What the Vision Plan
Doesn't Cover

The Vision Plan does not cover the following supplies
or expenses:

more than one eye exam (for each covered person) in a consecutive 12-month period;

more than one pair of eyeglasses or contact lenses (for each covered person) in a consecutive 24-month period;

nonprescription sunglasses;

safety eyeglasses;

replacement contact lenses and contact lens insurance;

any loss or expense relating to medical or surgical treatment of the eye;

any loss or expense relating to orthoptics, vision training or aniseikonia;

any charge incurred for a covered expense not
recommended or performed by a physician or legally licensed optometrist or optician;

accidental injury or sickness arising out of or in the course of any work for pay or profit;

any injury or sickness for which you or your dependent are entitled to benefits under any Workers' Compensation law or any similar law; and

charges for treatment paid by any federal or state agency, or provided through a hospital run by a government agency, unless you or your dependent legally must pay charges.

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