2021 | VisionDavis Vision Plan
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.
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 + Family||$9.69||$8.08|
|Premiums may be paid either “before” or “after” taxes are deducted from your salary.|
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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.
|Eye Examination||Every January 1, covered in full after $10 copayment.||Up to $35|
|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 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|
|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|
|All Ranges of Prescriptions and Sizes||$0||$90|
|Tinting of Plastic Lenses||$0||$20|
|Polycarbonate Lenses||$07 or $30||$64|
|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|
|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.