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<br />c. <br /> <br />Aetna Discount Benefits <br />No waiting period; all ADA codes <br /> <br />Retiree Only <br />Family <br /> <br />S5.00 <br />S8.00 <br /> <br />RATES <br /> <br />OPTION ill <br />A. Vision Care Benefits (High Plan) <br />One eye exam per covered person per calendar <br />year and payment toward a set of frames and <br />lenses or contact lenses per covered person <br />once every two calendar years. <br /> <br />Exam: $50 <br />FrameslLenses: $150 <br /> <br />Embedded into High Plan <br /> <br />B. <br /> <br />Vision Care Discounts <br />Discounts on frames, lenses, contact lenses and eye examinations are available fÌ'om national <br />providers such as Pearle Vision, Sears Optical, JCPenney Optical and Target Optical. To find <br />a participating provider, go to Vision One's website at www.colemanagedvision.com, plan <br />number: 46907 or call (800) 804-4384. <br /> <br />Optional <br /> <br />Exclusions Specific to the Vision Care Benefits of the Plan <br />In addition, benefits are not provided for: any medical or surgical treatment of the eye; sunglasses, plan or prescription; safety <br />lenses or goggles; orthoptics, vision training or aniseikonia. <br /> <br />Employee's <br />Attained Age <br /><50 <br />50-64 <br />65+ <br /> <br />Dental and Vision Option <br />Retiree Retiree Retiree Family <br /> & Spouse & Child(ren) <br />$25.00 $49.00 $64.00 $88.00 <br />$28.00 $56.00 $67.00 $95.00 <br />$33.00 $65.00 $72.00 $103.00 <br /> <br />C:\Documents and Settings\ganderson\Loca1 Settings\Te~rary Internet Files\OLK5\EarlyRetdoc <br />