IN-NETWORK BENEFITS

Eye Examination Covered in full

Plan Savings

50% off frames2 (up to $150); 20% thereafter

15% off contacts

15% off contacts evaluation, fitting & follow-up care

GE VISION PLAN

With your vision plan you get a $150 eyewear allowance, a fully-covered in-network eye exam and additional savings every 12 months.

NEED ASSISTANCE?For more details about the plan, just log on to the Open Enrollment section of our Member site atdavisvision.com/GE or call 1 (800) 433-9375. For employees who are outside the U.S., please call our customer service team at 1 (518) 220-6043.

This is only a summary of your benefits. For a complete description, please refer to your GE Benefits Handbook.

Members enrolled in an HMO are only eligible for the GE Vision Value Option.

Visit davisvision.com/GE to locate network providers.

EYEWEAR ALLOWANCE

Glasses & Contacts

$150 Allowance1 -Your $150 allowance can be used toward in-network orout-of-network glasses (frames and lenses) and contacts.(See page 2 for in-network pricing and reimbursement information.)

THE EXCLUSIVE COLLECTION MEMBER MOBILE APPYOUR MEMBER SITE

Log in at davisvision.com/GE to find a list of in-network providers near you and access your benefit information.

The Exclusive Collection of frames is available at close to 9,000 locations across the U.S. Log in to browse frames, upload your picture totry on and find a Collection near you.3

Now your vision benefit detail is as mobile as you are. Key features include provider search with map integration, ID card, claim submission, eligibility and more.

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EXTRA PERKS• If you don’t use all of the $150 allowance on a single

pair of frames during the same visit, the remaining balance can be used on a second pair of glasses.

• 40% - 50% off the national average price of traditional LASIK. A reimbursement of up to $250 per eye ($500 total) is available.

• FREE one-year breakage warranty on all plan-covered eyeglasses (i.e. all spectacle lenses, Exclusive Collection frames and national retailer frames where our Exclusive Collection is not displayed).

Using an in-network provider provides the most value and maximizes your $150 allowance.

Warby Parker is now an in-network provider for GE members! Use your $150 allowance on prescription eyewear, starting at $95. Shop online at warbyparker.com/insurance or at any Warby Parker retail location.

Plan savings, pricing and Davis Vision’s breakage warranty do not apply to transactions at Warby Parker, however, Warby Parker’s one-year no-scratch lens guarantee and 30-day no-questions-asked return or exchange policy do apply!

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IN-NETWORK FRAME & LENS OPTIONS - PRICING SCHEDULE

Exclusive Collection Frames $57

Single Vision Lenses $41

Bifocal Lenses $66

Trifocal Lenses $96

Plastic Lenses $0

Polycarbonate Lenses $30

High-Index Lenses $55

Polarized Lenses $75

Progressive Lenses (Standard / Premium / Ultra) $50 / $90 / $140

Anti-Reflective (AR) Coating (Standard / Premium / Ultra) $35 / $48 / $60

Ultraviolet Coating $12

Tinting of Plastic Lenses (Solid / Gradient) $0

Plastic Photochromic Lenses (Transitions® Signature™) $65

Scratch-Resistant Coating $0

Scratch Protection Plan (Single Vision | Multifocal Lenses) $20 | $40

OUT-OF-NETWORK BENEFITS

You may receive services and eyewear from an out-of-network provider, but you will receive the greatest value and maximize your benefit if you select a provider who participates in the network.

OUT-OF-NETWORK REIMBURSEMENT

Up to $150 toward glasses (frames and lenses) and contacts. (Materials only)

1. Member is responsible for any balance after the $150 allowance has been exhausted. 2. Savings does not apply to frames from The Exclusive Collection. 3. The Davis Vision Exclusive Collection is available at participating providers and is subject to change. Davis Vision has done its best to accurately reflect plan coverage herein. If differences exist between this document and the plan contract, the contract will prevail.

You have $150 to use toward contacts or eyewear, plus special pricing on these in-network options:

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You just pay anything over $150!

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