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Midsize and Large Group Vision Benefit Summaries
These benefit summaries are for groups of 51 or more employees. For benefit summaries prior to July 1, 2009, please contact your Blue Shield sales representative or visit the closed plans page.
 
When providing a benefit summary to an applicant or Blue Shield member, you must also include a Notice of Language Assistance(PDF, 1MB)
Core Flex Vision Plans
Plan Name Download Size
Core Flex Vision Standard 0/25/75

English
Spanish
Chinese
Vietnamese

73KB
65KB
369KB
208KB

Core Flex Vision Plus 0/10/100

English
Spanish
Chinese
Vietnamese

72KB
65KB
373KB
207KB

Core Flex Vision Deluxe 0/0/130

English
Spanish
Chinese
Vietnamese

75KB
85KB
377KB
204KB

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Blue Shield Vision Benefit Summaries
Plan Name Download Size
Blue Shield Vision Eye Exam Only Plan

English
Spanish
Chinese
Vietnamese

59KB
57KB
283KB
214KB

Vision Basic 0/0/130

English
Spanish
Chinese
Vietnamese

60KB
64KB
358KB
226KB

Vision Basic 0/15/120

English
Spanish
Chinese
Vietnamese

59KB
61KB
355KB
204KB
Vision Basic 0/25/100

English
Spanish
Chinese
Vietnamese

59KB
62KB
357KB
220KB

Vision Basic Plus 0/15/120

English
Spanish
Chinese
Vietnamese

59KB
62KB
249KB
180KB

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Blue Shield Life Vision Benefit Summaries
Plan Name Download Size
Blue Shield Life Vision Eye Exam Only Plan

English
Spanish
Chinese
Vietnamese

60KB
63KB
326KB
219KB
Vision Basic 0/0/130 English
Spanish
Chinese
Vietnamese
67KB
65KB
384KB
226KB
Vision Basic 0/15/120 English
Spanish
Chinese
Vietnamese
69KB
62KB
384KB
186KB
Vision Basic 0/25/100 English
Spanish
Chinese
Vietnamese
65KB
62KB
386KB
232KB
Vision Basic Plus 0/15/120 English
Spanish
Chinese
Vietnamese
65KB
62KB
380KB
184KB
Vision Standard 0/0/100 English
Spanish
Chinese
Vietnamese

64KB
66KB
386KB
236KB

Vision Standard 0/0/130

English
Spanish
Chinese
Vietnamese

67KB
67KB
380KB
208KB

Vision Standard 0/15/120

English
Spanish
Chinese
Vietnamese

66KB
62KB
380KB
197KB

Vision Standard 0/15/130

English
Spanish
Chinese
Vietnamese

67KB
67KB
391KB
203KB

Vision Standard 0/25/100

English
Spanish
Chinese
Vietnamese

65KB
65KB
387KB
228KB

Vision Standard 0/25/120

English
Spanish
Chinese
Vietnamese

65KB
64KB
386KB
227KB

Vision Standard 0/25/130

English
Spanish
Chinese
Vietnamese

67KB
66KB
232KB
232KB

Vision Standard Voluntary 0/25/120

English
Spanish
Chinese
Vietnamese

66KB
65KB
400KB
231KB
Vision Plus 0/0/100

English
Spanish
Chinese
Vietnamese

63KB
64KB
373KB
185KB
Vision Plus 0/0/130 English
Spanish
Chinese
Vietnamese
66KB
65KB
439KB
207KB
Vision Plus 0/15/120 English
Spanish
Chinese
Vietnamese
64KB
64KB
400KB
228KB
Vision Plus 0/15/130 English
Spanish
Chinese
Vietnamese
67KB
66KB
407KB
231KB
Vision Plus 0/25/100 English
Spanish
Chinese
Vietnamese
65KB
64KB
400KB
227KB
Vision Plus 0/25/120 English
Spanish
Chinese
Vietnamese
64KB
64KB
400KB
225KB
Vision Plus 0/25/130 English
Spanish
Chinese
Vietnamese
67KB
66KB
404KB
187KB
Vision Deluxe 0/0/100

English
Spanish
Chinese
Vietnamese

63KB
65KB
377KB
228KB

Vision Deluxe 0/0/130

English
Spanish
Chinese
Vietnamese

66KB
66KB
377KB
185KB

Vision Deluxe 0/15/120 English
Spanish
Chinese
Vietnamese
65KB
62KB
397KB
186KB
Vision Deluxe 0/15/130 English
Spanish
Chinese
Vietnamese
67KB
66KB
405KB
229KB
Vision Deluxe 0/25/100 English
Spanish
Chinese
Vietnamese
65KB
62KB
398KB
185KB
Vision Deluxe 0/25/120 English
Spanish
Chinese
Vietnamese
65KB
62KB
398KB
185KB
Vision Deluxe 0/25/130 English
Spanish
Chinese
Vietnamese

67KB
63KB
385KB
385KB

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Other forms
Name Download Size
Find a vision proposal

Get a Quote

N/A

Vision claim form

English

73KB

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