Mulzer Crushed Stone, Inc. Eye Care Highlight Sheet

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1 Plan 1: Focus VSP with Safety Glasses Plan Summary Effective Date: 7/1/2013 Copays $10 Exam $25 Eye Glass Lenses or Frames $25 Eye Glass Lenses or Frames* Annual Eye Exam Up to $45 Regular / Safety Lenses Lenses (per pair) Single Vision Up to $30 / $30 Bifocal Up to $50 / $45 Trifocal Up to $65 / $60 Lenticular Up to $100 / $90 Progressive NA Contacts Fit & Follow Up Exams 15% discount No Benefit See Additional Focus Features. Elective Up to $130 Up to $105 Medically Necessary Up to $210 Frames $130** Up to $70 Frames (Safety) $65 Up to $25 Frequencies (months) Exam/Lens/Frame 12/12/24 12/12/24 Safety Lens/Frames 12/24 12/24 *Copay applies to a complete pair of glasses or to frames, whichever is selected. **The Costco allowance will be the wholesale equivalent. Wal-Mart: Members utilizing Wal-Mart with their VSP benefits will be reimbursed at the out of network allowances. Wal-Mart will file the claim on the member s behalf so the member will only have to pay their responsibility at the time of service. Lens Options (member cost)* (Other than Costco) Progressive Lenses Up to Lined Bifocal allowance. Std. Polycarbonate Solid Plastic Dye (except Pink I & II) Plastic Gradient Dye Photochromatic Lenses (Glass & Plastic) Scratch Resistant Coating Anti-Reflective Coating Ultraviolet Coating *Lens Option member costs vary by prescription, option chosen and retail locations. Monthly Rates Employee Only (EE) $9.76 EE + Spouse $19.24 EE + Children $17.72 EE + Spouse & Children $27.20

2 Additional Focus Choice Network Features Contact Lenses Elective Allowance includes fitting, exam and lenses. The cost of the fitting and evaluation is deducted from the contact allowance. Allowance can be applied to disposables, but the dollar amount must be used all at once (provider will order 3 or 6 month supply). Applies when contacts are chosen in lieu of glasses. Additional Glasses Frame Discount Laser VisionCare Low Vision 20% discount off the retail price on additional pairs of prescription glasses (complete pair). VSP offers a 20% discount off the remaining balance in excess of the frame allowance. VSP offers an average discount of 15% on LASIK and PRK. The maximum out-of-pocket per eye for members is $1,800 for LASIK and $2,300 for custom LASIK using Wavefront technology, and $1,500 for PRK. In order to receive the benefit, a VSP provider must coordinate the procedure. With prior authorization, 75% of approved amount (up to $1,000 is covered every two years). Rx Savings Our valued plan members and their covered dependents (even their pets) can save on prescription medications through any Walmart or Sam's Club pharmacy across the nation. This Rx discount is offered at no additional cost, and it is not insurance. To receive the Walmart Rx discount, Ameritas plan members just need to visit us at ameritasgroup.com and sign into (or create) a secure member account where they can access and print an online-only Rx discount savings ID card. Retail Chain Affiliate Providers Available With Focus Plans Effective January 1, 2012, retail chain affiliate providers, which include Costco Optical and Visionworks, give members added convenience and additional retail choices. Costco Optical has 400 locations across the country, while Visionworks manages nearly 400 optical stores in 37 states and DC, including well-known stores such as EyeMasters, Visionworks, Dr. Bizer s VisionWorld, Eye DRx, and Hour Eyes, to name a few. Members enjoy a covered-in-full benefit experience with equivalent frame benefit at any of these retail chain locations. Eye Care Plan Member Service Focus eye care from Ameritas Group features the money-saving eye care network of VSP. Customer service is available to plan members through VSP's well-trained and helpful service representatives. Call or go online to locate the nearest VSP network provider, view plan benefit information and more. VSP Call Center: Service representative hours: 5 a.m. to 7 p.m. PST Monday through Friday, 6 a.m. to 2:30 p.m. PST Saturday Interactive Voice Response available 24/7 Locate a VSP provider at: ameritasgroup.com/member View plan benefit information at: vsp.com Section 125 This plan is provided as part of the Policyholder's Section 125 Plan. Each employee has the option under the Section 125 Plan of participating or not participating in this plan. If an employee does not elect to participate when initially eligible, he/she may elect to participate at the Policyholder's next Annual Election Period. This document is a highlight of plan benefits provided by Ameritas Life Insurance Corp. as selected by your employer. It is not a certificate of insurance and does not include exclusions and limitations. For exclusions and limitations, or a complete list of covered procedures, contact your benefits administrator.

