Plan Features IN NETWORK Vision Exam Lenses Single Bifocal Trifocal Progressive Frames Elective Contact Lenses Medically Necessary Contact Lenses Frequency (Months) Exam Lenses Frames Contacts OUT OF NETWORK Vision Exam Lenses Single Bifocal Trifocal Progressive Frames Elective Contact Lenses Medically Necessary Contact Lenses 15 15 VISION PLAN I S U M M A R Y O F C O V E R A G E BENEFITS GUIDE VISION PLAN