Visit vsp.com or call 800.877.7195for more details on your visioncoverage and exclusive savings and promotions for VSP members.

CIS Benefits and VSP® Vision Care provide you an affordable eye care plan.

Using your VSP benefit is easy.• Register at vsp.com. Once your plan is effective,

review your benefit information.

• Find an eye care provider who’s right for you. The decision is yours to make—choose a VSP doctor, a participating retail chain, or any out-of-network provider. To find a VSP provider, visit vsp.com or call 800.877.7195.

• At your appointment, tell them you have VSP. There’s no ID card necessary. If you’d like a card as a reference, you can print one on vsp.com.

That’s it! We’ll handle the rest—there are no claim forms to complete when you see a VSP provider.

Eye Exams for Children80% of what we learn is through our eyes. Many states require that children get a comprehensive eye exam before Kindergarten. Schedule an eye exam for your child at the beginning of every school year and start the year off right. Visit vsp.com to find a VSP provider that specializes in child eye care.

Choice in EyewearFrom classic styles to the latest designer frames, you’ll find hundreds of options. Choose from featured frame brands, like Anne Klein, bebe®, Calvin Klein, Flexon®, Lacoste, Nike, Nine West, and more1. Visit vsp.com to find a provider who carries these brands.

Plan Information

VSP Provider Network: VSP SignatureVSP Coverage Effective Date: 01/01/2016 - 12/31/2016

Benefit Description CopayYour Coverage with VSP Providers

WellVision Exam®

• Focuses on your eyes and overall wellness• Every other calendar year - Adults• Every calendar year - Children

$0

Prescription Glasses

Frame

• $120 allowance on a wide selection of frames• 20% savings on the amount over your

allowance• Every other calendar year

$0

Lenses

• Single vision, lined bifocal, and lined trifocal lenses

• Progressive lenses• Polycarbonate lenses covered for

dependent children• Every other calendar year - Adults• Every calendar year - Children

$0

$50$0

Lens Enhancements

• Average savings of 35% - 40% on lens enhancements

Contacts (instead of glasses)

• $166 allowance for contacts and contact lens exam (fitting and evaluation)

• 15% savings on a contact lens exam (fitting and evaluation)

• Every other calendar year - Adults• Every calendar year - Children

$0

Extra Savings

Glasses and Sunglasses• 30% off additional glasses and sunglasses, including lens

enhancements, from the same VSP provider on the same day as your WellVision Exam. Or get 20% off from any VSP provider within 12 months of your last WellVision Exam

Laser Vision Correction• Average 15% off the regular price or 5% off the

promotional price; discounts only available from contracted facilities

• After surgery, use your frame allowance (if eligible,) for sunglasses from any VSP doctor

Your Coverage with Out-of-Network Providers

If you see a non-participating provider, visit vsp.com for details or to submit a claim online. All claims must be submitted within one year from the date of service. If not filing a claim online, send an itemized receipt with employee name, DOB, last 4 digits of SS#, patient name and DOB to: VSP, PO Box 997105, Sacramento, CA 95899-7105. Keep a copy for your records.

Exam ......................................... up to $71 LensesSingle Vision ...................... up to $51Lined Bifocal ..................... up to $77Lined Trifocal .................. up to $100

Frame ................................... up to $66Contacts ........................... up to $166

VSP guarantees coverage from VSP network providers only. Coverage information is subject to change. In the event of a conflict between this information and your organization’s contract with VSP, the terms of the contract will prevail. Based on applicable laws, benefits may vary by location.

VSP provides vision claims payment services only and does not assume financial risk or obligation with respect to payment of claims. 1. Brands/Promotion subject to change.

©2015 Vision Service Plan. All rights reserved.VSP, VSP Vision care for life, and WellVision Exam are registered trademarks of Vision Service Plan. Flexon is a registered trademark of Marchon Eyewear, Inc. All other brands are trademarks or registered trademarks of their respective owners.

JOB#21825CM 7/15

Vision every 24 months - VSP-3

Big Value. More Savings with VSP® Vision Care.With Exclusive Member Extras, savings never looked so good. We put our members first by providing exclusive special offers from leading industry brands, totaling more than $2,500 in savings.

• Limited time: Extra $40 to spend on bebe, Calvin Klein, Flexon and Nike frames through December 31, 20151,3

• Extra $20 to spend on featured frame brands1,3

• Mail-in rebate savings and free trials on popular contact lens brands

• Up to 50% savings on UNITY® digital lenses2,3

• Up to 40% savings on sunsync® light-reactive lenses2,3

• Satisfaction guarantee on Transitions everyday lenses

• Up to $500 savings on LASIK at NVision and TLC eye centers

• Savings for VSP members and their extended family on digital hearing aids (up to $2,400 per pair) and replacement batteries through TruHearing®4

• Savings on EyePromise EZ Tears dry eye and contact lens comfort formula

• Financing for vision care expenses with the CareCredit credit card

Visit vsp.com to find our Premier Program locationsthat offer wide selections of featured frame brandsand Bonus Offers to maximize value.

1. Brands/promotion subject to change 2. Savings based on doctor’s retail price and vary by plan and purchase selection; average savings determined after benefits are applied. 3. Available only to VSP members with applicable plan benefits. 4. Savings compared to national average retail prices on state-of-the-art digital hearing aids; offer not available in WA

©2015 Vision Service Plan. All rights reserved. VSP, UNITY, and sunsync are registered trademarks of Vision Service Plan. All other brands are trademarks or service marks of their respective owners.

For more great offers, scan or visit vsp.com/specialoffers.

JOB#21830XA 8/15

EXTRA $20TO SPEND