Open Season is November 13 through midnight December 11, 2017 Eastern timeTo enroll visit BENEFEDS.com or call 1-877-888-FEDS (3337), TTY: 1-877-889-5680.

Questions? Contact FEP BlueVision Customer Service:Phone: 1-888-550-BLUE (2583), TTY: 1-800-523-2847; 8 a.m. to 8 p.m. Monday – Friday (Eastern time)

Learn more atwww.fepbluevision.com

• Virtual Frame Try On

• Locate an FEP BlueVision Provider

• Learn about theEye Exam

• Find out moreabout FEPBlueVision coverage

No hidden costs. No out-of-pocket guesswork. FEP BlueVision members enjoy comprehensive coverage at signifi cantly lower prices.

Enroll today and get started with a routine eye exam. Being proactive can help detect symptoms of systemic diseases such as diabetes, thyroid disease and neurological impairments.

ZERO COPAYComprehensive

Routine Eye Exam

FULLY-COVEREDFEP BlueVision

Collection Frames 1

GENEROUSFrame Allowance at

Independent Providers & Retail Locations

ENHANCEDFrame Allowance for

High Option Members at of up to $200

EF PT O Z

Sample Eyewear PurchaseAverage

Retail CostStandard

OptionHigh

Option

Eye Examination $103 $0 $0

FEP BlueVision® Collection Frames $160 $0 $0

Premium Progressive Lenses $247 $90 $90

Ultraviolet Coating $23 $0 $0

Premium Anti-Refl ective Coating $92 $48 $33

Plastic Photochromic Lenses(i.e. Transitions® SignatureTM) $110 $65 $0

Polycarbonate Lenses $66 $0 $0

1-Year Breakage Warranty $30 $0 $0

Total $831 $203 $123

SAVINGS $628 $708

MEMBER EDUCATION

Focus on what matters most.2018 FEP BLUEVISION®

OR

OVER 2,000FRAMES TO CHOOSE FROM

BLUVISEDU2018

1Collection is available at participating independent provider offices. Collection is subject to change.2Additional discounts are not applicable at Costco, LensCrafters, Sam’s Club or Walmart locations.3Industry standard for Hi-Index

Note: This is a summary of the many features and benefits of FEP BlueVision. For a complete description, please refer to your benefit brochure.

The FEP BlueVision Plan complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

Para obtener asistencia en español, llame al servicio de atención al cliente al número que aparece en su tarjeta de identificación.

Benefits Standard Option High Option

Optional Lenses and Treatments In-Network Only In-Network Only

Ultraviolet Protective Coating Nothing Nothing

Polycarbonate Lenses Nothing Nothing

Blended Segment Lenses $20 $20

Intermediate Lenses $30 $30

Standard Progressives $50 Nothing

Premium Progressives (Varilux®) $90 $90

Select Progressive Lenses $70 $70

Ultra Progressive Lenses (Digital) $195 $195

Photochromic Glass Lenses $20 $20

Plastic Photosensitive Lenses (Transitions® SignatureTM) $65 Nothing

Polarized Lenses $75 $75

Standard Anti-Reflective (AR) Coating $35 $20

Premium AR Coating $48 $33

Ultra AR Coating $60 $45

High-Index Lenses (up to 1.67)3 $55 $55

Benefits Standard Option High Option

Eye Exam (Once per year) No copay, covered every calendar yearSpectacle Lenses (One per year)

No copay, covered every calendar year

Lens Treatments Lens options are either covered-in-full or at significant savings over retail. For a complete list of lens treatment options, please refer to the 2018 brochure.

FEP BlueVision Exclusive Collection1 Covered-in-full and includes any frame from the FEP BlueVision Exclusive Collection1

Frames

No copay, covered every 2 calendar years

Non-Collection Frames: $130 toward any provider supplied frame, plus 20% off charges over $1302.

No copay, covered every calendar year

Non-Collection Frames: $150 toward any provider supplied frame, plus 20% off charges over $1502.

Additional $50 frame allowance when you purchase frames from any location.

Contact Lenses (in lieu of eyeglasses)

Up to $130 per calendar year toward contact lenses, evaluation, fitting and follow-up fees, plus 15% off charges over $1302.

Up to $150 per calendar year toward contact lenses plus 15% off charges over $1502. Evaluation, fitting and follow-up fees fully covered for non-specialty lenses and covered up to $60 for specialty contact lenses.

Vision Correction Surgery Save up to 40% to 50% on traditional LASIK surgery at QualSight LASIK. To take advantage of the discount, you must call 855-502-2020.

What you pay for in-network services

2018 Premiums Standard Option High Option

BIWEEKLY MONTHLY BIWEEKLY MONTHLY

Self Only $3.95 $8.56 $5.67 $12.29

Self Plus One $7.90 $17.12 $11.33 $24.55

Self and Family $11.85 $25.68 $17.00 $36.83