* Employee only
* Employee + Spouse/same-sex domestic partner
* Employee and Child(ren)
* Family

This comprehensive plan provides coverage that can include eye examinations, frames/lenses or contact lenses and other vision related expenses. The UD vision plan is administered through Superior Vision Services, which boasts a national provider network of more than 27,000 locations. The Superior Vision Services network includes ophthalmologists, optometrists and optical companies that provide broad geographic coverage throughout every state in the U.S.

Through the Flexible Benefit Program, the University provides pre-tax Flex Credit to cover the premium for full-time employees; benefits for dependents and retirees are voluntary at an additional cost.

Using your Vision Benefits

You decide how to use your in-network or out-of-network vision benefits. You select an in-network provider and identify yourself at the time of service by providing the information that is shown on your personalized Superior Vision I.D. card.

You may also use out-of-network services by paying the out-of-network provider in-full for all services and materials. To receive your reimbursement, you must submit an itemized invoice or receipt from your provider to Superior Vision Claims Services. You will be reimbursed according to the out-of-network schedule of reimbursements less any applicable co-pay amount(s). The chart below provides a general outline of the benefits and reimbursement levels under the plan.

SERVICE	FREQUENCY
Comprehensive Eye Exam ($15.00 co-pay)	12 months
Lens	12 months
Frames	24 months
Contact Lenses*	12 months

Benefit	Benefit Amount In-Network	Benefit Amount Out-of-Network*
Comprehensive Eye Exam
Ophthalmologist (M.D.)	Covered in Full	Up to $34.00
Optometrist (O.D.)	Covered in Full	Up to $26.00
Standard Lenses (Per Pair)
Single Vision	Covered in Full	Up to $26.00
Bifocal	Covered in Full	Up to $39.00
Trifocal	Covered in Full	Up to $49.00
Lenticular	Covered in Full	Up to $78.00
Frame-Standard**	Up to $150 Retail*	Up to $79.00
Contact Lenses (Per Pair)*
Medically Necessary	Covered in Full	Up to $210 retail
Elective-Cosmetic	Up to $120 retail*	Up to $100 retail

*Contact lenses a are in lieu of eyeglass lenses and frames benefit.
**The insured is responsible for paying any charges in excess of this allowance.

Discounts! Discounts! Discounts!

Under the vision plan, you can also receive a discount of 20% off the provider’s charges for prescription eyeglass lens upgrades, such as: Coatings, Transitions, Polaroid, Polycarbonate, Ultra-thin Materials (High Index), Tints, etc.

For example, you pay the difference in price between the provider’s standard trifocal price and the price of the progressive power lens design selected. This additional cost for progressive power lenses is subject to a 20% discount from participating providers who are identified with a “DP” (Discount Plan) in their directory listings.

Superior Vision Services has contracted a special network of over 500 refractive surgeons nationwide who specialize in the popular elective procedures of radial keratotomy (RK), photo-refractive keratotomy (PRK) and LASIK. These providers offer Superior Vision Plan members a 20% discount off their usual and customary surgical fees for these procedures.

Easy Access to Member Services

A single call by a member or provider to a Member Services Rep. can answer your questions regarding benefits, eligibility, coverage, provider information and claims. Call the Member Services toll-free line, 800-507-3800, or you may find additional information on the Superior Vision Services website at http://www.superiorvision.com.

Benefits Rate Chart