Common use of Optical Plan Clause in Contracts

Optical Plan. All employees who participate in the UnitedHealthcare plans shall be covered by the Optical rider for their plan. Benefits will be as follows: Vision Benefits UHC Plans Benefits Apply Both In-Network and Out-of-Network Routine Eye Exams Adults: One exam every 12 months with a $10 copay Children: One exam every 12 months with a $10 copay Lenses Adults: Every 24 months, $20 allowance for single lenses, $30 for bifocal, $40 for trifocal and $75 for lenticular Children: Lenses covered in full every 12 months (more frequently if medically necessary) Frames Adults: $30 allowance every 24 months Children: Up to $100 covered in full every 12 months (more frequently if medically necessary). Cost above $100 covered at 60%. Contact Lenses Adults: $75 allowance every 24 months Children: Single purchase of pair of contact lenses or 1 box of contact lenses per eye covered at 100% Child is defined as a member less than age 19. Provider might require payment in full at the time of service. The patient then submits a claim to UnitedHealthcare for reimbursement.

Optical Plan. All employees who participate in the UnitedHealthcare plans shall be covered by the Optical rider for their plan. Benefits will be as follows: Vision Benefits Benefits‌ UHC Plans Benefits Apply Both In-Network and Out-of-Network Network‌ Routine Eye Exams Adults: One exam every 12 months with a $10 copay Children: One exam every 12 months with a $10 copay Lenses Adults: Every 24 months, $20 allowance for single lenses, $30 for bifocal, $40 for trifocal and $75 for lenticular Children: Lenses covered in full every 12 months (more frequently if medically necessary) necessary)‌ Frames Adults: $30 allowance every 24 months Children: Up to $100 covered in full every 12 months (more frequently if medically necessary). Cost above $100 covered at 60%. 60%.‌ Contact Lenses Adults: $75 allowance every 24 months Children: Single purchase of pair of contact lenses or 1 box of contact lenses per eye covered at 100% Child is defined as a member less than age 19. Provider might require payment in full at the time of service. The patient then submits a claim to UnitedHealthcare for reimbursement.