Limitations and Exclusions:

Limitations:

Vision Exam and Vision Materials - Fees charged by a provider for services other than Vision Exam or Covered Vision Materials must be paid in full by the member to the Opticare doctor.  Such fees or materials are not covered under this policy.

Exclusions:

• No Benefits will be paid for services or materials connected with or charges arising from orthoptic or vision training, subnormal vision aids, and any associated supplemental testing.
• Medical and/or surgical treatment of the eye(s) or supporting structures.
• An eye or vision Exam, or any corrective eye wear, required by an employer as a condition of employment.
• Services provided as a result of Worker's Compensation law, or similar legislation, or required by any governmental agency or program whether Federal, state, or subdivisions thereof
• Plano (non-prescription) lenses, non-prescription sun glasses, or two pairs of glasses in lieu of bifocals.
• Lost or broken lenses, frames, glasses, or contact lenses will not be replaced except in the next benefit period when vision materials would next become available.

FOR MORE INFORMATION:
For more information on how to obtain coverage for your company or how benefits are administered, contact our sales team, or call (877) 615-7732.

Some provisions, benefits, exclusions, or limitations listed herein may vary depending on your state of residence.

This underwritten plan is governed by M-9059; VC-45.
Date:11/2007