Forvis Mazars offers a vision plan designed to help you maintain your eye health while reducing the cost of routine vision care. This plan is provided by VSP and offers access to a nationwide network of participating providers with discounted rates on eye exams, glasses, and contact lenses. By using in-network providers, you can maximize your benefits and lower your out-of-pocket expenses. If you choose to use an out-of-network provider, reimbursement may be limited and you may be responsible for costs above the plan allowance.
| Exam Only (Base) |
VSP Standard |
VSP Premier |
|
|---|---|---|---|
| Well Vision Exam |
$10 Every calendar year |
$10 Every calendar year |
$10 Every calendar year |
| Contact Lens Fitting & Evaluation | NA |
Up to $60 Every calendar year |
Up to $60 Every calendar year |
|
Frames 20% off amount over your allowance Retail Frame Allowance Featured Frame Brand Allowance (Altair or Marchon frames only) |
NA |
$15 (included in prescription glasses) $130 allowance $150 allowance Every other calendar year |
$15 (included in prescription glasses) $200 allowance $220 allowance Every calendar year |
|
Lenses Single vision, lined bifocal, & lined trifocal lenses Polycarbonate lenses |
NA |
$15 (included in prescription glasses) $0 Every calendar year |
$15 (included in prescription glasses) $0 Every calendar year |
|
Lens Options Standard progressive lenses Anti-Reflective Coating Other Add-Ons & Services |
NA |
$0 Not covered 30% average savings Every calendar year |
$0 $40 30% average savings Every calendar year |
|
Contacts (instead of glasses) Applicable Allowance Co-pay does not apply |
NA |
$100 allowance Every calendar year |
$175 allowance Every calendar year |
|
Contacts: Medically Necessary (NCL) Prior Authorization Required |
NA |
$15 Every calendar year |
$15 Every calendar year |
| LightCare | NA | NA | $200 allowance |
| Your Monthly Premium | $0.00 | $6.14 | $15.56 |
| Exam Only (Base) |
VSP Standard |
VSP Premier |
|
|---|---|---|---|
| Well Vision Exam |
$10 Every calendar year |
$10 Every calendar year |
$10 Every calendar year |
| Contact Lens Fitting & Evaluation | NA |
Up to $60 Every calendar year |
Up to $60 Every calendar year |
|
Frames 20% off amount over your allowance Retail Frame Allowance Featured Frame Brand Allowance (Altair or Marchon frames only) |
NA |
$15 (included in prescription glasses) $130 allowance $150 allowance Every other calendar year |
$15 (included in prescription glasses) $200 allowance $220 allowance Every calendar year |
|
Lenses Single vision, lined bifocal, & lined trifocal lenses Polycarbonate lenses |
NA |
$15 (included in prescription glasses) $0 Every calendar year |
$15 (included in prescription glasses) $0 Every calendar year |
|
Lens Options Standard progressive lenses Anti-Reflective Coating Other Add-Ons & Services |
NA |
$0 Not covered 30% average savings Every calendar year |
$0 $40 30% average savings Every calendar year |
|
Contacts (instead of glasses) Applicable Allowance Co-pay does not apply |
NA |
$100 allowance Every calendar year |
$175 allowance Every calendar year |
|
Contacts: Medically Necessary (NCL) Prior Authorization Required |
NA |
$15 Every calendar year |
$15 Every calendar year |
| LightCare | NA | NA | $200 allowance |
| Your Monthly Premium | $0.00 | $12.28 | $21.51 |
| Exam Only (Base) |
VSP Standard |
VSP Premier |
|
|---|---|---|---|
| Well Vision Exam |
$10 Every calendar year |
$10 Every calendar year |
$10 Every calendar year |
| Contact Lens Fitting & Evaluation | NA |
Up to $60 Every calendar year |
Up to $60 Every calendar year |
|
Frames 20% off amount over your allowance Retail Frame Allowance Featured Frame Brand Allowance (Altair or Marchon frames only) |
NA |
$15 (included in prescription glasses) $130 allowance $150 allowance Every other calendar year |
$15 (included in prescription glasses) $200 allowance $220 allowance Every calendar year |
|
Lenses Single vision, lined bifocal, & lined trifocal lenses Polycarbonate lenses |
NA |
$15 (included in prescription glasses) $0 Every calendar year |
$15 (included in prescription glasses) $0 Every calendar year |
|
Lens Options Standard progressive lenses Anti-Reflective Coating Other Add-Ons & Services |
NA |
$0 Not covered 30% average savings Every calendar year |
$0 $40 30% average savings Every calendar year |
|
Contacts (instead of glasses) Applicable Allowance Co-pay does not apply |
NA |
