EyeMed Vision EyeMed Services Network Frequency Benefit Out-of-Network EyeMed Exam 12 Months $20 $40 Reimbursement Prescription Glasses Plan $100 Allowance + 01/01/2023 – 12/31/2023 Eyeglass Frames 24 Months $75 Reimbursement 20% Discount on Balance Eyeglass Lenses Provider Search $30 / $50 / $70 www.eyemed.com Single / Bifocal / Trifocal 24 Months $20 Reimbursement Contact Lenses Additional Information $100 Allowance + Elective 24 Months $100 Reimbursement 15% Discount on Balance Medically Necessary 12 Months Covered 100% $210 Reimbursement