Your Vision Benefits For Eligible Members & Dependents of PSC - CUNY Welfare Fund Account: 6747/6747M/6753

WHY SHOULD I SCHEDULE MY COVERED EYE EXAM TODAY? • Ninety percent of people age 45 and over need eyeglasses. • Many serious, sight-threatening eye diseases do not have early warning signs or symptoms. • The most effective method of detecting vision problems is a comprehensive eye exam performed by a doctor of optometry.

Even if you do not wear eyeglasses, protect your eyesight by scheduling a complete eye exam.

Professional services provided by: 1-800-VISION-1 • www.generalvision.com At any of the listed GVS Optical Providers, receive the following benefits at NO COST to You:

Plan 1: GVS/PSC-CUNY SURCHARGE SCHEDULE EYE EXAM: Comprehensive Eye Examination by Plastic Photosensitive Lenses: Doctor of Optometry Single Vision $65.00 Our professional eye examination determines your Bifocal $80.00 prescription. It also aids the doctor in detecting High Trifocal $120.00 Hi-Index $130.00 Blood Pressure, Diabetes, Retinal Disorders, and Corneal Standard Progressive $105.00 Disorders. The examination also includes Cataract and Premium Progressive Retail Less 35% Glaucoma Screening. Even if you do not wear eyeglasses, protect your eyes by scheduling a complete eye Hi-Index: examination ** Single Vision 1.60 $60.00 ** Bifocal 1.60 $100.00 FRAMES: Selection of various frames ** Standard Progressives 1.60 $150.00 Any style, any color, any size up to a retail value of $150* ** Premium Progressives 1.60 Retail Less 35% All Other High Index Lenses Retail Less 35% within the GVS Frame Collection. Polycarbonates: LENSES: All First Quality Single Vision, Children 16yrs and under No Charge Conventional Bifocal, Blended Bifocal, Single Vision $30.00 Bifocal $50.00 Standard Progressive, Trifocal, Cataract, