Monterey Bay Public Employees Trust Regional Hospitals of Distinction

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Overview of 2012 Vision Benefits provided to
Classified, Confidential/Supervisorial, and
Certificated by Vision Service Plan (V.S.P.)
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Monterey Bay Public Employees TrustOverview of
V.S.P. Vision Benefits Certificated, Classified,
Confidential/Supervisorial
No I.D. Cards. No claim forms.

• Locate a V.S.P. doctor by visiting vsp.com,
  calling 1-800-877-7195, or getting V.S.P.s List
  of Participating Doctors from H. S.B.A. office.
• Make an appointment and tell the doctor you
  are a V.S.P. member.
• Your doctor and V.S.P. will handle the rest.

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Monterey Bay Public Employees TrustOverview of
V.S.P. Vision Benefits Certificated, Classified,
Confidential/Supervisorial
You get the best value from your V.S.P. benefit
when you visit a V.S.P. network doctor. If you
desire not to see a V.S.P. doctor, co-pays still
apply. Youll also receive a lesser benefit and
typically pay more out-of-pocket. You are
required to pay the provider in full at the time
of your appointment and submit a claim to V.S.P.
for partial reimbursement. If you decide to see
a provider not in the network, call V.S.P. first.
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Monterey Bay Public Employees TrustOverview of
V.S.P. Vision Benefits Certificated, Classified,
Confidential/Supervisorial

• Exam
• In-V.S.P.-network One exam covered in full
  every twelve (12) months (15.00 co-pay)
• Out-of-V.S.P.-network Reimbursement up to
  42.00 every twelve (12) months.

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Monterey Bay Public Employees TrustOverview of
V.S.P. Vision Benefits Certificated, Classified,
Confidential/Supervisorial

• Prescription Glasses - Lenses
• In-V.S.P.-network Lenses (single vision,
  lined bifocal, lined trifocal lenses, and tints)
  covered in full every twenty-four (24) months
• Out-of-V.S.P.-network Reimbursement for
  single vision to 40.00, bifocal vision up to
  60.00, trifocal vision up to 80.00, and tints
  up to 5.00 every twenty-four (24) months.

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Monterey Bay Public Employees TrustOverview of
V.S.P. Vision Benefits Certificated, Classified,
Confidential/Supervisorial

• Prescription Glasses - Frames
• In-V.S.P.-network Frame of your choice
  covered up to 115.00 every twenty-four (24)
  months. Plus 20 off any out-of-pocket costs
  every twenty-four (24) months.
• Out-of-V.S.P.-network Reimbursement up to
  45.00 every twenty-four (24) months.

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Monterey Bay Public Employees TrustOverview of
V.S.P. Vision Benefits Certificated, Classified,
Confidential/Supervisorial

• Contacts
• In-V.S.P.-network Your 105.00 allowance
  applies to the cost of your lenses and the
  fitting and evaluation exam every twenty-four
  (24) months, which is in addition to your vision
  exam to insure proper fit (no co-pay).
• Out-of-V.S.P.-network Reimbursement up to
  105.00 every twenty-four (24) months.

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Monterey Bay Public Employees TrustOverview of
V.S.P. Vision Benefits Certificated, Classified,
Confidential/Supervisorial

• Extra Discounts (Prescription Glasses)
• In-V.S.P.-network Up to 20 savings on lens
  extras such as scratch resistant and
  anti-reflective coating and progressives every
  twenty-four (24) months 20 off additional
  prescription glasses and sunglasses every
  twenty-four (24) months.
• Out-of-V.S.P.-network None.

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Monterey Bay Public Employees TrustOverview of
V.S.P. Vision Benefits Certificated, Classified,
Confidential/Supervisorial

• Extra Discounts (Contacts)
• In-V.S.P.-network Exclusive pricing on annual
  supplies of popular brands 15 off cost of
  contact lens exam (fitting and evaluation) every
  twenty-four (24) months.
• Out-of-V.S.P.-network None.

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Monterey Bay Public Employees TrustOverview of
V.S.P. Vision Benefits Certificated, Classified,
Confidential/Supervisorial

• Rates (effective 4/01/2012)
• 22.56 per month (composite rate -- same rate
  for Single, Two-Party, or Full Family).

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Monterey Bay Public Employees TrustOverview of
V.S.P. Vision Benefits Certificated, Classified,
Confidential/Supervisorial

• Disclaimer
• This presentation provides only a general
  overview of your Vision benefits
• For complete information, consult your copy of
  the Overview of V.S.P. Benefits or contact either
  V.S.P. (1-800-877-7195 or www.vsp.com) or Health
  Services Benefit Administrators
  (1-831-757-1711 or 1-888-742-3380).

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