The vision benefit is a fully insured vision benefit provided through Superior Vision. For the highest level of benefits please use an in-network provider. The City of Lewisville participates in the Superior Select Southwest Network. The waiting period for eligible employees and their dependents, if elected, is 30 days from date of hire.

Deductions for vision premiums are taken 24 times per year or less depending on your effective date.

Vision Premiums

Coverage level	Per month
Employee only	$0.00
Employee + spouse	$3.75
Employee + child(ren)	$3.65
Employee + family	$8.05

 

Benefits	in-network	out-of-network
Vision Exam:
Exam with Dilation	$15 copay	$35 allowance
Lenses:
Single     Bifocal     Trifocal	$20 copay; then 100% $20 copay; then 100% $20 copay; then 100%	$25 allowance $40 allowance $45 allowance
Contact Lenses
Elective     Medically Necessary	$125 allowance $20 copay; then 100%	$80 allowance $150 allowance
Frequency:
Examination     Lenses or Contact Lenses     Frame	Once every 12 months Once every 12 months Once every 12 months	Once every 12 months Once every 12 months Once every 12 months