3 Plan 2: Vision Perfect $200 Reimbursement Plan Summary Effective Date: 7/1/2013 Copays $0* Maximum Calendar Year $200 Annual Eye Exam Lenses (per pair) Single Vision Bifocal Trifocal Lenticular Progressive Contacts Elective/Medically Necessary Frames Frequencies (months) Exam/Lens/Frame None ** *Copay applies to the first service received **After the doctor is paid for services, submit a claim within 90 days for reimbursement (180 days in North Carolina). Monthly Rates Employee Only (EE) $7.24 EE + Spouse $14.20 EE + Children $12.48 EE + Spouse & Children $19.44 Rx Savings Our valued plan members and their covered dependents (even their pets) can save on prescription medications through any Walmart or Sam's Club pharmacy across the nation. This Rx discount is offered at no additional cost, and it is not insurance. To receive the Walmart Rx discount, Ameritas plan members just need to visit us at ameritasgroup.com and sign into (or create) a secure member account where they can access and print an online-only Rx discount savings ID card. Eyewear Savings at Wal-Mart Ameritas plan members may receive up to 15% off eyewear frames and lenses purchased at any Walmart Vision Center nationwide. Members may also bring in their current vision prescription from any vision care provider and purchase eyewear at Walmart. This savings arrangement is not insurance: it is available to members at no additional cost to their plan premium. To receive the eyewear savings identification card, Ameritas plan members can visit ameritasgroup.com and sign-in (or create) a secure member account. Members must present the Ameritas Eyewear Savings Card at time of purchase to receive the discount. The member is responsible for filing the claim on Vision Perfect plans. Ameritas Information We're Here to Help This plan was designed specifically for the associates of. At Ameritas Group, we do more than provide coverage - we make sure there's always a friendly voice to explain your benefits, listen to your concerns, and answer your questions. Our customer relations associates will be pleased to assist you 7 a.m. to midnight (Central Time) Monday through Thursday, and 7 a.m. to 6:30 p.m. on Friday. You can speak to them by calling toll-free: For plan information any time, access our automated voice response system or go online to ameritasgroup.com/member.

4 Triple Choice Eye Care Plans Triple Choice Plans let you offer your employees a choice between three plans in one policy. Your employees select the plan that best suits their coverage and financial needs. On the July 1, 2013, effective date, all eligible employees may choose between the three plans shown or choose to waive coverage. The employee must remain in the plan he or she chose until the next renewal date. At each annual election period, employees may switch between plans without penalty. Section 125 This plan is provided as part of the Policyholder's Section 125 Plan. Each employee has the option under the Section 125 Plan of participating or not participating in this plan. If an employee does not elect to participate when initially eligible, he/she may elect to participate at the Policyholder's next Annual Election Period. This document is a highlight of plan benefits provided by Ameritas Life Insurance Corp. as selected by your employer. It is not a certificate of insurance and does not include exclusions and limitations. For exclusions and limitations, or a complete list of covered procedures, contact your benefits administrator.

5 Plan 3: Focus VSP Basic Plan Summary Effective Date: 7/1/2013 Copays $10 Exam $25 Eye Glass Lenses or Frames* $25 Eye Glass Lenses or Frames Annual Eye Exam Up to $45 Lenses (per pair) Single Vision Up to $30 Bifocal Up to $50 Trifocal Up to $65 Lenticular Up to $100 Progressive NA Contacts Fit & Follow Up Exams 15% discount See Additional Focus Features. Elective Up to $130 Up to $105 Medically Necessary Up to $210 Frames $130** Up to $70 Frequencies (months) Exam/Lens/Frame 12/12/24 12/12/24 *Copay applies to a complete pair of glasses or to frames, whichever is selected. **The Costco allowance will be the wholesale equivalent. Wal-Mart: Members utilizing Wal-Mart with their VSP benefits will be reimbursed at the out of network allowances. Wal-Mart will file the claim on the member s behalf so the member will only have to pay their responsibility at the time of service. Lens Options (member cost)* (Other than Costco) Progressive Lenses Up to Lined Bifocal allowance. Std. Polycarbonate Solid Plastic Dye (except Pink I & II) Plastic Gradient Dye Photochromatic Lenses (Glass & Plastic) Scratch Resistant Coating Anti-Reflective Coating Ultraviolet Coating *Lens Option member costs vary by prescription, option chosen and retail locations. Monthly Rates Employee Only (EE) $8.82 EE + Spouse $18.30 EE + Children $16.78 EE + Spouse & Children $26.26

