Thank You for Your Interest in Blue View Vision!

THANK YOU FOR YOUR INTEREST IN BLUE VIEW VISION!

Blue View Visionis very flexible and easy to use.This proposal outlines the basic components of the plan, including quick answers about what’s covered and how

we stand apart from the rest.

Your Blue View VisionSMProposal

April 1, 2018 to March 31, 2021

Focusing on the Healthof Our Members

At Anthem BlueCross and Blue Shield, we knowthe health of your business andthe health of your employees are related. And since vision exams can help lead to the early detection of major health problems before they become more serious, you’ll findthat mostof our plans include benefits for an annual comprehensiveeye exam.

In addition, because chronic health conditionssuch as Diabetes are on the rise, we clinically integrate with our health plan to identify thosewho are athigh risk. Through our 360º Health® program1,a registered nurse will proactively reach out tothese members and help them enroll in a 360º Health ConditionCare program gearedtoward managing their specific condition.

Maintaining proper vision is not only good for your employees, butyou benefit as well since:

Uncorrected vision can decreaseemployee performance by as much as 20% 2

Even a slight vision problem can reduce workplace productivity by10%and work accuracy by 40% 3

Vision disorders are the second most prevalent health problem in the country, affecting more than 120 million people 4

More than 8 outof 10 employees want vision coverage as part oftheir health benefits, even thoughonly 6 out of 10even need vision correction 5

70-75%of computer workers experience eye andvision problems6

GoingBeyond

Children’s eyesare particularly susceptible to harmful ultravioletlight exposure. That’s why we include Transitions®lensesat no additional cost on all lensesfor children under the age of 19. And because kids tend to be a little rough on things, lightweight impact-resistant polycarbonate lenses and scratch resistant coating is included on all standard lenses for childrenunder 19.

Access to aDiverse National Network

Blue View Vision’s provider network is comprisedof more than 50,000 providers and provider locations nationwide,offering a generous mix of independent practitioners and marquee retail locations includingLensCrafters®,Pearle Vision®,Sears OpticalSM,Target Optical®,and JCPenney®Optical stores. Having retail locations means your employees can take care of their vision needs outside their working hours.

Freedom of Choice

While benefits and savings are typically greater from in-networkproviders, members are free tovisit an out-of-network provider. They have the option of receiving an eye examfrom one provider and choosingto fill their prescription at another location. And with Blue View Vision, there are no frame towerrestrictionsso members can choose the eyeglass frame they likebest.

Outstanding Customer Service

We are committed to providing the best serviceand support possible, setting ourselves apart with:

Among the longest customer service hours in theindustry, with extended eveningand weekend hours

Closed just twodays a year!

Dedicated knowledgeable representatives

High service metric standards that are consistently met or exceeded

Additional Savings

Members can access special savings from in-network providers even after their benefits have been exhausted. They can enjoy unlimited savings on things like extra pairs of eyewear, and even non-covered items such assunglasses and popular accessories.

Multi-lineCarrier

Another great advantage we can offer is the power of packaging multiple product lines, such as health and vision.This allows for the convenience ofone bill, one ID card, and one point of contact.

1 Member’shealthplanmustinclude360ºHealth®program

2 VisionCouncilofAmerica,Visionin Business,2007

3 ”VisioninBusiness”,VisionCouncilofAmerica,July2007

4VisionCouncilofAmerica(VCA),VisionCare:FocusingontheWorkplaceBenefit,Fall2008.

5ConsumerPerceptionsofManagedVisionCare,JobsonResearch,2008

6AmericanOptometricAssociation

Cornerstone

PROPOSEDBLUEVIEWVISIONPLANDESIGN

VISIONCARESERVICESIN-NETWORKOUT-OF-NETWORK

Routineeyeexam(onceevery12months)$20copay,thencoveredinfull$42allowance

Eyeglassframes

Membersmayselectaneyeglassframeandreceivethefollowingallowancetowardthe purchaseprice(onceevery24months)

$140allowancethen20%offany remainingbalance

$45allowance

Eyeglasslenses(Standard)

Factoryscratchcoatingincluded.Polycarbonatelensesincludedforchildrenunder19 yearsold.lensesincludedforchildrenunder19yearsold.

Onceevery12months,membersmayreceiveanyoneofthefollowinglensoptions:

Standardplasticsinglevisionlenses(1pair)

Standardplasticbifocallenses(1pair)

Standardplastictrifocallenses(1pair)

$20copay,thencoveredinfull

$40allowance

$60allowance

$80allowance

Eyeglasslensupgrades

Whenreceivingservicesfroma BlueViewVisionprovider, membersmaychoosetoupgrade theirneweyeglasslensesata discountedcost.Eyeglasslens copaymentapplies.

