Individuals
Couple
Family
Enrollment Fee
Monthly Premiums
Individuals
: $35
Couple
: $60
Family
: $95
Enrollment Fee: $16
Annual Premiums
Individuals
: $420
Couple
: $720
Family
: $1,140
Enrollment Fee: Waived
Emerald Dental/Vision
Annual Co-Payment
Complete Eye Exam
Standard Single Vision Lenses
Lined Bi-Focals
Lined Tri-Focals
Generic Progressive Lenses
Thin Lenses
Tint #1 Plastic Lenses Only
Scratchcote
Frames
Contact Lenses
LASIK
Additional Benefits
Vision Benefits
Annual Co-Payment
: $25 per person
Complete Eye Exam
: No Charge After Annual Copay
Standard Single Vision Lenses
: No Charge
Lined Bi-Focals
: No Charge
Lined Tri-Focals
: No Charge
Generic Progressive Lenses
: 20% Off
Thin Lenses
: $45-$60
Tint #1 Plastic Lenses Only
: No Charge
Scratchcote
: $22
Frames
: $100 Allowance
Office Visit
Oral Exam
X-Rays
Porcelain Crown
Cleaning
Ant. Root Canal (EFR)
Amalgam One Surface Filling
Denture Upper or Lower
Other Dental Procedures
Dental Benefits
Office Visit
: No Charge
Oral Exam
: No Charge
X-Rays
: No Charge
Porcelain Crown
: $145
Cleaning
: No Charge
Ant. Root Canal (EFR)
: $90
Amalgam One Surface Filling
: $10
Denture Upper or Lower
: $220