Avesis Vision Calculator 2024
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
Georgia
Hawaii
Iowa
Idaho
Illinois
Indiana
Kansas
Kentucky
Louisiana
Massachusetts
Maryland
Maine
Michigan
Minnesota
Missouri
Mississippi
Montana
North Carolina
North Dakota
Nebraska
New Hampshire
New Jersey
New Mexico
Nevada
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...
Plan A ($10/$10 copay 12 lenses/frames)
Plan B ($10/$15 copay 12 lenses/frames)
Plan C ($10/$25 copay 12 lenses/frames)
Plan D ($10/$10 copay 12 lenses/frames)
Plan E ($10/$15 copay 12 lenses/frames)
Plan F ($10/$25 copay 12 lenses/frames)
Plan A ($10/$10 copay 12/24 lenses/frames)
Plan B ($10/$15 copay 12/24 lenses/frames)
Plan C ($10/$25 copay 12/24 lenses/frames)
Plan D ($10/$10 copay 12/24 lenses/frames)
Plan E ($10/$15 copay 12/24 lenses/frames)
Plan F ($10/$25 copay 12/24 lenses/frames)
Plan A ($10 copay 12 lenses/frames)
Plan B ($15 copay 12 lenses/frames)
Plan C ($10 copay 12 lenses/frames)
Plan D ($15 copay 12 lenses/frames)
Plan A ($10 copay 12/24 lenses/frames)
Plan B ($15 copay 12/24 lenses/frames)
Plan C ($10 copay 12/24 lenses/frames)
Plan D ($15 copay 12/24 lenses/frames)
Contribution:
Please choose...
Employer Paid
Voluntary
Lens Option Package:
L1 (included)
L2
L3
L6
L7
Submit
