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State Vision Plan

EyeMed administers the vision benefits for the State Employee's Group Insurance Program. When plan participants utilize a network provider, the benefit levels are greater. Services provided by an out-of-network provider are paid at a lower benefit level.

Plan participants must submit an EyeMed Claim form for reimbursement when an out-of-network provider is used.

 FY2023 Plan Year

Service In-Network​ ​Out-of-Network​** Frequency​
Eye Exam ​$30 copayment ​$30 allowance ​Once every 12 months
Standard Frames

​$30 copayment (up to $175 retail frame cost; member responsible for balance over $175)

$70 allowance
Once every 24 months​
Vision Lenses*
(single, bifocal and trifocal)
​$30 copayment

​$50 allowance for single vision lenses

$80 allowance for bifocal and trifocal lenses
​Once every 12 months
Contact Lenses
(all contact lenses are in lieu of spectacle lenses)
​$120 allowance ​$120 allowance ​Once every 12 months
* Vision Lenses: Member pays  all optional lens enhancement charges. In-Network providers may offer additional discounts on lens enhancements and multiple pair purchases.
** Out-of-network claims must be filed within one year from the date of service.