Intellisurvey, Inc. Monthly Rates Employee Only (EE) $5.50 EE + Spouse $11.66 EE + Children $12.31 EE + Spouse & Children $20.15 Additional Balanced Care Vision I Choice Network Features Allowance can be applied to disposables, but the dollar amount must be used all at once (provider will order 3 or 6 month supply). Applies when contacts are chosen in Contact Lenses Elective lieu of glasses. For plans without a separate contact fitting & evaluation (which includes follow up contact lens exams), the cost of the fitting and evaluation is deducted from the allowance. 20% off additional complete pairs of prescription glasses and/or prescription Additional Glasses sunglasses.* Frame Discount VSP offers 20% off any amount above the retail allowance.* VSP offers an average discount of 15% off or 5% off a promotional offer for LASIK Custom LASIK and PRK. The maximum out-of-pocket per eye for participants is Laser VisionCare $1,800 for LASIK and $2,300 for custom LASIK using Wavefront technology, and $1,500 for PRK. In order to receive the benefit, a VSP provider must coordinate the procedure. With prior authorization, 75% of approved amount (up to $1,000 is covered every two Low Vision years). Based on applicable laws, reduced costs may vary by doctor location. Domestic Partner California state law requires that coverage shall be provided to Registered Domestic Partners that is equal to, and subject to the same terms and conditions as, the coverage provided to a spouse. Registered Domestic Partner means a partner of the Insured as long as the partnership meets the requirements for such relationship as defined in Section 297 of the California Family Code or the functional equivalent registration of any other state or local jurisdiction. Vision Plan Participant Service Balanced Care Vision I from The Standard features the money-saving eye care network of VSP. Customer service is available to plan participants through VSP's well-trained and helpful service representatives. Call or go online to locate the nearest VSP network provider, view plan benefit information and more. VSP Call Center: 800.877.7195  Service representative hours: 5 a.m. to 7 p.m. Pacific Monday through Friday, 6 a.m. to 2:30 p.m. Pacific Saturday  Interactive Voice Response available 24/7 Locate a VSP provider at: www.standard.com/services Standard Insurance Company