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Hood College Vision Benefits Comparison 7/1/10-6/30/11









Carrier Vision Benefits of America** BlueChoice 13 HMO* BlueChoice Opt Out Plus Open Access B* BluePreferred 12*





In Network Out of Network In Network Out of Network In Network Out of Network In Network Out of Network

www.carefirst.com www.carefirst.com www.carefirst.com

Network of Providers www.visionbenefits.com (Davis network) (Davis network) (Davis network)



12 months for exam & lenses; 12 months for exam 12 months for exam

Frequency 12 months for exam & lenses & frames

24 months for frames & lenses & frames & lenses & frames

$10 copay at

CareFirst vision

center; $25 at

CareFirst physician

Exam 100% $ 40.00 $10 copay N/A office N/A $10 copay $ 33.00

$20 copay for up to

$50 wholesale ($100- $40 copay for up to $40 copay for up to $40 copay for up to

$135 retail). Member $70 retail. You pay $70 retail. You pay $70 retail. You pay

Frames $ 50.00 N/A N/A N/A

receives discount for 90% of the amount 90% of the amount 90% of the amount

more expensive over $70 over $70 over $70

frames.

Single Lenses $20 copay $ 40.00 $35 copay N/A $35 copay N/A $35 copay N/A

Bifocal Lenses $20 copay $ 60.00 $55 copay N/A $55 copay N/A $55 copay N/A

Trifocal Lenses $20 copay $ 90.00 $65 copay N/A $65 copay N/A $65 copay N/A

Lenticular Lenses $20 copay $ 120.00 $110 copay N/A $110 copay N/A $110 copay N/A

Contacts (conventional) $ 150.00 $ 150.00 80% of Retail N/A 80% of Retail N/A 80% of Retail N/A

Contacts (disposable) $ 150.00 $ 150.00 90% of Retail N/A 90% of Retail N/A 90% of Retail N/A

Note: All benefits are reimbursement amounts except where indicated as copays.



* This vision coverage is not a separate election. It is included with the appropriate CareFirst medical/prescription drug plan.





** REMEMBER: If you elected VBA last year, you made a 2-year commitment. If you fail to fulfill your 2-year commitment, you will be 'locked out' of participating in the VBA plan for the next 2 years. If

this is your first time enrolling with VBA, you also will be making a 2-year commitment. If you fail to fulfill your 2-year commitment, you will be 'locked out' of participating in VBA for the following 2 years.



NOTE THERE IS NO VISION COVERAGE IF YOU ELECT THE HSA PLAN



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