LSU System Vision Plan

Employees may enroll during the first 30 days of employment and each year thereafter during the Annual Enrollment period in April. Coverage is effective the first of the month following 30 days of employment.

Eligibility

Employees appointed to work a minimum of 30 hours (75%) or more per week are eligible to participate in the Vision Plan. Dependents are also eligible for coverage. Premiums are available for tax sheltering under the Cafeteria Plan. Once enrolled, coverage can only be canceled annually during the Open Enrollment period.

Services

The "Always Vision" Plan pays for many routine vision care expenses. The program allows you to access benefits at a nationwide network including Wal-Mart vision centers, independent optometrists, and ophthalmologists, and retail chains such as Sears, JC Penney, Vision Plaza, and Eyemasters.

Vision Benefit Summary

	Wal-Mart Vision Centers	Providers (Participating Independent Optometrists, Ophthalmologists, Retail Outlets)	Out-of-Network Allowance
Exam	$10 Co-pay	$10 Co-pay	Up to $30
Materials	$0 Co-pay	$15 Co-pay	See below
Standard Plastic Lenses:
Single Vision	Covered	Covered by $15 Co-pay	Up to $25
Bifocal	Covered	Covered by $15 Co-pay	Up to $40
Trifocal	Covered	Covered by $15 Co-pay	Up to $50
Lenticular	$80 Allowance	$80 Allowance	Up to $50
Progressive	$70 Allowance	$70 Allowance	Up to $40

Lens Options:
Scratch Resistant Coating	Covered	N/A	N/A
Polycarbonate Lenses for Children	Covered	N/A	N/A
Frames: Members choose from any frame available at provider locations	No Co-pay Up to $74 retail allowance, depending on plan selected. $74 covers two-thirds of frames available at Wal-Mart.	A minimum $100 retail frame (retail amount may vary at some providers). Covers a wide selection of frames.	Up to $40 retail
Contact Lenses	No Co-pay	After $15 Co-pay	Up to $130 retail
Includes fit, follow-up, and materials

Elective Comprehensive Plan Allowance	Up to $130 retail	Up to $130 retail	Up to $130 retail
Medically necessary lenses	Up to $210 retail	Up to $210 retail	Up to $210 retail
Laser Vision Correction	20% discount on LASIK or PRK retail prices with participating providers

Frequency

Examination	Once every 12 months
Spectacle Lenses	Once every 12 months
Frames	Once every 12 months
Contact Lenses	Once every 12 months

Premiums

Premiums	Bi-Weekly	Monthly
Employee Only	$4.15	$8.29
Employee & Spouse	$6.98	$13.96
Employee & Children	$7.13	$14.26
Family	$11.49	$22.98

To find a provider, members can visit www.AlwaysVision.com or call 1-888-729-5433.

For more information on the plan and its limitations and exclusions or the enrollment or waiver form, please click here.