CaliforniaChoice offers an outstanding selection of ancillary benefitoptions including Voluntary Vision!

The Vision One Eyecare Program from EyeMed Vision Care offers allCaliforniaChoice members discounts on frames, lenses, and eyeexaminations at any Sears, JCPenney, Target optical centers andparticipating Pearle Vision locations.

The Voluntary Vision Program offers comprehensive vision benefits andprescription eyewear through a vast network of doctors to any or allemployees. Eye exams with $10 copay for eyeglasses and $40 copay forcontact lenses every twelve months.

Easy to UseProviders conveniently located in stores like Sears, JCPenney, participating Pearle VisionCenters* and many others. Simply visit the participating provider closest to you andpresent your I.D. card to verify your eligibility.

FREE

All CaliforniaChoice medical members and theirdependents are eligible for immediate savings:

Save up to 58% on all your eyecare needsUp to 58% savings on frames, 42% on bifocalsand 20% on contact lenses.

Save $5 or $10 on Eye ExaminationsMany participating licensed independentDoctors of Optometry offer $5 discounts offtheir regular exam fees and $10 off theirregular contact lens exam fees.

Premium (monthly) $9.75Employee / Employee + Family $20.75

All CaliforniaChoice members and theirdependents may enroll in the VoluntaryVision Plan.

Comprehensive vision benefitsMembers access quality vision care andprescription eyewear through a vastnetwork of doctors. Out-of-Networkcoverage also available.

Eye Examinations as low as $10 foreyeglasses and $40 for contact lensesIn-Network benefits provide a lowcopayment of only $10 for an eyeglassexam and $40 for a contact lens exam.

Vision One Eyecare Voluntary Vision

VISIONTwo Great Plans

* Some Pearle Vision Centers are franchises and do not participate.

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Voluntary Vision

VISIONTwo Great Plans

Vision One EyecareBenefits

Eye ExaminationsFor eyeglassesContact lenses

FramesAny frame available atprovider location

LensesSingle VisionBifocalTrifocal

Lens OptionsStandard-progressivePolycarbonateScratch-resistant coatingUltraviolet coatingSolid or gradient tintPhotochromic

Anti-reflective coating

Contact Lenses

$ 5 off$10 off

Save 15% off retail at nationwidelocations and use the VisionOne Contact Lens Replacementprogram for additional savingsand convenience.

Employee Cost40% off ofretail price

$ 50$ 70$105

$65$40$15$15$1520% off ofretail price$45

Typical Savings58%56%55%35%

46%42%45%

33%40%40%40%33%25%

30%

$10 copay (1 per 12 months)

$40 copay (1 per 12 months)

In-Network CopayNO COSTUp to $100 retail value(1 per 12 months)

(1 per 12 months)

$10$10$10

(in addition to lens copayment above)$65$40$15$15$15$30

$45

$10

(1 per 12 months, in lieu of lenses andframes up to $100 retail value)

$20 reimbursement$20 reimbursement

Out-of-NetworkReimbursement$30 reimbursementUp to $100 retail value(1 per 12 months)

$20 reimbursement$30 reimbursement$40 reimbursement

Not covered

$50 reimbursement

(1 per 12 months, in lieu of lensesand frames up to $100 retail value)

In-Network Out-of Network

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