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2022 Retiree Vision Plan Premiums

The premiums shown below are effective January 1, 2022 through December 31, 2024.

​State-Sponsored Vision Plans

Vision Service Plan (Basic)

Vision Service Plan (Basic)
​Level of Coverage​Total Premium
​Party Code 1​$5.82
​​Party Code 2​$11.18
​​Party Code 3​$12.03

Vision Service Plan (Premier)

Vision Service Plan (Premier)
​Level of Coverage​Total Premium
​​Party Code 1​$15.55
​​Party Code 2​$30.66
​​Party Code 3​$33.34
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