Vision

Vision Plan Specifications

Eligible family members are spouse or children.  This is a stand-alone vision plan through BlueCross & BlueShield of MN.  You can enroll family members in the vision plan who are not in your BlueCross & BlueShield health plan  or vice versa.  

Eyewear Only
Voluntary monthly premiums (3-Tier)

    
Employee    $5.85
Employee ♦ one family member    $10.96
Employee ♦ two or more family members    $16.85

Eligible family members include spouse and children under 26 years of age.

No Printer?  Electronic Signature Instructions

Vision Enrollment Form

Hint:  If you are enrolling two or more family members, don't limit enrollment to only those family members who wear glasses/contacts.  It will not cost any more in premium to cover all your eligible family members who may at some point in the future have need for eyewear.