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2019 Vision Plan Premiums

For employees in CoBen, the state share and employee share do not apply. Therefore, the total vision premium will be deducted from your monthly CoBen allowance. The following tables show premiums effective January 1, 2019.

State-Sponsored Vision Plans

Vision Service Plan (Basic)

Vision Service Plan (Basic)
Level of Coverage	State Share	Employee Share	Total Premium
Party Code 1	$8.64	$0	$8.64
Party Code 2	$8.64	$0	$8.64
Party Code 3	$8.64	$0	$8.64

Vision Service Plan (Premier)

Vision Service Plan (Premier)
Level of Coverage	State Share	Employee Share	Total Premium
Party Code 1	$8.64	$8.84	$17.48
Party Code 2	$8.64	$17.68	$26.32
Party Code 3	$8.64	$28.46	$37.10

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