OBTAINING SUPPLEMENTAL ESSENTIAL MEDICAL EYE CARE SERVICES COVERED PERSON HAS A GROUP MEDICAL PLAN Supplemental Essential Medical Eye Care provides coverage for certain vision-related medical services as a supplement to Covered Person’s group medical plan. Covered Persons should refer to the plan booklet, certificate of coverage or other benefits description for their group medical plan to determine available benefits and how to obtain medical plan benefits. The eye care provider should first submit a claim to Covered Person’s group medical plan when participating in the medical plan’s network. Any amounts not paid by the primary medical plan may then be considered for payment by VSP. This process is referred to as Coordination of Benefits (“COB."). Please refer to the Coordination of Benefits section of Covered Person’s Evidence of Coverage for additional information regarding COB. COVERED PERSON DOES NOT HAVE A GROUP MEDICAL PLAN When Covered Person does not have a group medical plan, or when a VSP Preferred Provider does not participate with Covered Person’s group medical plan, the Supplemental Essential Medical Eye Care provides plan benefits as follows: 1. Covered Person contacts VSP Preferred Provider and makes an appointment. 2. Covered Person pays the applicable Copayment at the time Supplemental Essential Medical Eye Care services are rendered and amounts for any additional services not covered by the Plan. 19