VSP Vision Plan In-Network Out-of-Network Benefit Frequency Eye Exam $10 copay $45 allowance 1x every year Eyeglass Frames $10 copay $140 allowance, then 20% discount on remaining balance $70 allowance 1x every 2 years Lenses (Single/Bifocal/Trifocal/Lenticular) $25 copay $30 - $65 allowance 1x every year Contact Lenses (Conventional) $120 allowance $105 allowance 1x every year Contact Lenses (Medically-necessary) Covered in full $210 allowance 1x every year

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