We are excited to introduce the country’s most flexible dual-choice vision benefit offering, from one of America’s fastest-growing insurance and benefits providers, AlwaysCare Benefits, and the nation’s largest provider of eyecare coverage, VSP® Vision Care. For the first time, AlwaysCare will offer its vision plans side-by-side with plans administered by VSP Vision Care, giving employees the best access to both retail and private practitioner vision care. With either choice, employees will receive high-quality vision coverage that meets their unique budget and lifestyle needs while improving health and lowering out-of-pocket costs.

AlwaysCare’s Preferred Choice Vision PlansGiving your clients the freedom to choose their network!

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AlwaysCare’s Network

Combination of independent eye doctors plus local, regional and large national retail providers.

VSP’s Network

With AlwaysCare’s Prefered Choice Vision Plans, your clients can choose from 57,000+ access points!

Largest national network of Independent eye doctors

• 46,000 access points in medical and retail settings• 88% offer early morning, evening or weekend hours• Exam and wide selection of quality eyewear in one

location

Group Name:

Agency/Agent:

Effective Date:

Preferred Choice Vision Plans AlwaysCare Vision Care Plan

Services Out of Network

Allowance

Exam: $10 Co-pay Up to $35

Materials: $25 Co-pay

Lenses:

Single Vision Covered in full Up to $25

Bifocal Covered in full Up to $40

Trifocal Covered in full Up to $50

Lenticular Covered in full Up to $50

Polycarbonate lenses for Children (to age 19) Covered in full Not covered

Other Lens Options:

Progressive Lenses Value Added Providers

1

Member responsibility after co-pay Other Providers

Standard $40 $70 allowance Up to $40

Premium $100 $70 allowance Up to $40

Ultra Balance over $70 allowance; up to

20% off Usual & Customary $70 allowance Up to $40

Frames:

Member can choose from any frame. $130 retail allowance Up to $50 retail

allowance

Contact Lenses3: $0 Co-pay

Elective $130 retail allowance Up to $105

Medically Necessary Covered in Full Up to $210

Standard Contact Lens Fitting Exam Fee5 Up to $60 Co-pay Not Covered

Specialty Contact Lens Fitting Exam Fee6 Not Covered Not Covered

Plus AlwaysCare offers additional discounts

Additional pairs of glasses, contact lenses and more: Providers identified as Value Added or Service Plus offer special negotiated fees and discounts for extra purchases of lenses and coatings, frames, contact lenses and other products1,4.

Laser vision correction: Members have access to preferred pricing. Visit www.AlwaysCareBenefits.com for a list of participating laser vision correction providers. This is not an insured benefit.

Rate Guarantee:

Rates valid from September 1, 2014 to September 1, 2016.

Final rates are subject to home office underwriting verification of participation and other factors.

Notes: 1. Members can visit www.AlwaysAssist.com to search for Value Added Providers. Out-of-

pocket expenses may vary and are subject to change without notice. Some non-Value Added Providers, such as Walmart, Sam’s Club and Costco, may be less expensive.

2. Special payment and reimbursement terms apply for material purchases at Costco. 3. Contact lenses are in lieu of eyeglass lenses & frames. 4. Material special discounts may be used in conjunction with the insurance transaction

for non-covered services as well as with additional purchases. 5. The standard contact lens fitting exam fee applies to a new or existing contact lens user

who wears spherical disposable, daily wear, or extended wear lenses only. 6. The specialty contact lens fitting exam fee applies to a new or existing contact lens user

who wears toric, gas- permeable, mono-fit or multi-focal lenses.

For more complete information, please refer to the Certificate, or the employer’s Master Policy, which will be issued when coverage becomes effective and will prevail. Policy Form Series VI-2002, VI-2007, NVIGRP2002 and NVIGRP 05/07.

Frequencies

Exam (1 per 12 mos); Std. Plastic Lenses (1 per 12 mos); Frames (1 per 12 mos); Contact Lenses (1 per 12 mos)

Plan Rates Monthly Premiums

Employee $7.04

Employee + Spouse $14.04

Employee + Child(ren) $15.02

Family $24.00

Participation Requirements Must Maintain Current Participation of 40% Overall

Preferred Choice Vision Plans VSP® Vision Care Plan

Services Out of Network

Allowance

Exam: $10 Co-pay Up to $45

Materials: $25 Co-pay

Lenses:

Single Vision Covered in full Up to $30

Bifocal Covered in full Up to $50

Trifocal Covered in full Up to $65

Lenticular Covered in full Up to $100

Polycarbonate lenses for Children (to age 19) Covered in full Not covered

Other Lens Options:

Progressive Lenses After co-pay Not covered

Standard $55

Premium $95 - $105

Custom $150 - $175

Frames:

Member can choose from virtually any frame on the market.

