Vision Insurance

Offering low or no out-of-pocket costs for eye exams, eyeglasses and contact lenses when services are rendered by a participating provider.  If using a non-participating provider or supplier, reimbursement up to the plan allowance. Claim forms required.  

Benefits available once yearly from date of last service/treatment.

All completed forms/applications should be sent to Bollinger at:

Bollinger
400 Market St. Suite 450
Philadelphia, PA 19106
Fax: 215-351-9012
Email: PICPA@BollingerInsurance.com

PLEASE NOTE: Benefits for this plan are based on a service date basis.

Forms and Documents

Brochure
A Guide to your Vision Benefits

Application
Application / Change Form

Letter & Rates
Block Vision Rate Letter
Find a Provider
Retail Chains in Network
Personal Liason Contact
Claim Form-Out of network Provider