Avesis Vision Calculator
Please complete the form below to create a quote.
Agent/Agency Information
Name:
Email:
Phone Number:
Group Information
Employer Name:
State:
Please choose...
Alaska
Alabama
Arkansas
Arizona
California
Colorado
Connecticut
District of Columbia
Delaware
Florida
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Iowa
Idaho
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Indiana
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Maryland
Maine
Michigan
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Mississippi
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Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Virginia
Vermont
Wisconsin
West Virginia
Wyoming
Zip Code:
Plan Design
Choose a Plan:
Please choose...
Materials Only $0 copay 12/12 lenses/frame
Materials Only $10 copay 12/12 lenses/frame
Materials Only $25 copay 12/12 lenses/frame
Materials Only $0 copay 12/24 lenses/frame
Materials Only $10 copay 12/24 lenses/frame
Materials Only $25 copay 12/24 lenses/frame
Exam + Materials $10/$0 copay 12/12/12 exam/lenses/frame
Exam + Materials $10/$10 copay 12/12/12 exam/lenses/frame
Exam + Materials $10/$25 copay 12/12/12 exam/lenses/frame
Exam + Materials $10/$0 copay 12/12/24 exam/lenses/frame
Exam + Materials $10/$10 copay 12/12/24 exam/lenses/frame
Exam + Materials $10/$25 copay 12/12/24 exam/lenses/frame
Contribution:
Please choose...
75%-100% Contribution (Employer Paid)
50%-74% Contribution (Contributory)
0%-49% Contribution (Voluntary)
Rate Tiers:
Please choose...
Employee Only, Employee + One, Employee + Family
Employee Only, Employee + Spouse, Employee + Child(ren), Employee + Family
Lens Option Package:
L1 (included)
L2
L3
L6
L7
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