Introducing DeltaVision® in partnership with VSP®

You’ll see the difference with DeltaVision®

Personalized Care. DeltaVision members 3 in 4 receive quality care that focuses on their adults need eyes and overall wellness. Our eye care vision correction.1 provider will look for vision problems and signs of other health conditions.

Eyewear. Choose that’s right for 1 in 4 you and your budget. From classic styles children need to the latest designer fashions, there vision correction.1 are hundreds of options for DeltaVision members. Only 1 in 5 Value and Savings. DeltaVision members Americans get an receive great benefits on exams and annual medical exam.2 eyewear at an affordable price.

Enroll Today!

Sources: 1. Vision Council, VisionWatch December 2014; 2. American Journal of Preventative Medicine 2012, 42, Issue 2:164-173. Delta Dental of Tennessee DeltaVision® Plan 130

Delta Dental has partnered with VSP to provide DeltaVision®. Now you can enjoy the benefits of comprehensive vision care. DeltaVision® offers the same quality coverage, exceptional service, and unparalleled networks you’ve come to expect from Delta Dental, making it an easy addition to your healthcare network.

DeltaVision 130 Benefits

WellVision Exam $10 Copay Exams Comprehensive eye exam to ensure overall visual wellness Once every 12 months Prescription $25 Copay • $130 allowance for wide selection of frames Frames Included in • 20% savings on amount over allowance Once every 24 months Prescription Glasses Copay • $70 Costco frame allowance Included in • Single vision, lined bifocal and lined trifocal lenses Once every 12 months Prescription Glasses Copay Covered • Polycarbonate lenses for children $0 Enhancements • Standard Progressive Lenses

Optional Copay Ranges • Premium Progressive Lenses Lens Enhancements $95 - $105 • Custom Progressive Lenses Average savings of $150 - $175 • Tints/Photochromic Adaptive Lenses 20-25% on other lens $15 - $17 • Scratch Resistant Coating enhancements $17

Contact Lenses - Instead of Glasses Contacts • $130 allowance for contacts; copay does not apply up to $60 Once every 12 months • exam (fitting and evaluation) Extra Savings Featured Frames $150 allowance on featured frame brands. Check vsp.com for current offers. 20% savings on additional glasses and , including lens enhancements, from any VSP Glasses and Sunglasses provider within 12 months of your last WellVision Exam No more than a $39 copay on routine retinal screening as an enhancement to a WellVision Retinal Screening Exam Value Added Programs Included Primary Eyecare, Eye Health Management (including Diabetic Exam Reminder Letters)

Your coverage with Out-of-Network Providers • Exam - up to $45 • Lined Bifocal Lenses - up to $50 • Progressive Lenses - up to $50 • Frame - up to $70 • Lined Trifocal Lenses - up to $65 • Contacts - up to $105 • Single Vision Lenses - up to $30 • Lenticular Lenses - up to $100 • Necessary Contact Lenses - up to $210

To learn more about DeltaVision® plans visit DeltaDentalTN.com/DeltaVision

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