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Vision Benefits




            NAPAl provides Vision benefits through the following plan:
            CareFirst BlueVision Plus Option B
              » Choose from a large national network of providers.
              » In-Network and Out-of-Network coverage. (Note: If you use an out-of-network provider then you
                will need to pay the full cost up-front then submit for reimbursement)
              » Vision exam covered in full with a $10 copay and substantial discounts on vision correction
                materials through Davis Vision.
              » Please refer to the attached summary plan description for more details.




                                                                              CareFirst BlueVision
                                                                                 Plus Option B
                                 Benefits                                    $10 Exam/12 Month

                                                                          In                      Out


              Coinsurance                                               100%                   Allowance



              Exam                                                    $10 Copay              $45 Allowance




              Eye Glasses Lenses                                     Single: 100%         Single: $52 Allowance

                                                                     T ower: 100%
              Frame Allowance                                        Non-Tower:              $60 Allowance
                                                                   $130 Allowance


              Contact Lenses                                   Elective: No copay for    Elective: $112 Allowance
                                                               Davis Vision Collection


              Service Interval                                         12 Mos.                   As INN



              Lenses and Frame Service Interval                        12/24 Mos.                As INN


                                                       Monthly Rates

              Individual                                                              $7

              Parent/Child                                                            $14

              Employee/Spouse                                                         $17

              Family                                                                  $20
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