KEHP_2025_BSG.pdf — PaddleOCR-VL (Baidu)

Anthem Optional Vision Insurance

You may choose optional employer-sponsored, employee-paid, vision insurance administered by Anthem. Routine eye checkups are about more than making sure you can see clearly. They're also important to overall health, safety, and learning. Even if you can see well, regular eye exams are important to help keep your eyes healthy — and catch other health problems early.1

With Blue View VisionSM, you have access to one of the country's largest networks of eye doctors and eye-care retailers. This makes it easy to get eye care at the best time for you.

	Bronze3	Silver3	Gold3
Exam with dilation as necessary	10 co-pay	10 co-pay	10 co-pay
Frames	125 allowance and 20% off any remaining balance	150 allowance and 20% off any remaining balance	150 allowance and 20% off any remaining balance
Eyeglass lenses: single vision, bifocal, trifocal, lenticular	25 co-pay	10 co-pay	10 co-pay
Standard progressive lens	Standard fixed price/discount	Standard fixed price/discount	20 co-pay
Contact lenses
Conventional	150 allowance, 15% off balance over 150	150 allowance, 15% off balance over 150	175 allowance, 15% off balance over 175
Disposable	150 allowance	150 allowance	175 allowance
Medically necessary	Covered in full	Covered in full	Covered in full
Frequency
Examination	Once every calendar year	Once every calendar year	Once every calendar year
Lenses or contact lenses	Once every calendar year	Once every calendar year	Once every calendar year
Frame	Once every two calendar years	Once every two calendar years	Once every calendar year

43,000 eye doctors in the Insight Network.2
31,000 locations.2
Online shopping at Glasses.com, ContactsDirect.com, Lencrafters.com, Targetoptical.com, ray-ban.com/insurance, Oakley.com and 1-800 CONTACTS®.
National network of optical retail stores like LensCrafters\circledR, Target Optical\circledR, and most Pearle Vision\circledR stores.

Monthly Rates	Bronze	Silver	Gold
Employee only	$5.52	$6.46	$13.12
Employee + spouse	$10.94	$12.80	$26.14
Employee + child(ren)	$11.22	$13.12	$26.80
Family	$16.64	$19.48	$39.82

Your vision benefits cover:
Adult routine eye exam.
Frames and either eyeglass lenses or contact lenses for adults.
Pediatric routine eye exams.
Frames and either eyeglass lenses or contact lenses for covered children up to age 26. For children up to age 21, UV-blocking Transitions\circledR lenses are included to protect their eyes from harmful UV rays and impact-resistant polycarbonate lenses at no extra cost.
Factory scratch coating on standard eyeglass lenses.

1 American Optometric Association, Evidence-Based Clinical Practice Guideline, Comprehensive Adult Eye and Vision Examination 2015 (accessed July 2023): aoa.org. 2 Zelis Network360® data, January 2023.

3 In-network rates for each tier, out-of-network reimbursement limitations may apply.