$130 retail allowance 20% off any amount above the retail allowance

Up to $70 retail allowance

Contact Lenses1:

Elective $130 retail allowance; co-pay does not apply Up to $105

Medically Necessary Covered in full after co-pay Up to $210

Fitting and Evaluation Fee2

Up to $60 co-pay Not covered

Plus VSP Choice Plan offers additional discounts

Additional pairs of glasses: 20% off additional pairs of prescription glasses and/or non-prescription sunglasses3.

Laser vision correction: Discounts average 15-20% off or 5% off a promotional offer for laser surgery, including PRK, Lasik, and

Custom Lasik4.

Rate Guarantee:

Rates valid from September 1, 2014 to September 1, 2016.

Final rates are subject to home office underwriting verification of participation and other factors.

Notes: 1. When contact lenses are purchased instead of glasses, the Member can receive

both lenses and a frame 12 months from the date of service. 2. The contact lens fitting exam fee: at in-network providers, Member receives 15%

off of contact lens exam services; Member co-pay will never exceed $60. 3. 20% off unlimited additional pairs of glasses valid through any VSP Choice

Preferred Provider within 12 months of the last covered eye exam. 4. Custom LASIK coverage only available using wavefront technology with the

microkeratome surgical device. Other LASIK procedures may be performed at an additional cost to the member. LaserVision Care discounts are only available from VSP-contracted facilities.

For more complete information, please refer to the Certificate, or the employer’s Master Policy, which will be issued when coverage becomes effective and will prevail. Policy Form Series VI-2002, VI-2007, NVIGRP2002 and NVIGRP 05/07.

Frequencies

Exam (1 per 12 mos); Std. Plastic Lenses (1 per 12 mos); Frames (1 per 12 mos); Contact Lenses (1 per 12 mos)

Plan Rates Monthly Premiums

Employee $7.56

Employee + Spouse $15.10

Employee + Child(ren) $16.16

Family $25.82

Participation Requirements Must Maintain Current Participation of 40% Overall

AlwaysCare has negotiated special fees with thousands of optical locations for extra purchases of lenses and coatings, frames, contact lenses and other products. These discounts may be used in conjunction with your insurance transaction for non-covered services as well as with additional purchases. Providers identified as “Value Added (VA)” or “Service Plus (SP)” in the AlwaysCare Online Directory offer the following additional values. Members receive the fully insured plan allowances minus any co-pays towards everyday retail prices at Walmart, Sam’s Club and Costco locations.*

Value Added Providers (VA)

Purchase a second pair of glasses or contact lenses and receive preferred pricing:

Lenses • Single vision plastic lenses – $40• Bifocal plastic lenses – $60 • Trifocal – $70• Progressive lenses (Standard) – $110• Progressive lenses (Premium and Ultra) – 20% discount

Frames – Up to 35% discount

Contact Lenses – 5 - 15% discount, depending on type

Other Products – 20% discount on non-prescription sunglasses and other ancillary products / solutions**

• UV Coating – $15 • Solid Tinting / Gradient Tinting – $15• Standard scratch resistance coating – $15• Standard anti-reflective coating – $45 • Premium anti-reflective coating – $70• Ultra anti-reflective coating – 20% discount• Polarized – $75 • Transition – $75• Progressive Lenses: Standard — $110 Premium — $170 Ultra — Member receives a 20% discount

• Standard Polycarbonate – $40• High Index (Single Vision) 1.56-1.60 – $60 1.66+ – 20% discount• High Index (Multi-focal) 1.56-1.60 – $75 1.66+ – 20% discount

These schedules are subject to change without notice. Added value discounts may not be available in all geographical areas and vary by network. Many Providers are not able to offer discounts on “Prestige” frames. Special lens packages which combine numerous lens enhancements at value price points are not covered by these added value programs. Cannot be combined with any other promotions or discounts.

*Additional discounts are not applicable. **Some retail chains sell sunglasses in departments outside of their optical shops where discounts do not apply.

1-888-729-5433, Ext. 2013Monday-Friday: 7:30 am—8:30 pm (CT)

Saturday: 9:00 am—3:00 pm (CT)www.AlwaysCareBenefits.com

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• UV Coating• Solid Tinting / Gradient Tinting• Standard scratch resistance coating• Standard anti-reflective coating

• Premium anti-reflective coating• Transition• Standard Polycarbonate

Lens Options – Add-ons for insured purchases:

Optical Materials Special Discounts

Service Plus Providers (SP)Receive 20% discount for the following add-ons to insured purchases:

Optical Materials Special Discounts

AlwaysAssistwww.AlwaysAssist.com

facebook.com/acbenefits twitter.com/acbenefitsFind us on these sites too!

First-time registration For Members:

Register for access by selecting “Member Registration” on the login screen and completing the required information.

Trouble logging in? Contact us:1-888-729-5433, Ext. 2013

www.AlwaysCareBenefits.com

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