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2019 Retiree Vision Premiums

​The premiums shown below are effective January 1, 2019.

​State-Sponsored Vision Plans

Vision Service Plan (Basic)

Vision Service Plan (Basic)
​Level of Coverage ​Total Premium
​Party Code 1 ​$7.53
​​Party Code 2 ​$14.62
​​Party Code 3 ​$15.73

Vision Service Plan (Premier)

Vision Service Plan (Premier)
​Level of Coverage ​Total Premium
​​Party Code 1 ​$20.40
​​Party Code 2 ​$40.35
​​Party Code 3 ​$43.89
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