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Page 9

VOLUNTARY VISION INSURANCE

How to find a participating vision

provider in your area:

1: Go to

www.cigna.com,

click on Find a

Doctor. Then, select the Cigna Vision

Directory link on the right of the page

below the row of boxes.

2: Enter the City and State and/or Zip Code

you wish to search.

3: Choose the Search button for your

results.

In-network benefits include additional lens enhancements, minimum 20% savings including but not limited to:

- Customer Pays:

Standard Polycarbonate: covered under plan for under 18 years of age; up to $40 for adults

Oversize lenses: covered under plan

Rose Tints: #1 and #2—covered under plan

All plastic dyed Tints: up to $17

Standard photochromic: up to $82

Standard anti-reflective coating: up to $45

Standard scratch/ultraviolet coating: up to $17

Standard progressives: up to $65

Healthy Rewards

—With Cigna Health Rewards, you can enjoy savings on Lasik corrective eye surgery of up to 15%!

Call (800) 870-3470 to find a LasikPlus provider near you.

Cigna Vision

Benefit

In-Network

(You Pay)

Out-of-Network

(You Pay)

Examination Copay

$10

$45

Frequency of Service:

Exams

Lenses

Frames

12 Months

12 Months

24 Months

12 Months

12 Months

24 Months

Basic Lenses:

Single Vision

Bifocal

Trifocal

Lenticular

$25 Copay, then

0%

0%

0%

0%

$25 Copay, then

$32

$55

$65

$80

Frames

$130 Allowance,

plus a 20% discount

on any amount that

exceeds the frame

allowance

$71

Contacts

Necessary

Cosmetic

0%

$110 Allowance

$210

$98

EMPLOYEE COST

Type of Coverage

Monthly

Cost

Employee Only

$5.67

Employee & Spouse

$10.74

Employee & Child(ren)

$12.61

Employee & Family

$17.73