VISION PLAN VSP CHOICE NETWORK In-Network Out-of-NetworkReimbursement EyeExam $10copayfor yearly examination Routine Retinal Screening no more than $39 Frames Allowance $200frame allowance; 20% savings on balance after allowance Lenses &Enhancements SingleVision $20copay LinedBifocal $20 copay Lined TrifocalLenses $20copay StandardProgressive Progressive Premium Tiers 1 – 3 Progressive Premium Tier 4 ContactLenses DisposableContacts ConventionalContacts Medically NecessaryContacts 13 // 2023 Employee BenefitGuide download: vision summary of benefits (SOB)