Vision Benefits Administered By Medical Eye Services (MES) Self-Funded For All Participants

Schedule of Vision Benefits
		In-Network	Out-of-Network
Vision Exam	Every 12 months.	No charge.	$40 allowance
Lenses	Every 24 months OR at 12-month intervals if the prescription change so indicates.	No charge for standard lenses.	Allowance varies based on lens type
Frames	Every 24 months.	No charge for standard frame.	$40 allowance
Contact Lenses	Every 24 months OR at 12-month intervals if the prescription change so indicates (this benefit is in lieu of lenses and frame).	Cosmetic or convenience: $150 allowance. Medically necessary: Covered in full.	Cosmetic or convenience: $150 allowance. Medically necessary: $250 allowance.