1Membersshouldasktheirprovider forhis/herrecommendationaswellas theprogressivebrandsbytier.

2Membersshouldasktheirprovider forhis/herrecommendationaswellas thecoatingbrandsbytier.

Contactlenses(onceevery12 months)

Thosewhoprefercontactlenses overglassesmaychooseto receivecontactlensesinsteadof eyeglasslensesandreceivean allowancetowardthecostofa supplyofcontactlenses.

LensOptions

 UVCoating

 Tint(SolidandGradient)

 StandardPolycarbonate

 lenses

 ProgressiveLenses1

Standard

PremiumTier1

PremiumTier2

PremiumTier3

 StandardAnti-ReflectiveCoating2

 PremiumTier1 Anti-ReflectiveCoating2

 PremiumTier2 Anti-ReflectiveCoating2

 OtherAdd-onsandServices

ElectiveConventionalLenses

ElectiveDisposableLenses

Non-ElectiveContactLenses

Membercostforupgrades

$15

$40

$20

$26

$32

$38

$45

$57

$68

20%offretailprice

$140allowancethen15%offany remainingbalance

$140allowance

(noadditionaldiscount)

Coveredinfull

Discountsonlens upgradesare notavailable

out-of-network

$100allowance

$210allowance

Contact lens allowance can only be applied toward the first purchase of contacts made during a benefit period. Any unused amount remaining cannot be used for subsequentpurchasesmadeduringthesamebenefitperiod,norcananyunusedamount becarriedoverto thefollowingbenefitperiod.

Contactlensesfittingandfollow-up

Acontactlensfittingandtwo follow-upvisitsareavailableonce acomprehensiveeyeexamhas beencompleted.

Standardcontactfitting**

Premiumcontactlensfitting***

Membercostupto$55

10%offretailprice

Discountsnotavailable out-of-network

**Astandardcontactlensfittingincludessphericalclearcontactlensesforconventionalwearandplannedreplacement. Examplesincludebutarenotlimitedtodisposableandfrequentreplacement.

***Apremiumcontactlensfittingincludesalllensdesigns,materialsandspecialtyfittingsotherthanstandardcontactlenses. Examplesincludebutarenotlimitedto toricandmultifocal.

VoluntaryMonthlyRates

Employee: $7.38

Employee+ Spouse: $12.92

Employee+ Child(ren): $14.02

Employee+ Family: $21.40

SignatureDate

EmployerPaidMonthlyRates

Employee: $5.58

Employee+ Spouse: $9.77

Employee+ Child(ren): $10.60

Employee+ Family: $16.18

SignatureDate

Theframeallowanceordiscountsassociated withthisvisionplanmay notapplytosomeframeswherethemanufacturerhasimposedano discountpolicyonsalesat retail andindependentprovider locations. Membersmaysubmit anout-of-network claim for reimbursementon suchframesup tothe scheduled amountindicatedin themembers benefit summary/certificateof coverage. Discounts aresubjectto changewithoutnotice.

This informationis intended tobea briefoutlineofplan benefits. Themostdetaileddescriptionof benefits,exclusions, and restrictionscanbe found in theCertificateofCoverage.

Transitionsandtheswirlareregisteredtrademarksof TransitionsOptical,Inc. Photochromicperformanceisinfluencedbytemperature,UVexposureand lensmaterial.

Anthem Blue Cross and BlueShieldis the tradename of:InIndiana:AnthemInsuranceCompanies,Inc.InKentucky: Anthem HealthPlansof Kentucky, Inc. InMissouri (excluding30 countiesintheKansasCity area): RightCHOICE® Managed Care, Inc. (RIT),Healthy Alliance® LifeInsurance Company(HALIC), andHMO Missouri, Inc.RIT and certain affiliatesadminister non-HMObenefitsunderwrittenbyHALIC andHMObenefitsunderwrittenbyHMOMissouri, Inc.RIT and certainaffiliates only provideadministrative services for self-fundedplansanddo notunderwrite benefits. InOhio: CommunityInsuranceCompany.InWisconsin:BlueCrossBlueShield ofWisconsin(BCBSWi),whichunderwritesor administers thePPOand indemnitypolicies;Compcare HealthServicesInsuranceCorporation(Compcare),whichunderwritesor administers theHMOpolicies;andCompcareandBCBSWi collectively,whichunderwriteor administer

thePOSpolicies.IndependentlicenseesoftheBlue CrossandBlueShield Association.® ANTHEM is aregisteredtrademarkofAnthem InsuranceCompanies,Inc.TheBlueCrossandBlue Shieldnamesandsymbols aretheregistered marksoftheBlueCrossandBlue ShieldAssociation. 8/11