6 Additional Focus Choice Network Features Contact Lenses Elective Allowance includes fitting, exam and lenses. The cost of the fitting and evaluation is deducted from the contact allowance. Allowance can be applied to disposables, but the dollar amount must be used all at once (provider will order 3 or 6 month supply). Applies when contacts are chosen in lieu of glasses. Additional Glasses Frame Discount Laser VisionCare Low Vision 20% discount off the retail price on additional pairs of prescription glasses (complete pair). VSP offers a 20% discount off the remaining balance in excess of the frame allowance. VSP offers an average discount of 15% on LASIK and PRK. The maximum out-of-pocket per eye for members is $1,800 for LASIK and $2,300 for custom LASIK using Wavefront technology, and $1,500 for PRK. In order to receive the benefit, a VSP provider must coordinate the procedure. With prior authorization, 75% of approved amount (up to $1,000 is covered every two years). Rx Savings Our valued plan members and their covered dependents (even their pets) can save on prescription medications through any Walmart or Sam's Club pharmacy across the nation. This Rx discount is offered at no additional cost, and it is not insurance. To receive the Walmart Rx discount, Ameritas plan members just need to visit us at ameritasgroup.com and sign into (or create) a secure member account where they can access and print an online-only Rx discount savings ID card. Retail Chain Affiliate Providers Available With Focus Plans Effective January 1, 2012, retail chain affiliate providers, which include Costco Optical and Visionworks, give members added convenience and additional retail choices. Costco Optical has 400 locations across the country, while Visionworks manages nearly 400 optical stores in 37 states and DC, including well-known stores such as EyeMasters, Visionworks, Dr. Bizer s VisionWorld, Eye DRx, and Hour Eyes, to name a few. Members enjoy a covered-in-full benefit experience with equivalent frame benefit at any of these retail chain locations. Eye Care Plan Member Service Focus eye care from Ameritas Group features the money-saving eye care network of VSP. Customer service is available to plan members through VSP's well-trained and helpful service representatives. Call or go online to locate the nearest VSP network provider, view plan benefit information and more. VSP Call Center: Service representative hours: 5 a.m. to 7 p.m. PST Monday through Friday, 6 a.m. to 2:30 p.m. PST Saturday Interactive Voice Response available 24/7 Locate a VSP provider at: ameritasgroup.com/member View plan benefit information at: vsp.com Triple Choice Eye Care Plans Triple Choice Plans let you offer your employees a choice between three plans in one policy. Your employees select the plan that best suits their coverage and financial needs. On the July 1, 2013, effective date, all eligible employees may choose between the three plans shown or choose to waive coverage. The employee must remain in the plan he or she chose until the next renewal date. At each annual election period, employees may switch between plans without penalty. Section 125 This plan is provided as part of the Policyholder's Section 125 Plan. Each employee has the option under the Section 125 Plan of participating or not participating in this plan. If an employee does not elect to participate when initially eligible, he/she may elect to participate at the Policyholder's next Annual Election Period. This document is a highlight of plan benefits provided by Ameritas Life Insurance Corp. as selected by your employer. It is not a certificate of insurance and does not include exclusions and limitations. For exclusions and limitations, or a complete list of covered procedures, contact your benefits administrator.

Oregon Association of Realtors Eye Care Highlight Sheet

Oregon Association of Realtors Eye Care Highlight Sheet Plan 1: Focus Plan Summary Effective Date: 1/1/2019 VSP Choice Network + Affiliates Deductibles $10 Exam $10 Exam $25 Eye Glass Lenses or Frames* $25 Eye Glass Lenses or Frames Annual Eye Exam Covered