$100 allowance Every calendar year |
$175 allowance Every calendar year |
|
Contacts: Medically Necessary (NCL) Prior Authorization Required |
NA |
$15 Every calendar year |
$15 Every calendar year |
| LightCare | NA | NA | $200 allowance |
| Your Monthly Premium | $0.00 | $13.16 | $24.80 |
| Exam Only (Base) |
VSP Standard |
VSP Premier |
|
|---|---|---|---|
| Well Vision Exam |
$10 Every calendar year |
$10 Every calendar year |
$10 Every calendar year |
| Contact Lens Fitting & Evaluation | NA |
Up to $60 Every calendar year |
Up to $60 Every calendar year |
|
Frames 20% off amount over your allowance Retail Frame Allowance Featured Frame Brand Allowance (Altair or Marchon frames only) |
NA |
$15 (included in prescription glasses) $130 allowance $150 allowance Every other calendar year |
$15 (included in prescription glasses) $200 allowance $220 allowance Every calendar year |
|
Lenses Single vision, lined bifocal, & lined trifocal lenses Polycarbonate lenses |
NA |
$15 (included in prescription glasses) $0 Every calendar year |
$15 (included in prescription glasses) $0 Every calendar year |
|
Lens Options Standard progressive lenses Anti-Reflective Coating Other Add-Ons & Services |
NA |
$0 Not covered 30% average savings Every calendar year |
$0 $40 30% average savings Every calendar year |
|
Contacts (instead of glasses) Applicable Allowance Co-pay does not apply |
NA |
$100 allowance Every calendar year |
$175 allowance Every calendar year |
|
Contacts: Medically Necessary (NCL) Prior Authorization Required |
NA |
$15 Every calendar year |
$15 Every calendar year |
| LightCare | NA | NA | $200 allowance |
| Your Monthly Premium | $0.00 | $21.02 | $39.48 |
| Employee Portion | Firm's Portion | Monthly Premium | |
|---|---|---|---|
| Employee Only | $0 | $0.66 | $0.66 |
| Employee & Spouse | $0 | $1.29 | $1.29 |
| Employee & Child(ren) | $0 | $1.37 | $1.37 |
| Employee & Family | $0 | $2.20 | $2.20 |
| Exam Only (Base) | |
|---|---|
| Well Vision Exam |
$10 Every calendar year |
| Frames | NA |
| Lenses | NA |
| Contacts (instead of glasses) | NA |
| Contacts: Medically Necessary (NCL) | NA |
| LightCare | NA |
|
Employee Portion |
Firm's Portion |
Monthly Premium |
|
|---|---|---|---|
| Employee Only | $6.14 | $0 | $6.14 |
| Employee & Spouse | $12.28 | $0 | $12.28 |
| Employee & Child(ren) | $13.16 | $0 | $13.16 |
| Employee & Family | $21.02 | $0 | $21.02 |
| VSP Standard | |
|---|---|
| Well Vision Exam |
$10 Every calendar year |
| Contact Lens Fitting & Evaluation |
Up to $60 Every calendar year |
|
Frames 20% off amount over your allowance Retail Frame Allowance Featured Frame Brand Allowance (Altair or Marchon frames only) |
$15 (included in prescription glasses) $130 allowance $150 allowance Every other calendar year |
|
Lenses Single vision, lined bifocal, & lined trifocal lenses Polycarbonate lenses |
$15 (included in prescription glasses) $0 Every calendar year |
|
Lens Options Standard progressive lenses Anti-Reflective Coating Other Add-Ons & Services |
$0 Not covered 30% average savings Every calendar year |
|
Contacts (instead of glasses) Applicable Allowance Co-pay does not apply |
$100 allowance Every calendar year |
|
Contacts: Medically Necessary (NCL) Prior Authorization Required |
$15 Every calendar year |
| LightCare | NA |
| Employee Portion | Firm's Portion | Monthly Premium | |
|---|---|---|---|
| Employee Only | $15.56 | $0 | $15.56 |
| Employee & Spouse | $21.51 | $0 | $21.51 |
| Employee & Child(ren) | $24.80 | $0 | $24.80 |
| Employee & Family | $39.48 | $0 | $39.48 |
| VSP Premier | |
|---|---|
| Well Vision Exam |
$10 Every calendar year |
| Contact Lens Fitting & Evaluation |
Up to $60 Every calendar year |
|
Frames 20% off amount over your allowance Retail Frame Allowance Featured Frame Brand Allowance (Altair or Marchon frames only) |
$15 (included in prescription glasses) $200 allowance $220 allowance Every calendar year |
|
Lenses Single vision, lined bifocal, & lined trifocal lenses Polycarbonate lenses |
$15 (included in prescription glasses) $0 Every calendar year |
|
Lens Options Standard progressive lenses Anti-Reflective Coating Other Add-Ons & Services |
$0 $40 30% average savings Every calendar year |
|
Contacts (instead of glasses) Applicable Allowance Co-pay does not apply |
$175 allowance Every calendar year |
|
Contacts: Medically Necessary (NCL) Prior Authorization Required |
$15 Every calendar year |
| LightCare | $200 allowance |