Why Enhance Your HAA Membership

THIS IS AN INDIVIDUAL INSURANCE PLAN

VSP Individual Vision Plan

A plan to see better.
And pay less.

Individual Vision Insurance underwritten by



VIEW VSP VISION PROVIDERS

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Individual Vision Insurance

Your Coverage with a VSP Network Provider.²

Well Vision^® Exam: $15 copay every 12 months

• Focuses on your eyes and overall wellness

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Prescription glasses: $25 copay

(see frames & lenses below) - in-network coverage

Frames: Every 12 months

Included in Prescription Glasses

• $150 allowance for a wide selection of frames
• $170 allowance for featured frame brands
• 20% savings on the amount over your allowance

Lenses: Every 12 months

Included in Prescription Glasses

• Single vision, lined bifocal, lined trifocal lenses
• Impact-resistant lenses for dependent children

Lens enhancements: Every 12 months

• Progressive Lenses (standard, premium or custom): $0-$175 copay
• Anti-glare: $41-$85 copay
• Light-reactive lenses: $75 copay
• Impact-resistant lenses: $31-$35 copay
• Scratch-resistant coating: $17-$33 copay
• Tinted lenses: $15-$17 copay
• UV protection: $16 copay
• Average savings of 30% on all other lenses enhancements¹

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Contacts (instead of glasses) $0 Copay

• $150 allowance for contacts and contact lens exam (fitting and evaluation)
  
  
• 15% savings on a contact lens exam (fitting and evaluation)

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Extra Savings

Glasses and Sunglasses:

• Extra $20 to spend on featured frame brands. Go to vsp.com/offers for details.


• 20% savings on additional glasses and sunglasses, including lens enhancements, from any VSP provider within 12 months of your last WellVision Exam.

Routine Retinal Screening:

• No more than a $39 copay on routine retinal screening as an enhancement to a WellVision Exam.

Laser Vision Correction:

• Average 15% off the regular price or 5% off the promotional price; discounts only available from contracted facilities.

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YOUR COVERAGE WITH OUT-OF-NETWORK PROVIDERS

Get the most out of your benefits and greater savings with a VSP network doctor. If you visit an out-of-network provider, you will have higher out-of-pocket expenses.

• Exam: up to $45
• Frame: up to $70
• Single Vision Lenses: up to $30
• Lined Bifocal Lenses: up to $50
• Lined Trifocal Lenses: up to $65
• Progressive Lenses: up to $50
• Contacts: up to $105

Note: If you choose to see an out-of-network provider, you will receive less coverage. Payment is expected at the time of service. Following your appointment, submit your itemized claim to Vision Service Plan, Attention: Claim Services, PO Box 385018, Birmingham, AL 35238-5018. Out-of-network coverage is not available in the states of Massachusetts and Washington, and coverage varies in the state of Maryland.

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Based on applicable laws, benefits may vary by location. Discounts on products and additional savings are not available in the states of Washington and Vermont.

1. ¹ Available only to VSP members with applicable plan benefits. Offers are only available through VSP Network Doctors and in-network locations.
   
   
2. ² Coverage terms and conditions are set forth in the policy under which the individual consumer is insured, and such terms and conditions vary according to the laws of the state in which the policy was issued.

©2020 Vision Service Plan. All rights reserved.

VSP and WellVision^® Exam are registered trademarks, and VSP Individual Vision Plan is a trademark of Vision Service Plan. All other brands or marks are the property of their respective owners.

49378 VCCM

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^{*Billing is administered through the Third Party Administrator
of H A Partners, Inc. or HealthyAmerica (depending on state).}

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THIS IS INDIVIDUAL VISION INSURANCE AND NOT MAJOR MEDICAL INSURANCE.

Read the member benefit summary carefully. This is a brief description of Individual Vision Insurance and is not an insurance contract, nor part of the insurance policy and is subject to the terms, conditions, limitations, and exclusions of the policy. Coverage may vary or may not be available in all states. You'll find complete coverage details in the member benefit summary and the VSP Individual Vision Care Policy (available upon request). Insurance benefits are provided by VSP Individual Vision Plans. There is no ownership affiliation between VSP Individual Vision Plans and Healthy America Association (HAA). As this is an individual insurance plan, you do not need to become a member of the United Business Association in order to purchase this plan.

Healthy America Association, VSP Individual Vision Plans, and HealthyAmerica are separate legal entities and have sole financial responsibility for their own products.

A BENEFIT BOOST SUBSCRIPTION

SML Dental Discount powered by
Aetna Dental Access^® Network

Saving on services will surely make you smile.

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Discount Dental Disclosure

This plan is NOT insurance. This is not a qualified health plan under the Affordable Care Act (ACA). Some services may be covered by a qualified health plan under the ACA. This plan does not meet the minimum creditable coverage requirements under M.G.L.c 111M and 956 CMR 5.00. This is not a Medicare prescription drug plan. Discounts on hospital services are not available in Maryland. The plan provides discounts at participating providers for services. The plan does not make payments directly to providers. The plan member is obligated to pay for all services but will receive a discount from participating providers. The range of discounts will vary depending on the type of provider and services. The licensed Discount Plan Organization Coverdell & Company, Inc., at 2850 W. Golf Road, Rolling Meadows, IL 60008, 1-866-215-1376. To view a list of participating providers visit www.findbestbenefits.com and enter promo code 725324. You have the right to cancel this plan within 30 days of the effective date for a full refund of fees paid. Such refunds are issued within 30 days of request.

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Dental Discounts powered by
Aetna Dental Access^® Network

Members can save 15% to 50%^* per visit, in most instances, on services at any of the many available dental practice locations nationwide. Dental services include: cleanings, x-rays, fillings, root canals, and crowns. Members can also save on specialty care such as orthodontics and periodontics where available.

^*Actual costs and savings vary by provider, service and geographical area.

The discount program provides access to the Aetna Dental Access^® network. This network is administered by Aetna Life Insurance Company (ALIC). Neither ALIC nor any of its affiliates offers or administers the discount program. Neither ALIC nor any of its affiliates is an affiliate, agent representative, or employee of the discount program. Dental providers are independent contractors and not employees of ALIC or its affiliates. ALIC does not provide dental care or treatment and is not responsible for outcomes.

Program not Available in AK, CT, IA, MA, RI, UT, VT & WA and this benefit is not available to residents of Vermont.

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Dental Provider Look-Up

Enter a valid zip code, then press the search button. The search engine will return a sampling of the participating providers nearest the zip code entered.

Zip Code:

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THIS IS NOT INSURANCE. IF YOU PURCHASE THIS PLAN, YOU ARE SIGNING UP FOR A MONTHLY MEMBERSHIP SUBSCRIPTION.

Read the brochure carefully. This is a brief description of the dental discount program and is not an insurance contract, and is subject to the terms, conditions, limitations, and exclusions. Coverage may vary or may not be available in all states. Coverdell and Company, Inc., a discount plan organization "DPO", administers the SML Dental Discount Program. Plan features and availability may vary by state. While we believe you will be pleased with your overall association membership, we cannot, however, warrant or guarantee the performance of any discount or service. Services and plan cost are subject to change.

Aetna Dental Access^®, Coverdell & Company, Inc., ALIC, Healthy America Association, and HealthyAmerica are separate legal entities and have sole financial responsibility for their own products.