Base Plan (Davis) Buy-Up Plan (VSP) Exam $0 copay $0 copay Glasses Lenses $0 copay $0 copay (Single / Bifocal/ Trifocal / Lenticular) Glasses Frames $0 retail frame allowance $0 retail frame allowance +10% off remaining balance +10% off remaining balance Contact Lenses $0 copay / $0 copay / (Medically Necessary / Elective) $0 copay with $0 retail allowance $0 retail allowance Each material benefit is paid out once per calendar year.
ACME Benefits Guide Page 22 Page 24