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2021 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, 2021.

State-Sponsored Vision Plans 

Vision Service Plan (Basic)

Vision Service Plan (Basic)
​Level of Coverage​State Share​Employee Share​Total Premium

​Party Code 1

​$8.27

​$0

​$8.27

​Party Code 2

​$8.27

​$0

$​8.27

​Party Code 3

​$8.27

​$0

​$8.27

​Vision Service Plan (Premier)

Vision Service Plan (Premier)
​Level of Coverage​State Share​Employee Share​Total Premium

​Party Code 1

​$8.27

​$8.46

​$16.73

​Party Code 2

​$8.27

​$16.92

$​25.19

​Party Code 3

​$8.27

​$27.24

​$35.51

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