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2020 Retiree Vision Plan Premiums

​The premiums shown below are effective January 1, 2020.

​State-Sponsored Vision Plans

Vision Service Plan (Basic)

Vision Service Plan (Basic)
​Level of Coverage​Total Premium
​Party Code 1​$6.41
​​Party Code 2​$12.37
​​Party Code 3​$13.31

Vision Service Plan (Premier)

Vision Service Plan (Premier)
​Level of Coverage​Total Premium
​​Party Code 1​$17.23
​​Party Code 2​$34.02
​​Party Code 3​$36.99
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