Vision Insurance Highlights - Guaranteed issue - No deductible - No waiting periods - No exclusions - Your choice of eye care providers - Annual examination - One pair of standard lenses or contact lenses per year - New frames every 24 months Preferred Vision Premiums * Monthly and Quarterly Premiums are available ONLY by bank credit or bank draft. 2-Year Rate Guarantee   MONTHLY QUARTERLY SEMI-ANNUAL ANNUAL Member Only $12.10 $36.30 $72.60 $145.20 Member & One $17.80 $53.40 $106.80 $213.60 Member & Family $26.80 $80.40 $160.80 $321.60 For claims and policyholder's Service, Call SPECTERA INC. 1-800-839-3242 Schedule of Benefits: In-Network When using a network provider, enrolled participants and eligible dependents are eligible for the following: Examinations A comprehensive VISION EXAM is provided ANNUALLY by a network optometrist or ophthalmologist after a $10 co-payment. Frames and Lenses One set of lined single/bifocal/trifocal lenses and one pair of high quality frames from a broad selection after a $20 co-payment. Lenses are 100% paid every 12 months. Frames are 100% paid every 24 months. This applies to the entire purchase, not the lenses and frames individually. At Private Practice Providers, frames chosen outside SPECTERA's broad selection, you will pay the wholesale cost less a $50.00 frame allowance. Your choice from a side selection of fashionable SPECTERA frames will be covered. A minimum frame allowance of $100.00 will be given on the already discounted frames from retail chain providers. Contact Lenses In lieu of lenses and a frame, you may select contact lenses from SPECTERA's broad selection of extended wear and disposable contacts with a $20.00 co-payment. A $105 credit will be applied toward the fitting fees and the purchase of contact lenses or disposable lenses chosen outside of SPECTERA's selections. For "necessary contacts" (when vision cannot be corrected to better than 70/20 with standard lenses) there is a $210.00 allowance. Refractive Eye Surgery: SPECTERA adds value to your VISION CARE PROGRAM with a life changing experience. SPECTERA participants receive access to discounted refractive eye surgery benefits from several provider locations. Schedule of Benefits: Out-of-Network Visit the eye doctor of your choice. If you choose to use a non-network provider, you will be reimbursed up to: Exam - Optometrist: $40.00 - Ophthalmologist: $40.00 Lenses - Single Vision: $40.00 - Bifocal: $60.00 - Trifocal: $80.00 - Frames: $50.00 Contact Lenses - Medically Necessary: $210.00 - Elective: $105.00 If you choose a non-network provider, you will need to send your itemized receipts with your Social Security number and the patient's date of birth to: SPECTERA 2811 Lord Baltimore Dr. Baltimore, MD 21244-2644 Contact For questions concerning enrollment or for additional information, call Ins/Mark of America In Houston, TX: 281-293-8292 FAX: 281-293-0144 Toll Free: 800-847-7503 For claims and policyholder's services, call: SPECTERA, INC. Corporate Headquarters 2811 Lord Baltimore Dr. Baltimore, MD 21244-2644 Customer Service: 1-800-638-3120 (8:30 a.m. to 8:00 p.m. EST) Provider Locator: 1-800-839-3242