rendered then file a claim form for reimbursement. Claims must be filed within 12 months of the date of service. Submit claims to:
Vision Services Plan
P.O. Box 997105
Sacramento, CA 95899-7105
More information can be obtained by calling VSP at 1.800.877.7195 or accessing www.vsp.com. Plan information and claim forms are available at www.vsp.com or available on Canvas > Life and career > About me > My Total Rewards.
| Plan Feature | In-Network | Out-of-Network |
| Claims Forms | Not required | Required |
| Examination (Once every 12 months) | 100% after $10 co-pay | Up to $45 |
| Lenses (Once every 12 months) | ||
| Single | 100% after $20 co-pay | Up to $30 |
| Bifocal | 100% after $20 co-pay | Up to $50 |
| Trifocal | 100% after $20 co-pay | Up to $65 |
| Lenticular | 100% after $20 co-pay | Up to $100 |
| Frames (once every 24 months) | 100% within plan allowance Retail frames: $225 Featured frames: $275 Costco equivalent frames: $125 |
Up to $70 |
| Contact Lenses (instead of a complete pair of prescription glasses) | ||
| If elective (not medically necessary) | Up to $225 | Up to $105 |
| If medically necessary (means by doctor’s authorization glasses cannot be worn) | 100% after $20 co-pay | Up to $210 |
Premiums can be found on Canvas.