Dental Rider Plan Option
Vision HMO Plan for Small Groups from VSP
In network now for 2026
This vision benefit plan for adults only includes 12/12/24 $0 coverage. Review the plan's EOC for full information.
• Exam focuses on your eyes and overall
wellness- includes dilation - $0
• Optional Routine Retinal Screening - Up to $39
• $150.00 allowance towards a frame of your
choice
• 20% savings on the amount over your
allowance *not available at Costco,
Walmart or Sam’s Club $0
• Single vision, lined bifocal, and lined trifocal
lenses
• Members can elect many popular lens
enhancements at additional costs
• Average savings of 25% on lens enhancements
*not available at Costco, Walmart or Sam’s Club
• $150.00 allowance for contacts
• Contact lens exam (fitting and evaluation):
covered in full after copay of up to $60
• Member receives 15% off* contact lens exam
services *not available at Costco, Walmart or Sam’s Club
• Exam - $45
• Lenses:
o Single vision - $30
o Lined Bifocal - $50
o Lined Trifocal - $60
• Frame - $50
• Elective Contact Lenses - $100
(in lieu of lenses and frame)
