Superior Vision

Vision Plan Benefits for AACET

Co-Pays                                                                                            Services/Frequency

Exam $10                                                                                                                Exam 12 months

Materials1 $10                                                                                                         Frame 12 months

Contact Lens Fitting $25                                                                                           Contact Lens Fitting 12 months

(standard & specialty) Lenses 12 months                                                                    Contact Lenses 12 months

                                                                                                                              (Based on date of service)

Benefits

                                    In-Network                                             Out-of-Network

Exam (Ophthalmologist)            Covered in full                                                                Up to $42 retail

Exam (Optometrist)                  Covered in full                                                                Up to $36 retail

Frames                                    $125 retail allowance                                                       Up to $70 retail

Contact Lens Fitting (standard2) Covered in full                                                                Not covered

Contact Lens Fitting (specialty2) $50 retail allowance                                                        Not covered

Lenses (standard) per pair

Single Vision                            Covered in full                                                                 Up to $28 retail

Bifocal                                     Covered in full                                                                 Up to $42 retail

Trifocal                                    Covered in full                                                                 Up to $56 retail

Progressive lens upgrade          See description3                                                               Up to $56 retail

Contact Lenses4 $130 retail allowance                                                                             Up to $100 retail

Co-pays apply to in-network benefits; co-pays for out-of-network visits are deducted from reimbursements

Materials co-pay applies to lenses and frames only, not contact lenses

See your benefits materials for definitions of standard and specialty contact lens fittings

Covered to provider’s in-office standard retail lined trifocal amount; member pays difference between progressive and standard retail lined trifocal, plus applicable co-pay

Contact lenses are in lieu of eyeglass lenses and frames benefit

Discount Features

Look for providers in the Provider Directory who accept discounts,

as some do not; please verify their services and discounts (range

from 10%-40%) prior to service as they vary.

Discounts on Covered Materials

Frames: 20% off amount over allowance

Lens options: 20% off retail

Progressives: 20% off amount over retail lined trifocal lens,

including lens options

The following options have out-of-pocket maximums5 on standard

(not premium, brand, or progressive) lenses.

Maximum Member Out-of-Pocket

Single Vision                                                                              Bifocal & Trifocal

Scratch coat $13                                                                                   $13

Ultraviolet coat $15                                                                               $15

Tints, solid or gradients $25                                                                   $25

Anti-reflective coat $50                                                                          $50

Polycarbonate $40                                                                           20% off retail

High index 1.6 $55                                                                          20% off retail

Photochromics $80                                                                          20% off retail

Discounts on Non-Covered Exam and Materials

Exams, frames, and prescription lenses: 30% off retail

Lens options, contacts, other prescription materials: 20% off retail

Disposable contact lenses: 10% off retail.

Refractive Surgery

Superior Vision has a nationwide network of refractive

surgeons and leading LASIK networks who offer

members a discount. These discounts range from

5%-50%, and are the best possible discounts available

to Superior Vision.

Discounts and maximums may vary by lens type. Please check with your provider.

www.superiorvision.com

 

Customer Service - 800-507-3800

The Plan discount features are not insurance.

All allowances are retail; the member is responsible

for paying the provider directly for all non-covered

items and/or any amount over the allowances,

minus available discounts. These are not covered

by the plan.

Discounts are subject to change without notice.

Disclaimer: All final determinations of benefits,

administrative duties, and definitions are governed

by the Certificate of Insurance for your vision plan.

Please check with your Human Resources

department if you have any questions

 

The bi-weekly premiums for the new vision plan are:

   
                                                            Employee Only - $2.99  
                                                       Employee + Spouse - $5.52  
                                                        Employee + Family - $7.81  

See your Human Resources Manager or Benefits Specialist for AACET application and vision enrollment form or download from the Forms link. 


THIS INSURANCE IS NOT BEING OFFERED THROUGH THE STATE OF ARKANSAS. SUPERIOR VISION INSURANCE IS BEING OFFERED EXCLUSIVELY THROUGH AACET FOR AACET MEMBERS ONLY.