This page below gives you immediate access to the California group Vision Insurance plan descriptions and
rate guides you will need to help employers and their staff get the information that is easy to understand and use.

VISION INSURANCE PLANS for Small Groups
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Vision Carriers.....   Aetna  |  Anthem Blue Cross  |  Blue Shield  |  UHC  |  VSP
Vision Rate Guide Provider Networks
Company
Name of Plan
Deductible
Frame Allowance
Aetna
Vision


Vision Carriers.....   Aetna  |  Anthem Blue Cross  |  Blue Shield  |  UHC  |  VSP
Vision Applications & Forms Comparison Plans / 2-2012 Vision Rate Guide Provider Networks
Company
Name of Plan
Deductible
Frame Allowance
Anthem
Blue Cross
Blue View...   English - Spanish in-network - $25 /
out-of-network - reimburse up to $49
in-network- up to $125 /
out-of-network - reimburse up to $50
Anthem
Blue Cross
Blue View Plus...   English - Spanish
in-network - $15 /
out-of-network - reimburse up to $49
in-network- up to $125 /
out-of-network - reimburse up to $50
Vision Carriers.....   Aetna  |  Anthem Blue Cross  |  Blue Shield  |  UHC  |  VSP
Vision Rate Guide Provider Networks
Company
Name of Plan
Deductible
Frame Allowance
Blue Shield
Vision Basic 0-100...   English - Spanish
$0
in-network- up to $75 /
out-of-network - $40
Blue Shield
Vision Basic 0-130...   English - Spanish
$0
in-network- up to $130 /
out-of-network - $40
Blue Shield
Vision Basic 10-75...   English - Spanish
$10
in-network- up to $75 /
out-of-network - $40
Blue Shield
Vision Basic 10-130...   English - Spanish
$10
in-network- up to $130 /
out-of-network - $40
Blue Shield
Vision Standard 0-75...   English - Spanish
$0
in-network- up to $75 /
out-of-network - $40
Blue Shield
Vision Standard 0-100...   English - Spanish
$0
in-network- up to $100 /
out-of-network - $40
Blue Shield
Vision Standard 0-130...   English - Spanish
$0
in-network- up to $130 /
out-of-network - $40
Blue Shield
Vision Standard 10-75...   English - Spanish
$10
in-network- up to $75 /
out-of-network - $40
Blue Shield
Vision Standard 10-130...   English - Spanish
$10
in-network- up to $130 /
out-of-network - $40
Blue Shield
Vision Standard 25-75...   English - Spanish
$25
in-network- up to $75 /
out-of-network - $40
Blue Shield
Vision Plus 0-75...   English - Spanish
$0
in-network- up to $75 /
out-of-network - $40
Blue Shield
Vision Plus 0-100...   English - Spanish
$0
in-network- up to $100 /
out-of-network - $40
Blue Shield
Vision Plus 0-130...   English - Spanish
$0
in-network- up to $130 /
out-of-network - $40
Blue Shield
Vision Plus 10-75...   English - Spanish
$10
in-network- up to $75 /
out-of-network - $40
Blue Shield
Vision Plus 10-100...   English - Spanish
$10
in-network- up to $100 /
out-of-network - $40
Blue Shield
Vision Plus 10-130...   English - Spanish
$10
in-network- up to $130 /
out-of-network - $40
Blue Shield
Vision Deluxe 0-100...   English - Spanish
$0
in-network- up to $100 /
out-of-network - $40
Blue Shield
Vision Deluxe 0-130...   English - Spanish
$0
in-network- up to $130 /
out-of-network - $40
Blue Shield
Vision Deluxe 10-100...   English - Spanish
$10
in-network- up to $100 /
out-of-network - $40
Blue Shield
Vision Deluxe 10-130...   English - Spanish
$10


