TrueView Eye Care Plan Summary

Life is Good Eye Care Highlight Sheet www.reliancematrix.com Plan 1: TrueView Plan H Summary EyeMed Access Network Out of Network Deductibles $10 Exam No deductible $20 Eye Glass Lenses Annual Eye Exam Covered in full Up to $35 Lenses (per pair) Single Vision Covered in full Up to $25 Bifocal Covered in full Up to $40 Trifocal Covered in full Up to $55 Lenticular 20% discount No benefit Progressive See lens options NA Contacts Fit & Follow Up Exams Standard Standard: Member cost up to $55 No benefit Premium (Allowance) Premium: 10% off of retail No benefit Elective Up to $130 Up to $104 Medically Necessary Covered in full Up to $200 Frame Allowance $130 Up to $65 Frequencies (months) Exam/Lens/Frame 12/12/24 12/12/24 Based on date of service Based on date of service Lens Options (member cost) EyeMed Access Network Out of Network Progressive Lenses Standard Standard: $65 + lens deductible No benefit Premium Premium: lens cost - 20% discount - $120 allowance + Standard Progressive cost No benefit Std. Polycarbonate $40 No benefit Tint (solid and gradient) $15 No benefit Scratch Resistant Coating $15 No benefit Anti-Reflective Coating $45 No benefit Ultraviolet Coating $15 No benefit Plastic Photochromatic/Transition NA No benefit Lasik or PRK Average discount of 15% off retail price or 5% off promotional price at US Laser Network participating providers. No benefit Effective Date: 1/1/2026