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Vision
Principal

Vision PPO


Principal Vision utilizes one of the largest vision care networks in the industry, offering you a wide selection of experienced Ophthalmologists, Optometrists, and Opticians through VSP.

The network includes convenient retail locations including Costco Optical, Visionworks, Clarkson Eyecare, Shopko Eyecare Center, Visioncare Associates, Rxoptical and more.

Referrals: Not Required

Out of Network Benefits: Available
You simply get an allowance toward services and you pay the rest. Just pay in full at the time of service, and then file a claim for reimbursement.

To locate a network provider, visit: www.vsp.com

vsp
Principal
Vision PPO Plan
Network: VSP Choice
Group:1092308
Member Services:
(800) 877-7195 		 In Network Out of
Network
Copay

Examination

Materials 		 

$10

$10 		 

$45 allowance

See below
Benefit Frequency
Examination
Lenses
Frames 		 
Every 12 months
Every 12 months
Every 12 months
Lenses

Single Vision
Bifocal
Trifocal
Lenticular 		 

100%
100%
100%
100% 		 

$30 allowance
$50 allowance
$65 allowance
$100 allowance
Contact Lenses
(in place of lenses)

Elective

Medically Necessary 		 


$150 allowance

100% 		 


$105 allowance

$210 allowance
Frames $150 allowance +
20% off balance		 $70 allowance