Joint Council #28 - Teamsters Vision Benefits

Washington Teamsters Welfare Trust Vision Plan SUMMARY OF VISION PLAN AVAILABLE FOR NEGOTIATION
The following data is for illustrative purposes only. It is NOT intended to be construed as an all inclusive description of the Plan benefits or any limitations/exlusions that may apply. It is not to be used for general distribution purposes or in lieu of a Plan booklet. Every reasonable effort has been made to insure that the following information is accurate as of the date of issue, however, in all cases the applicable Plan booklet (inclusive of all revisions or modifications made subsequent to the latest printed editions) shall govern the eligibility for the benefits payable under all Washington Teamsters Welfare Trust programs. The Board of Trustees retains the right of final determination in questions of interpretation. Click here to see BENEFITS CONTACT INFORMATION AND PHONE NUMBERS.
PLAN EXT
ELIGIBILITY	To determine eligibility, please contact NW Administrators.
	To search for Preferred Providers near you, click here.
SCHEDULE OF BENEFITS	FIRST PAIR OF GLASSES		SECOND PAIR OF GLASSES
	NBN Panel Provider	Non-Panel Provider	NBN Panel Provider	Non-Panel Provider
Deductible	None	None	$10.00	None
Examination	Paid in Full	$35.00	None	None
	A vision examination is provided by the Plan once every 365 days*
Lenses (per pair)
Single Vision	Paid in Full**	$30.00	Paid in Full**	$25.00
Bifocal	Paid in Full**	$40.00	Paid in Full**	$35.00
Trifocal	Paid in Full**	$45.00	Paid in Full**	$40.00
Lenticular	Paid in Full**	$90.00	Paid in Full**	$85.00
	One pair of lenses is provided by the Plan once every 365 days.*		A second pair of lenses is provided once every 365 days*. If not obtained at the time of the first pair, the 365-day period is from the date the second pair of lenses was ordered.

Frames	Paid in Full***	$30.00	Paid in Full***	$25.00
	Frames are provided by the Plan once every 730 days.*		Frames are provided by the Plan once every 730 days.* If not obtained at the time of the first pair, the 730-day period is from the date the second frame was ordered.

Contact Lenses Subnormal	Paid in Full	$200.00	None	None
	Contact lenses (sub-normal) are provided once every 730 days.*
Contact Lenses Elective	$150.00	$90.00	$150.00 (Employee only)	$80.00 (Employee only)
	Must be eligible for exams and lenses. Contact Lenses are in lieu of all other services for 365 days.*		Employee is eligible for a second pair of contact lenses 730 days* after last second pair is ordered, if there is a change in prescription or the lenses are damaged and unusable.
* These time frames are strictly enforced (i.e., to the day). Paid in full means the cost of basic lenses is covered in full. Certyain lense extras such as scratch coat, some tints, progressives, UV filters, special lens edge treatments, etc are not covered. * Paid in full means for the frames selection covered by your Plan, not all frames. Back to top