Active Health Summary Plan Description
As of September 1, 2017
En Español (PDF)

10.6 Limitations

Extra Cost. This Plan is designed to cover your visual needs rather than cosmetic materials. If you select any of the following there will be an extra charge:

  1. Blended lenses;
  2. Contact lenses (except as noted elsewhere herein);
  3. Oversize lenses;
  4. Progressive multifocal lenses;
  5. Photochromic lenses or tinted lenses other than Pink #1 or #2;
  6. Coated lenses;
  7. Laminated Lenses;
  8. A frame that costs more than the Plan allowance;
  9. Certain limitations on low vision care;
  10. Cosmetic lenses;
  11. Optional cosmetic processes; or
  12. UV protected lenses.

Not Covered. There is no benefit for professional services or materials connected with:

  1. Orthoptics or vision training and any associated supplemental testing.
  2. Plano lenses (non-prescription).
  3. Two (2) pair of glasses in lieu of bifocals.
  4. Lenses and frames furnished under this program which are lost or broken will not be replaced except at the normal intervals when services are otherwise available.
  5. Medical or surgical treatment of the eyes.
  6. Any eye examination, or any corrective eyewear, required by an Employer as a condition of employment.
  7. Corrective vision services, treatments, and materials of an experimental nature.