2018 Aflac Incorporated Benefits Guide

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VISION PLAN
EL IGIBI L ITY:
All full- and part-time employees, their legal spouses or registered domestic partners, and eligible dependents
are eligible for coverage on the first day of employment.
YOU SHOULD KNOW:
➤➤Vision plan coverage is offered by VSP.
➤➤From annual eye exams to benefits for glasses and contacts, the Aflac vision plan expands the scope of benefits for you and
your family. This stand-alone plan offers options and services that may not be available through your health plan coverage.
You may enroll in the vision plan even if you do not participate in the Aflac Health Plan coverage available to you.
➤➤Freedom of choice: The vision plan offers you the freedom to use in-network or out-of-network care providers. Benefits
are greater when you use providers who participate in the VSP Choice Network. See the directory of vision care
providers under Find a VSP Doctor at .
➤➤Service frequency: The plan covers an annual eye exam and lenses (including contacts) once every 12 months and frames
once every 24 months. Benefit periods are measured from the date you last had the same type of service.
➤➤Winning team: The plan is administered by Ameritas in partnership with VSP Vision Care, the nation’s largest provider of eye
care coverage.
Coverage
VSP Choice Network
In-Network Out-of-Network
Deductibles • $10 per exam
• $25 for eyeglass lenses or frames 1
• $10 per exam
• $25 for eyeglass lenses or
frames1
Maximum benefit (per calendar year) None None
Frequency of coverage
➤➤Exam
➤➤Lenses
➤➤Frames
Once every 12 months2
Once every 12 months2
Once every 24 months2
Once every 12 months2
Once every 12 months2
Once every 24 months2
Plan pays:
Eye exam (each 12 months) Covered in full 3 Up to $524
Lenses (one pair, each 12 months)
➤➤Single vision
➤➤Bifocal
➤➤Trifocal
➤➤Lenticular
➤➤Progressive
➤➤Contacts
• Elective
• Medically necessary
• Fit and follow-up exams
Covered in full 3
Covered in full 3
Covered in full 3
Covered in full 3
See lens options on the next page.
Up to $1803 (See Benefits for Contact Lenses on the next page.)
Covered in full 3
15% discount
Up to $554
Up to $754
Up to $954
Up to $1254
Not covered
Up to $1054
Up to $2104
Not covered
Frames (each 24 months) $180,3 plus 20% discount off any remaining cost Up to $704
Additional pair of glasses 20% discount Not covered
Low vision (every 24 months) 75% of preapproved amount,5 up to $1,000 maximum benefit Not covered
1 The deductible applies to a complete pair of glasses or frames,
whichever is selected.
2 Beginning from your previous use of this service.
3 After you meet the applicable in-network annual deductible.
4 After you meet the applicable out-of-network annual deductible.
5 Call VSP for preapproval requirements.
How to Apply for
Aflac Coverage