BENEFITS CENTER
Vision Benefits
Review the available Platinum Control vision benefit coverage below.
RESOURCES
DOCUMENT
Vision Plan
PROVIDER
BlueCross BlueShield — MTBCP019
WAITING PERIOD
1st of month following 30 days
COST BREAKDOWN
Employee Only
Per Paycheck $0.00
TOTAL / YR EMPLOYER EMPLOYER
$121.42 $121.42 $0.00
Employee + Child(ren)
Per Paycheck $3.10
TOTAL / YR EMPLOYER EMPLOYER
$202.02 $121.42 $80.60
CALL
Employee + Spouse
Per Paycheck $3.82
TOTAL / YR EMPLOYER EMPLOYER
$220.74 $121.42 $99.32
Employee + Family
Per Paycheck $6.93