Vision Service Plan

Supervisor

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CCPOA Benefit Trust Fund has increased the eye care benefit offered by the State.
No need to apply - this benefit is already yours!

Call the Trust's Eligibility Department to ensure you are receiving your Supervisory-level benefit. 800-468-6486

Our vision services provider is Vision Service Plan (VSP), the nation's largest eye care doctor network. VSP is a great way to protect your vision wellness.

VSP benefits are designed to provide for your essential vision needs. Certain cosmetic or elective eyewear options may be at some additional cost to you. Before selecting your eyewear, ask your vision care professional which options are fully covered by your Vision Service Plan, or view your personalized information at: www.vsp.com

VSP takes the privacy of their members protected health information seriously. They are committed to ensuring that the confidential data they manage on behalf of their clients and members stays that way. For more information, please see the VSP Notice of Privacy Practices.

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Benefit Highlights

CCPOA Supervisory Vision Benefits

Your coverage from a VSP Doctor
Exam every calendar year covered in full after copay

Prescription Glasses
Lenses every calendar year
Single vision, lined bifocal and lined trifocal lenses including tinted and photochromatic lenses. Covered in full after copay

Frames every calendar year
Frame of your choice covered up to $85.

OR
Contacts every calendar year
When you choose contacts instead of glasses, your $110 contact allowance applies to the cost of your contacts and the contact lens exam (fitting and evaluation). This exam is in addition to your vision exam to ensure proper fit of your contacts.

CCPOA MEMBER ONLY Second Pair Benefit
Second Pair Lenses	Frames
•  Every calendar year	•  Every other calendar year.
Second Pair Lenses	•  Frame of your choice covered up to $85
•  Single Vision Up to $25	This enhancement allows you to obtain a second pair of prescription glasses or contact lenses. For additional information on using this second pair benefit, please contact the Trust.
•  Bifocal Up to $40
•  Trifocal Up to $50
•  Frame Up to $40
•  Contact Lenses Up to $110

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Extra Discounts and Savings

Laser Vision Correction Discounts

Contacts
15% off the contact lens exam (fitting and evaluation)

Dollar for dollar you get the best value from your VSP benefit when you visit a VSP network doctor. If you decide not to see a VSP doctor, copays described below apply. You are required to pay the provider in full at the time of your appointment and submit a claim to VSP for reimbursement.

Out-Of-Network Reimbursement Amounts:
Exam Up to $35
Lenses:
Single Vision: Up to $25
Bifocal: Up to $40
Trifocal: Up to $50
Frame: Up to $40
Contact Lenses: Up to $110

Second Pair
Lenses
Single Vision: Up to $25
Bifocal: Up to $40
Trifocal: Up to $50
Frame: Up to $40
Contact Lenses: Up to $110

 

ADDITIONAL LINKS & RESOURCES

2012 CoBen Rate Chart

VSP website

What Does It Cost?

Supervisors:
VSP care is part of your CoBen benefits.

State Contribution for VSP:$8.64

Effortless Benefits.

Choose a VSP doctor at www.vsp.com or call
800-877-7195.

Make an appointment and tell the doctor you are a VSP member.
That’s it! No ID cards or filling out claim forms.