Supplemental Vision Insurance

Administered by UMR (Spectera EyeCare)

The chart below provides a brief summary of your optional Vision benefits. Note that you have the ability to receive services through a provider outside of the network. As always, we urge you to stay within the network, as your benefits are greater and your out-of-pocket expenses will be less.

	UMR
	In-Network	Out-of-Network
Frequency of Service
Exams	12 months
Lenses	12 months
Frames	24 months
Contact Lenses	In lieu of complete set of glasses
Benefits
Annual Eye Exam	$10 Copay	$50
Single Vision Lenses	$25 Copay	$48
Lined Bifocal Lenses	$25 Copay	$67
Lined Trifocal Lenses	$25 Copay	$86
Lenticular Lenses	$25 Copay	$126
Frames	Up to $130 retail + 30% discount	$48
Contact Lenses
Fit and Follow-Up Exams
Contact Lenses—Elective	Formulary—Up to 4 boxes* Non-Formulary — Up to $130*	Up to $105
Contact Lenses—Medically Necessary	Covered in full*	Up to $210
Child Age Limit	To age 26

*Materials copay may apply

To learn more, call 800-638-3120, or visit myspectra.com.

30% discount available at most participating in-network provider locations. Please verify all discounts with your provider.

As a Spectra vision plan member, you can save on high-quality hearing aids when you buy them from HealthInnovations. Visit uhchearing.com for more information.