2021 | Vision
Davis Vision Plan

Highlights

Print this page

How It Works 

  • Convenient Network Locations — A national network of credentialed preferred providers throughout the 50 states.
  • Freedom of Choice — Access to care through either our network of independent, private practice doctors (optometrists and ophthalmologists) or select retail partners.

The plan offers a network of providers that service your eye-care needs with only a modest member copayment shown in the Schedule of Benefits.

Out-of-network benefits

The out-of-network benefit allows you to select any provider and reimburses a fixed dollar amount based on the schedule shown for the out-of-network services*.

You will receive the greatest value and maximize your benefit dollars if you select a provider who participates in the network. However, you may choose an out-of-network provider, but you must pay the provider directly for all charges and then submit a claim for reimbursement.

*This is not a contract: This is a benefits highlights summary. All benefits are subject to the provisions and exclusions of the master contract.

Vision Bi-weekly Rates Per Pay Period

20 PAY 24 PAY
Employee Only $3.40 $2.83
Employee + Family $9.69 $8.08
Premiums may be paid either “before” or “after” taxes are deducted from your salary.

Contact

Get the App

Access your insurance and the tools to help you use it anytime, anywhere with the mobile app.

Davis Vision Plan Features Summary

The following chart indicates the benefits the plan pays for the services you receive. For more information, see the Davis plan literature.

IN-NETWORK OUT-OF-NETWORK
SERVICES
Eye Examination Every January 1, covered in full after $10 copayment. Up to $35
EYEGLASSES
Spectacle Lenses Every January 1, covered in full for standard single-vision, lined bifocal, or trifocal lenses after $15 copayment. Spectacle Lenses (per pair) up to: Single Vision: $25, Bifocal/progressive: $40, Trifocal: $60, and Lenticular: $100.
Frames $1306 Retail allowance toward any frame from provider, plus 20% off balance2. Also, up to $180 frame allowance at Visionworks, plus 20% on any overage OR Every other January 1, covered in full any fashion or designer frame from Davis Vision’s collection1 (value up to $175). Up to $50
CONTACT LENSES
Contact Lens Evaluation, Fitting & Follow Up Care Every January 1, collection contacts: covered in full OR Non collection contacts: standard contacts: 15% discount2, specialty contacts3: 15% discount2. Elective Contacts: up to $150 Medically necessary contacts: up to $210
Contact Lenses (In Lieu of Eyeglasses) $150 retail allowance toward provider supplied contact lenses, plus 15% off balance2 OR Every January 1, covered in full any contact lenses from Davis Vision’s contact lens collection1. N/A
ADDITIONAL DISCOUNTED LENS OPTIONS & COATINGS
Most Popular Options - Savings based on in-network usage and average retail values.
WITH VISION PLAN WITHOUT VISION PLAN
Scratch-Resistant Coating $0 $40
Polycarbonate Lenses $04-$30 $64
Standard Anti-Reflective (AR) Coating $35 $62
Standard Progressives (no-line bifocal) $50 $154
Plastic Photosensitive (Transitions®5) $65 $123
FRAMES - ADDITIONAL OPTIONS
Fashion Frame (From the Davis Vision Collection) $0 $125
Designer Frame (From the Davis Vision Collection) $0 $175
Premier Frame(From the Davis Vision Collection) $25 $225
LENSES
All Ranges of Prescriptions and Sizes $0 $90
Plastic Lenses $0 $33
Oversized Lenses $0 $20
Tinting of Plastic Lenses $0 $20
Scratch-Resistant Coating $0 $40
Polycarbonate Lenses $07 or $30 $64
Ultraviolet Coating $12 $28
Standard Anti-Reflective (AR) Coating $35 $62
Premium AR Coating $48 $80
Ultra AR Coating $60 $113
Standard Progressive Additional Lenses $50 $154
Premium Progressives (Varilux®8, etc.) $90 $248
Ultra9 Progressive Addition Lenses $140 $430
High-Index Lenses $55 $120
Polarized Lenses $75 $103
Plastic Photosensitive Lenses $65 $123
Scratch Protection Plan Single Vision/Multifocal Lenses $20/$40 N/A
1 The Davis Vision Collection is available at most participating independent provider locations. Collection is subject to change. Collection is inclusive of select toric and multifocal contacts.
2 Additional discounts not applicable at Walmart, Sam’s Club or Costco® locations.
3 Including, but not limited to toric, multifocal and gas permeable contact lenses.
4 For dependent children, monocular patients and patients with prescriptions of 6.00 diopters or greater.
5 Transitions® is a registered trademark of Transitions Optical Inc.
6 Enhanced frame allowance of $180 only available at Visionworks® locations nationwide.
7Polycarbonate lenses are covered in full for dependent children, monocular patients and patients with prescriptions 6.00 diopters or greater.
8Varilux® is a registered trademark of Societe Essilor International.
9Category includes digital free-form progressive lenses.
Davis Vision has made every effort to correctly summarize your vision plan features. In the event of a conflict between this information and your organization’s contract with Davis Vision, the terms of the contract or insurance policy will prevail.
  • You can locate a provider by calling Davis Vision customer service at 1-877-923-2847, using the app, or by logging on to the Open Enrollment section of our Member site at davisvision.com and click “Find a Provider”.
  • You have access to a Member Online Portal.