in-network- up to $130 /
out-of-network - $40
Vision Carriers.....   Aetna  |  Anthem Blue Cross  |  Blue Shield  |  UHC  |  VSP
Vision Rate Guide N/A Provider Networks
Company
VISION - Name of Plan
Deductible
Frame Allowance
UHC
Spectera Plan 1
$10
in-network- up to $150 /
out-of-network - $45
UHC
Spectera Plan 2
$10
in-network- up to $150 /
out-of-network - $45
UHC
Spectera Plan 3
$10
in-network- up to $150 /
out-of-network - $45
UHC
Spectera Plan 4
$10

in-network- up to $150 /
out-of-network - $45
Vision Carriers.....   Aetna  |  Anthem Blue Cross  |  Blue Shield  |  UHC  |  VSP
Vision Applications & Forms
Vision Rate Guide N/A Provider Networks
Company
VISION - Name of Plan
Effective
Deductible / Benefits
VSP
Signature Plan A $25
1-2012
Exams - $25 copay every 12 months.
Prescription Glasses - $0 copay (included in exam copay) every 24 months.
Frame - $0 copay (included in exam copay) and up to $150 + 20% off the amount over your allowance.
Lenses - $0 copay (included in exam copay). Eevery 24 months.
Contact Lens - $0 copay, every 12 mo. $150 allowance for contacts and contact lens exam.
VSP
Signature Plan B $25
1-2012
Exams - $25 copay every 12 months.
Prescription Glasses - $0 copay (included in exam copay) every 12 months.
Frame - $0 copay (included in exam copay) and up to $150 + 20% off the amount over your allowance.
Lenses - $0 copay (included in exam copay). Every 24 months.
Contact Lens - $0 copay, every 12 mo. $150 allowance for contacts and contact lens exam.
VSP
Choice Affiliate Plan A $25 / $25
1-2013
Exams - $25 copay every 12 months.
Prescription Glasses - $25 every 24 months.
Frame - $0 copay (included in Prescription Glasses copay). Up to $150 + 20% off the amount over your allowance every 24 months.
Lenses - $0 copay (included in Prescription Glasses copay). Every 24 months.
Contact Lens - $0 copay, every 24 mo. $120 allowance for contacts and contact lens exam. 15% off contact lens exam.
VSP
Choice Affiliate Enhanced Plan B $25
1-2013
Exams - $25 copay every 12 months.
Prescription Glasses - Copay combined with exam, every 12 months.
Frame - $0 copay (combined with exam). Up to $150 + 20% off the amount over your allowance every 24 months.
Lenses - $0 copay (combined with exam). Every 24 months.
Contact Lens - $0 copay, every 12 mo. $150 allowance for contacts and contact lens exam. 15% off contact lens exam.
VSP
Choice Affiliate Plan C $25
1-2013
Exams - $25 copay every 12 months.
Prescription Glasses - Copay combined with exam, every 12 months.
Frame - $0 copay (combined with exam). $150 + 20% off the amount over your allowance every 12 months.
Lenses - $0 copay (combined with exam). Every 12 months.
Contact Lens - $0 copay, every 12 mo. $150 allowance for contacts and contact lens exam. 15% off contact lens exam.
VSP
Voluntary Choice Affiliate Enhanced
Plan B $20 / $20
1-2013
Exams - $20 copay every 12 months.
Prescription Glasses - $20 copay.
Frame - $0 copay (included in Prescription Glasses copay). Up to $150 + 20% off the amount over your allowance every 24 months.
Lenses - $0 copay (included in Prescription Glasses copay). Every 12 months.
Contact Lens - $0 copay, every 12 mo. $120 allowance for contacts and contact lens exam. 15% off contact lens exam.
VSP
Voluntary Choice Affiliate Plan C $25
1-2013
Exams - $25 copay every 12 months.
Prescription Glasses - Copay combined with exam, every 12 months.
Frame - $0 copay (combined with exam). $150 + 20% off the amount over your allowance every 12 months.
Lenses - $0 copay (combined with exam). Every 12 months.
Contact Lens - $0 copay, every 12 mo. $150 allowance for contacts and contact lens exam.
Vision Carriers.....   Aetna  |  Anthem Blue Cross  |  Blue Shield  |  UHC  |  VSP
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