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Vision Benefit Summary

Vision Benefit Summary

Vision Plan
Eligibility All beneficiaries eligible for a medical plan are eligible for the Vision Plan.
Anti-reflective lenses Not covered.
Designer frames Not covered.
Frames CBF/1992 Benefit Plan – $14.00 per set

1993 Benefit Plan/Prefunded Benefit Plan – $33.13 per set

Limited to 1 set of frames every 24 months.

Lenses

All services must be prescribed by a physician, optometrist or optician. Limited to one set of lenses every 24 months.

New lenses are only covered if:

The new prescription differs by an axis change fo 20 degrees or .50 diopter sphere or cylinder change.

The lenses improve visual acuity by at least one line on the standard eye chart.

Mine Safety Glass Program Services or supplies provided by a Mine Safety Glass Program are not covered.
Photosensitive lenses Not covered.
Oversized lenses Not covered.
Optional features Not covered.
Routine Examination CBF/1992 Benefit Plan – $20.00 per exam. 1 exam every 24 months.

1993/Prefunded Benefit Plan – $46.75 per exam. 1 exam every 24 months.

Services covered by the Medical Plan Not covered.
Sunglasses Not covered.
Tinting Rose tints No. 1 or No. 2 are covered if prescribed for medical reasons.
All other tints are not covered.
Vision Training Not Covered