If you are a new retiree who has not been eligible for coverage through the Harrison Trust in any of the previous 12 consecutive months, you, your spouse and your dependents will be eligible for vision benefits after six months of coverage under the Harrison Trust.

If you are covered under Retired Plan A, B, or C, you will have the option of purchasing vision coverage for yourself and your dependents. You may choose whether or not to purchase vision coverage during the open enrollment period in November for coverage effective January 1. Your choice will last the entire year, and you may add or drop vision coverage only during the open enrollment period for coverage the following calendar year.

This Plan is your vision benefit if you are enrolled in the Trust Plan or Providence. If you are enrolled in the Kaiser Plan, your vision benefits are provided by Kaiser.

1. To find a VSP network doctor close to your home or work, call VSP at 1-800-877-7195, or visit their web site at www.vsp.com.

2. To receive the maximum benefit, select a VSP network doctor and make an appointment. Identify yourself as a VSP member. Your doctor will handle the rest.

3. Your VSP network doctor you will charge you a $15 copay for the exam.

4. If your VSP network doctor prescribes glasses, your lenses are covered in full. You may choose from a wide selection of frames, covered up to $130, plus 20% off on any out-of-pocket costs. Your copay to the VSP eyewear dispenser will be $25.

Note: If you select cosmetic items including but not limited to, oversize lenses, tinted, coated or blended lenses, or select a frame that is outside the cost range of VSP's allowance, you will need to pay for these in addition to the $25 copayment. You will be advised by the VSP doctor of the out-of-pocket expense before you place your order.

5. You do not have to use a VSP network doctor. You may use a qualified vision care provider of your choice. Remember, you may use a VSP network doctor to dispense your glasses even if your exam was performed by a non-network doctor. Likewise, you may obtain an eye examination from a VSP network doctor and have your glasses dispensed from a non-VSP provider.

Selecting a VSP network doctorr assures direct payment to the doctor and is a guarantee of quality and cost control.

6. Extra discounts and savings. When visiting a VSP network doctor you'll receive:

• 20% off on additional glasses and sunglasses.
• Up to 20% savings on lens extras such as scratch resistant and anti-reflective coatings and progressives.
• Exclusive pricing on annual supplies of contacts.
• 15% discount off the cost of contact lens exam (fitting and evaluation).

7. If you use a non-VSP provider:

a. Obtain your exam and any necessary eyewear (lenses, frame or contacts) and pay the bill in full. Remember to get an itemized receipt.

b. Mail the itemized receipt to:

VSP
PO Box 997195
Sacramento, CA 95899-7195

When mailing the receipt, be sure to identify the Plan as Harrison Electrical Workers Trust Fund and include the following information:

I. Your name;

II. Address;

III. Social security number;

IV. Patient's name (you, your spouse or dependent);

V. Date of birth; and

VI. Patient's relationship to you (the retiree).

VSP will reimburse you according to the non-VSP provider reimbursement schedule;

c. You must submit a copy of the provider's itemized billing statement to VSP within six months of the date of service.

d. If you have Internet access, sign on to www.vsp.com, select the Out-of-Network Reimbursement Form" and follow the directions.