Microsoft Word - 2022 - FT Employee Benefits Enrollment Guid

Commonwealth Emergency Physicians

Health Insurance - Vision Driving to work, reading a news article, and watching TV are all activities you likely perform every day. Your ability to do all of these activities, though, depends on your vision and eye health. Vision insurance can help you maintain your vision as well as detect various health problems. Commonwealth Emergency Physicians’s vision insurance entitles you to specific eye care benefits. Our vision policy has been renewed with Cigna for the period 2022. Your vision benefits include the following:

Type of Service

CIGNA VISION – C1 Standard PPO Comprehensive In Network Out-of-Network Frequency

Exam Copay

$10

N/A

12 months

Up to $45

12 months

Exam Allowance

100% covered after copay

Materials Copay

$25

N/A

12 months

Eyeglass Lenses Allowances Single Vision Lined Bifocal Lined Trifocal Lenticular Contact Lenses Allowances Elective Therapeutic

100% covered after copay 100% covered after copay 100% covered after copay 100% covered after copay

Up to $32 Up to $55 Up to $65 Up to $80

12 months 12 months 12 months 12 months

Up to $130 100% covered

Up to $105 Up to $210

12 months 12 months

Frame Retail Allowance

Up to $140

Up to $77

12 months

Employee only—$6.21 Employee & spouse—$12.41 Employee & child—$12.54 Family—$20.01

Monthly Payroll Deductions

7