Access to the benefits and large group pricing on this website is predicated upon joining
Elevate Wellness, a national association with over 90,000 members. Learn more
When it comes to Vision Benefits...the difference is clear...
Competitive coverage with access to an extensive network of vision providers.
Plans provide coverage for exams, lenses, contact lenses, frames and even LASIK.
| Enrollment Deadline | 18th of month Prior to Effective date |
| Provider Lookup (Davis Vision) | http://www.solsticebenefits.com/provider-search.aspx (Davis Vision) |
| Plan Summary, Services & Co-pays |
In Network Benefits
| Eye Examination inclusive of Dilation (when professionally indicated) | 12 Months |
| Spectacle Lenses | 12 Months |
| Frame | 24 Months |
| Contact Lens Evaluation, Fitting & Follow Up Care | 12 Months |
| Contact Lenses (in lieu of eyeglasses) | 12 Months |
Copayments
| Eye Examination | $10 |
| Spectacle Lenses | $25 |
| Contact Lens Evaluation, Fitting & FollowͲUp Care¹ | $25 |
| Eyeglass Benefit Frame (Average Retail Value) | |
| Non-Collection Frame Allowance (Retail): Up to $150 | Up to $130 Plus a 20% discount on any overage (1) |
| Davis Vision Frame Collection(2) (in lieu of Allowance): | |
| Fashion level Up to $125 | Included |
| Designer level Up to $175 | Included |
| Premier level Up to $225 | $25 copayment |
| Eyeglass Benefit Spectacle Lenses (Average Retail Value) | Member Charges |
|---|---|
| Clear plastic singleͲvision, lined bifocal, trifocal or lenticular lenses (any size or Rx) ($60 to $120) | Included |
| Tinting of Plastic Lenses ($20) | Included |
| Scratch Resistant Coating ($25-$40) | Included |
| Polycarbonate Lenses (Children (3)/ Adults) ($60-$75) | $0 or $30 |
| Ultraviolet Coating ($25-$30) | $12 |
| Anti-Reflective (AR) Coating(Standard/Premium/Ultra) ($50-$125) | $25 / $48 / $60 |
| Progressive Lenses(Standard / Premium / Ultra(4)) ($150-$300) | $50 / $90 / $140 |
| Intermediate-Vision Lenses ($150-$175) | $30 |
| High-Index Lenses ($90-$150) | $55 |
| Polarized Lenses ($95-$110) | $75 |
| Plastic Photosensitive Lenses ($95-150) | $65 |
| Scratch Protection Plan: Single Vision | Multifocal Lenses | $20/$40 |
Contact Lens Benefit (in lieu of eyeglasses)
| Non-Collection Contact Lenses: Materials Allowance | Up to $130 Plus a 15% discount on any overage(1) |
| - Evaluation, Fitting & Follow-Up Care - Standard Lens Types | Included |
| - Evaluation, Fitting & Follow-Up Care - Specialty Lens Types | Up to $60 with an additional 15% discount off any overage |
| Collection Contact Lenses (2) (in lieu of Allowance): Materials | |
| - Disposable | 4 boxes / multi-packs |
| - Planned Replacement | 2 boxes / multi-packs |
| - Evaluation, Fitting & Follow-up Care | Included |
| Medically Necessary Contact Lenses (with prior approval) - Materials, Evaluation, Fitting & Follow-Up Care |
Included |
| Out of Network Reimbursement Schedule | up to: |
|---|---|
| Eye Examination | $40 |
| Frame | Included |
| Scratch Resistant Coating ($25-$40) | $50 |
| Single Vision Lenses | $40 |
| Bifocal/Progressive Lenses | $60 |
| Trifocal Lenses | $80 |
| Lenticular Lenses | $100 |
| Elective Contact Lenses | $105 |
| Medically Necessary CL | $225 |
