Page 14 - Burnham EE Guide 01-20
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HEALTH BENEFITS: VISION PLAN




                 Guardian Vision Plan (VSP Network)

                 Burnham provides employees with the opportunity to purchase vision coverage through the Guardian Vision
                 Plan, utilizing the Vision Service Plan (VSP) network. This plan provides professional vision care and high
                 quality lenses and frames through a broad network of optical specialists. You will receive richer benefits if you
                 utilize a network provider. If you utilize a non-network provider, you will be responsible for paying all charges at
                 the time of your appointment and will be required to file an itemized claim with Guardian.

                 To find in-network providers, visit www.guardiananytime.com or call 877-814-8970 (refer to the “VSP
                 Signature” network).

                                                                Guardian Vision Plan (VSP Network)

                                                               In-Network                     Non-Network
                  Copays
                  Vision Exam (once per calendar year)                         $10 Copay
                  Materials                                                    $25 Copay
                  Glasses

                  Frames (once per 2 calendar years)        $130 Allowance +                $48 Reimbursement
                                                       20% Discount Over Allowance
                  Lenses (once per calendar year)
                   Single Vision                               No Charge                    $48 Reimbursement
                   Bifocal                                     No Charge                    $67 Reimbursement
                   Trifocal                                    No Charge                    $86 Reimbursement
                  Contact Lenses
                  Elective (once per 1 calendar year         $130 Allowance                $130 Reimbursement
                  in lieu of frames and lenses)
                  Laser Correction Surgery

                  Discount                            Up to 15% Off the Usual Charge           No Discount
                                                        or 5% Off Promotional Price




                  HEALTH BENEFITS: EMPLOYEE ASSISTANCE PROGRAM




                 Standard Insurance Employee Assistance Program

                 Burnham provides employees and their families with free, confidential assistance to help with personal or
                 professional issues that may interfere with work or family responsibilities and obligations through the Standard
                 Insurance Employee Assistance Program (EAP). Services are available 24 hours a day, seven days a week via
                 a toll-free nationwide number. Employees and their household members can receive up to three counseling
                 sessions per person, per issue, per year.

                 To access the EAP, log into www.workhealthlife.com/standard3 or call 888-293-6948 to be connected to an
                 EAP counselor.

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