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Population: New or Prospective Non-Represented

Benefit Details

Vision Coverage

PSEG does not offer a separate vision plan. However, certain vision expenses are eligible for reimbursement under the programs listed below.

Lasik Vision Benefit

There is a maximum lifetime benefit of $1,000 per employee and each eligible dependent for Lasik eye surgery or an equivalent procedure for the improvement of vision. No deductible or coinsurance applies to this benefit.

You pay for the cost of the procedure at the time of service, then fill out the Lasik Eye Surgery Benefits claim form, attach any receipts, and mail them to the address on the form.

For a more detailed description of your benefits, see Lasik Vision Benefits under the Medical Benefits Program section of the Benefits 2000 Non-Represented summary plan description.

Dental/Vision Option

If you are enrolled in the Dental/Vision option under the Benefits 2000 Dental Benefits Program, you and your family have coverage for both dental and vision expenses. For vision coverage, you have the freedom to visit any provider you choose. The following are the combined benefits for the dental/vision option:

Dental/Vision Option

Plan Pays
  • First $250 of Family's Covered Expenses:

100%
  • Next $1,500 of Family's Covered Expenses:

80%
  • Maximum Covered Vision Expenses:

$300 per family, per year
  • Maximum Total Annual Reimbursement (for combined dental and vision expenses):

$1,450 per year (on $1,750 of eligible expenses)

Please note: You cannot submit more than $300 in vision expenses per family each year for reimbursement under this option.

Medical Options

If you are enrolled in an medical coverage under the Benefits 2000 Medical Benefits Program, vision coverage is outlined below:

Horizon Traditional Deductible

Although there is no coverage for hardware or routine exams, one pair of contact lenses is covered following cataract surgery.

Horizon POS In- and Out-of-Network

Although there is no coverage for hardware or routine exams, one pair of contact lenses is covered following cataract surgery.

Aetna HMO

Plan Pays

  • Routine eye exam from a participating optometrist or ophthalmologist (no referral required): (frequency based on patient age and whether or not he/she currently wears glasses; contact Aetna for more details)

100% after copay
  • Lens reimbursement and discount program:

$70 every 24 months
  • One pair of contact lenses following cataract surgery

100%

Horizon HMO—NJ

Plan Pays

  • Annual routine eye exam from a participating optometrist or ophthalmologist (no referral required):

100% after copay
  • Lens reimbursement and discount program:

$50 every 24 months
  • One pair of contact lenses following cataract surgery:

100%


Horizon EPO—Albany Area

Plan Pays

  • One routine eye exam every 24 months:

100% after copay
  • One pair of frames and lenses once every 24 months:

Frames: $25
Single vision lenses: $30
Double vision lenses: $50
Triple vision lenses: $60
Contacts: $75
  • One pair of contact lenses following cataract surgery:

80%

Horizon EPO—CT

Plan Pays

  • Routine eye exam (includes refraction):
    • Annually for children through age 18; and
    • Once every 2 calendar years for adults age 19 and over
    Includes medical care to treat injury or illness to the eye

100% after copay
  • Visits for treatment of injury/illness to the eye:

100% after copay