Overview of 2016 Vision Benefits

Retirees by

Vision Service Plan (V.S.P.)

Monterey Bay Public Employees Trust

Overview of 2016 Vision Benefits(Vision Service Plan) - Retirees

No I.D. Cards. No claim forms.• Locate a V.S.P. doctor by visiting

vsp.com, calling 1-800-877-7195, or getting V.S.P.’s List of Participating Doctors from P.G.A. office.

• Make an appointment and tell the doctor you are a V.S.P. member.

• Your doctor and V.S.P. will handle the rest.

Monterey Bay Public Employees Trust

Overview of 2016 Vision Benefits(Vision Service Plan) - Retirees

You get the best value from your V.S.P. benefit when you visit a V.S.P. network doctor. If you desire not to see a V.S.P. doctor, co-pays still apply. You’ll also receive a lesser benefit and typically pay more out-of-pocket. You are required to pay the provider in full at the time of your appointment and submit a claim to V.S.P. for partial reimbursement. If you decide to see a provider not in the network, call V.S.P. first.

Monterey Bay Public Employees Trust

Overview of 2016 Vision Benefits(Vision Service Plan) - Retirees

Exam• In-V.S.P.-network: One exam covered in full every twelve (12) months ($15.00 co-pay);

• Out-of-V.S.P.-network: Reimbursement up to $42.00 every twelve (12) months.

Monterey Bay Public Employees Trust

Overview of 2016 Vision Benefits(Vision Service Plan) - Retirees

Prescription Glasses - Lenses• In-V.S.P.-network: Lenses (single vision, lined bifocal, lined trifocal lenses, and tints) covered in full every twenty-four (24) months;

• Out-of-V.S.P.-network: Reimbursement for single vision to $40.00, bifocal vision up to $60.00, trifocal vision up to $80.00, and tints up to $5.00 every twenty-four (24) months.

Monterey Bay Public Employees Trust

Overview of 2016 Vision Benefits(Vision Service Plan) - Retirees

Prescription Glasses - Frames• In-V.S.P.-network: Frame of your choice covered up to $115.00 every twenty-four (24) months. Plus 20% off any out-of-pocket costs every twenty-four (24) months.

• Out-of-V.S.P.-network: Reimbursement up to $45.00 every twenty-four (24) months.

Monterey Bay Public Employees Trust

Overview of 2016 Vision Benefits(Vision Service Plan) - Retirees

Contacts• In-V.S.P.-network: Your $105.00 allowance applies to the cost of your lenses and the fitting and evaluation exam every twenty-four (24) months, which is in addition to your vision exam to insure proper fit (no co-pay).

• Out-of-V.S.P.-network: Reimbursement up to $105.00 every twenty-four (24) months.

Monterey Bay Public Employees Trust

Overview of 2016 Vision Benefits(Vision Service Plan) - Retirees

Extra Discounts (Prescription Glasses)• In-V.S.P.-network: Up to 20% savings on lens extras such as scratch resistant and anti-reflective coating and progressives every twenty-four (24) months; 20% off additional prescription glasses and sunglasses every twenty-four (24) months.

• Out-of-V.S.P.-network: None.

Monterey Bay Public Employees Trust

Overview of 2016 Vision Benefits(Vision Service Plan) Retirees

Extra Discounts (Contacts)• In-V.S.P.-network: Exclusive pricing on annual supplies of popular brands; 15% off cost of contact lens exam (fitting and evaluation) every twenty-four (24) months.

• Out-of-V.S.P.-network: None.

Monterey Bay Public Employees Trust

Overview of 2016 Vision Benefits(Vision Service Plan) - Retirees

Rates (effective 4/01/12)

• $22.56 per month (composite rate -- same rate for Single, Two-Party, or Family).

Monterey Bay Public Employees Trust

Overview of 2016 Vision Benefits(Vision Service Plan) - Retirees

Disclaimer• This presentation provides only a general overview of your Vision benefits;• For complete information, consult your copy of the Overview of V.S.P. Benefits or contact either V.S.P. (1-800-877-7195 or www.vsp.com) or Health Services & Benefit Administrators (1-831-757-1711 or 1-888-742-3380).