Posts Tagged ‘featured’

Vision

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VSP 12 Month Plan

Benefit Description Copay Frequency
Your Coverage with VSP Doctors and Affiliate Providers*
WellVision Exam
  • Focuses on your eyes and overall wellness
$0 Every plan year
Prescription Glasses $0 See frame and lenses
Frame
  • $130 allowance for a wide selection of frames
  • $150 allowance for featured frame brands
  • 20% savings on the amount over your allowance
Included in Prescription Glasses Every plan year
Lenses
  • Single vision, lined bifocal and lined trifocal lenses
  • Polycarbonate lenses for dependent children
Included in Prescription Glasses Every plan year
Lens Enhancements
  • Standard progressive lenses
  • Premium progressive lenses
  • Custom progressive lenses
  • Average savings of 20-25% on other lens enhancements
  • UV Protection
  • Scratch Resistance Coating
  • Tints

$55

$95 – $105

$150 – $175

$0

$0

$0

Every plan year
Contacts
(instead of glasses)
  • $130 allowance for contacts; copay does not apply
  • Contact lens exam (fitting and evaluation)
$0 Every plan year
Diabetic Eyecare Plus Program Services related to diabetic eye disease, glaucoma and age-related macular degeneration (AMD). Retinal screening for eligible members with diabetes. Limitations and coordination with medical coverage may apply. Ask your VSP doctor for details. $20 As needed
Extra Savings

Glasses and Sunglasses20% savings on additional glasses and sunglasses, including lens enhancements, from any VSP doctor within 12 months of your last WellVision Exam.


Laser Vision CorrectionAverage 15% off the regular price or 5% off the promotional price; discounts only available from contracted facilities

VSP 24 Month Plan

Benefit Description Copay
Your Coverage with VSP Doctors and Affiliate Providers*
WellVision Exam
  • Focuses on your eyes and overall wellness
  • Children to age 19 every plan year
  • Adults Every other plan year*
$0
Prescription Glasses $0
Frame
  • $130 allowance for a wide selection of frames
  • $150 allowance for featured frame brands
  • 20% savings on the amount over your allowance
  • Children to age 19 every plan year
  • Adults Every other plan year
Included in Prescription Glasses
Lenses
  • Single vision, lined bifocal and lined trifocal lenses
  • Polycarbonate lenses for dependent children
  • Children to age 19 every plan year
  • Every other plan year
Included in Prescription Glasses
Lens Enhancements
  • Tints/Photochromic adaptive lenses
  • Scratch-resistant coating
  • UV protection
  • Standard progressive lenses
  • Premium progressive lenses
  • Custom progressive lenses
  • Average savings of 20-25% on other lens enhancements
  • Children to age 19 every plan year
  • Adults Every other plan year
$55 $95 – $105 $150 – $175 $0 $0 $0
Contacts (instead of glasses)
  • $130 allowance for contacts; copay does not apply
  • Contact lens exam (fitting and evaluation)
  • Children to age 19 every plan year
  • Adults every other plan year
$0
Additional Coverage Diabetic Eyecare Plus Program
Extra Savings

Glasses and Sunglasses20% savings on additional glasses and sunglasses, including lens enhancements, from any VSP doctor within 12 months of your last WellVision Exam.

Extra $20 to spend on featured frame brands. Go to vsp.com/specialoffers for details


Laser Vision CorrectionAverage 15% off the regular price or 5% off the promotional price; discounts only available from contracted facilities


Retinal Screening No more than a $39 copay on routine retinal screening as an enhancement to a WellVision Exam.

Dental

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All dental plans are through Delta Dental and are fully insured plans

Non-EHB Dental Benefit Plans #5055

Plan A (2XXX)
Plan B (3XXX)
Plan C (4XXX)
Plan D (1XXX)
Delta Dental PPO
Delta Dental PPO
Delta Dental PPO
Delta Dental PPO
PPO Dentist
Premier or Nonpar
PPO Dentist
Premier or Nonpar
PPO Dentist
Premier or Nonpar
PPO Dentist
Premier or Nonpar
Diagnostic and Preventive
Diagnostic Services and Preventive Services
(Exams, Cleanings, Fluoride, and space maintainers)
100%
100%
100%
100%
50%
50%
100%
75%
Brush Biopsy
(to detect oral cancer)
100%
100%
100%
100%
50%
50%
100%
75%
Radiographs
(X-rays)
100%
100%
100%
100%
50%
50%
100%
75%
Emergency Palliative Treatment
(to temporarily relieve pain)
100%
100%
100%
100%
50%
50%
100%
50%
Basic Services
Oral Surgery Services (extractions and dental surgery)
90%
80%
80%
50%
50%
50%
50%
50%
Minor Restorative Services
(fillings and crown repair)
90%
80%
80%
50%
50%
50%
50%
50%
Periodontics
(to treat gum disease)
90%
80%
80%
50%
50%
50%
50%
50%
Endodontics
(root canals)
90%
80%
80%
50%
50%
50%
50%
50%
Relines and Repairs
(to bridges and dentures)
90%
80%
80%
50%
50%
50%
50%
50%
Other Basic Services
(misc. services)
90%
80%
80%
50%
50%
50%
50%
50%
TMD
(treatment of the disorder of the temporomandibular joint)
60%
50%
50%
50%
50%
50%
50%
50%
Major Services
Prosthodontics
(bridges, dentures and implants)
60%
50%
50%
50%
50%
50%
50%
50%
Major Restorative Services
(crowns)
60%
50%
50%
50%
50%
50%
50%
50%
Orthodontic Services
Orthodontic Services
(braces)
50%
50%
50%
50%
50%
50%
50%
50%
Orthodontic Age Limit
19
19
19
19
19
19
No age limit
No age limit
Maximum Benfits per person
Maximum Payment
(per person per calendar year on Diagnostic & Preventive, Basic Services and Major Services)
1,500
1,200
1,000
1,000
Per person lifetime maximum payment for Orthodontic Services
1,000
1,000
1,000
1,000

 

Medical

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The Plan Structure

  • A PPO Plan designed for Police Officers, Fire Fighters, Dispatchers, Municipal Employees and their families
  • All products are fully insures
  • Enhanced In-Network benefits through the Blue Cross Network in Michigan and any other states Blue Cross participates in.
  • Enhanced In-Network benefits for our of State members who receive and utilize our PHCS/MulitPlan ID card.
  • Members may go in and out of network anytime at members option, however, they should keep in mind that they receive a higher benefit level in network
  • No Gatekeepers
  • No Referrals needed
  • You Choose Your Doctors
  • 2nd and 3rd Opinions for Surgical Procedures

Numerous plans, prescription options, deductibles and co pays available.  We can tailor a plan to your needs including Health Savings Accounts, High Deductible Plans, and plans that meet the State of Michigan Hard Cap or 80/20 mandates for certain public employees.  We now have the ability to build a plan to meet your benefit and cost needs!

Premium Structure

  • Split Rate Premiums for Medical. This means separate rates for Active and Retired Members.

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