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Medical and Prescription Plans Spending Accounts Choosing the Right Medical Plan Waters Wellness Now – with Virgin Pulse! Dental Plan Vision Plan Retiree Health Care Reimbursement Plan Telemedicine with Teladoc Critical Illness Insurance and Accident Insurance Health Advocacy Services Medical Experts by Teladoc Hinge Health for Musculoskeletal Help Livongo for Diabetes or Hypertension Fitness Savings Savory Living for Nutrition Genetic Testing Key Health Definitions
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DEI Benefits

Vision Plan

Waters offers you the EyeMed Vision Plan, which provides routine exams and eye-wear at discounted rates when you receive care within EyeMed’s nationwide Insight Plan H network of vision care providers.

EyeMed Vision Plan Showing in-network pricing only. The full plan summary, including out of network coverage, is located in the Learn – Resource Library of WatersBenefitsNow.com.
Network	INSIGHT Plan H network
Premium	Employee only	$4.31/paycheck (bi-weekly rate) OR $4.67 (semi-monthly rate) ($112.08/year)
	Employee + children	$7.48/paycheck (bi-weekly rate) OR $8.11 (semi-monthly rate) ($194.64/year)
	Employee + spouse/partner	$8.05/paycheck (bi-weekly rate) OR $8.72 (semi-monthly rate) ($209.28/year)
	Family	$11.90/paycheck (bi-weekly rate) OR $12.90 (semi-monthly rate) ($309.60/year)
Routine Eye Exams Once per calendar year	100% covered
Retinal Imaging	Up to $39 copay
Frames Once every other calendar year	First $130, fully covered Balance after $130, 20%/80% coinsurance
Lenses Once per calendar year	Single, Bifocal, Trifocal, Lenticular	$20 copay
	Standard Progressives	$85 copay
		$105-$130 copay
Contacts Once per calendar year Contact Fit and Follow Up Contact Fit and Follow Up	Conventional Standard Premium	First $150, fully covered Balance after $150, 15%/85% coinsurance Up to $40 contact lens fit and two follow up visits 10% off retail price
	Disposable	First $150, fully covered Balance after $150, no coverage
	Medically Necessary	100% Covered
Laser Vision Correction LASIK or PRK from U.S. Laser Network	Retail Price	15% Discount
	Promotional Price	5% discount

For more details, including costs for additional services, out-of-network coverage, and provider search details, review the Vision Plan Summary in the Learn – Resource Library of WatersBenefitsNow.com, or go to www.eyemed.com, or call 1-866-804-0982.

This eGuide is only a brief summary of programs. For any additional information regarding the benefit plans, you can visit the Waters Benefits Now website at WatersBenefitsNow.com, refer to the summary plan descriptions available there, or contact the Waters Benefits Now Call Center at 1-866-994-5111 if you do not have access to a computer as a regular part of your job. In the event of a conflict between this eGuide and the official plan documents, the official plan documents will govern in all cases.