VISION BENEFITS

www.equitable.com/employeebenefits/

Customer Care: 1.866.274.9887

ELIGIBILITY

You must enroll online (see pages 6-7 in the Yellow Book for instructions) by November 17, 2023. Your effective date is on the first day of the month following two (2) full calendar months of employment. If you enroll dependents you must prove eligibility. Dependent Eligibility forms are found on the Enrollment site https://jmsmith.bcenroll.net under Posted Forms.

NOTE: If you do not enroll in Vision Benefits when first 'eligible', waiting periods for vision benefits apply.

VISION COVERAGE

NOTE: This is a convenient brief summary. Always check your booklet certificate. The contract is the official source of information.

CONTINUING COVERAGE AFTER I STOP WORKING

You may continue coverage for you and your covered dependents at your own expense under COBRA. You will be provided with information and costs upon leaving your employment with J M Smith Corporation.

You may visit the provider of your choice and select any provider on a treatment by treatment basis. It is important to remember your out-of-pocket costs may vary depending on your choice. You have two options:

1. In-Network (In-Network). Eye care providers that have agreed to provide eye care services at discounted rates for participants.
2. Out-Of-Network (Out-Of-Network). Eye care providers that have not agreed to provide eye care services at discounted rates for participants.