Forms & publications

This document briefly compares the per-visit costs of some benefits for SEBB vision plans. The figures listed in the comparison show what you pay for in-network services, with the amount up to which you would be reimbursed for out-of-network services in parentheses. If anything in these charts conflicts with the vision plan’s Certificate of Coverage (COC), the COC takes precedence. For information on specific benefits and exclusions, refer to the plan’s COC or contact the plan.