Your vision coverage GUARDIAN® is a registered trademark of The Guardian Life Insurance Company of America Aesop IntermediateLLC Kit created 12/05/2022 ALL ELIGIBLE EMPLOYEES Groupnumber:00554984 Option 1: Significant out-of-pocket savings available with your Full Feature plan by visiting one of VSP’s network locations, including one of the largest private practice provider networks, Visionworks and contracted Pearle Vision locations. Your Vision Plan Full Feature Your Network is VSP Choice Network Your Monthly premium $ 5.46 You and Spouse $ 10.33 You and Child(ren) $ 10.52 You, Spouse and Child(ren) $ 16.67 Copay Exams Copay $ 20 Materials Copay (waived for elective contact lenses) $ 20 Sample of Covered Services You pay (after copay if applicable): In-network Out-of-network Eye Exams $0 Amount over $59 Single Vision Lenses $0 Amount over $30 Lined Bifocal Lenses $0 Amount over $50 Lined Trifocal Lenses $0 Amount over $65 Lenticular Lenses $0 Amount over $100 Frames 80% of amount over $130¹ Amount over $70 Costco, Walmart and Sam's Club Frame Allowance Amount over $70 Contact Lenses (Elective) Amount over $130 Amount over $120 Contact Lenses (Medically Necessary) $0 Amount over $210 Contact Lenses (Evaluation and fitting) 15% off UCR No discounts Cosmetic Extras Avg. 20-25% off retail price No discounts Glasses (Additional pair of frames and lenses) 20% off retail price** No discounts Laser Correction Surgery Discount Up to 15% off the usual charge or 5% off promotional price No discounts Service Frequencies Exams Every calendar year Lenses (for glasses or contact lenses)‡‡ Every calendar year Frames Every two calendar years‡‡‡ Network discounts (glasses and contact lens professional service) Limitless within 12 months of exam. Dependent Age Limits 26 To Find a Provider: Register at VSP.com to find a participating provider. VSP • Additional Features Benefits: Safety Glass Rider • ‡‡Benefit includes coverage for glasses or contact lenses, not both. • ** For the discount to apply your purchase must be made within 12 months of the eye exam. 8