VISION

United Healthcare | Vision Plan (Spectera)

Vinci Brands provides vision coverage through United Healthcare. You can see a UHC’s in-network provider or an out-of-network provider, however, your costs will be lower if you visit an in-network provider. If you visit an in-network provider, you will be responsible for a copayment at the time of your service. If you receive services from an out-of-network doctor, you will pay all costs at the time of service and submit a claim for reimbursement.

Finding a Vision Provider Go to: www.myuhcvision.com United Healthcare’s network includes access to more than 44,000 providers and provider locations including independent ophthalmologists and optometrists, as well as Warby Parker and Sam’s Club.

Resources

Vision Summary

Services	In-Network	Out-of-Network
Copay Examination/Materials	$10 Copay	N/A
Examination (Every 12 Months based on date of service)	No Charge	Up to $40 Reimbursement
Lenses (Every 12 Months) Single Vision Bifocal Trifocal	No Charge	Up to $40 Reimbursement Up to $60 Reimbursement Up to $80 Reimbursement
Frames (Every 12 Months)	$130 Benefit	Up to $45 Reimbursement
Contact Lenses (Every 12 Months)	Additional Benefit to Frames
Cosmetic / Elective Contact Lenses	$130 Benefit
Standard Contact Lens Fitting	Additional Benefit to Frames
Non-elective (medically necessary)	$130 Benefit	Up to $105 Reimbursement
Frequency	$30 Benefit	Not Covered

Rates & Contributions
Rates & Contributions	Employee Per Month
Pre-tax
Employee only	$10.24
Employee + spouse	$17.42
Employee + child(ren)	$18.44
Employee + family	$27.66

Additional Discounts Available from Network Providers

Retinal Imaging: Pay no more than a $39 Copay.

Eyeglass Lens Upgrades: You may choose to upgrade your new eyeglass lenses at a discounted, low copay. Options include Transitions lenses (adults), standard polycarbonate lenses (adults), tints, UV coating, progressive lenses, anti-reflective coatings, and more.

Additional Pair of Eyeglasses: Members get 30% discount off frame coverage at most in-network providers and 20% discount for an additional par at participating providers.

Eyewear Accessories: Receive a 20% discount on items such as non-prescription sunglasses, lens cleaning supplies, contact lens solutions, eyeglass cases, and more.

Conventional Contact Lenses: Receive a 20% discount off the retail price for conventional contact materials only.

LASIK Laser Vision Correction Surgery: Discounts are available through QualSight LASIK. For more information visit www.myuhcvision.com.

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