SafeGuard Vision
PLAN43 - VOLUNTARY
Vision Examps: Every 12 months
Spectacle Lenses: Every 24 months
Frame (retail allowance): Every 24 months - $85
Medically necessary contact lenses: Every 24 months up to $250
Non-Medically necessary (cosmetic) contact lenses: Up to $120
EXAM DEDUCTIBLE: $10.00 co-pay
MATERIALS: $25.00 co-pay
RATES:
Employee only: $7.74/month
Employee and spouse: $13.86
Employee and two dependents: $19.27
For a list of plan providers, go to www.safeguard.net or
call 800-880-1800
If you should have a questions, need a brochure and application, please
call the benefits administrator, at (310) 945-5648
**RATES AND BENEFITS ARE SUBJECT TO CHANGE AND EMPLOYEES WILL BE INFORMED**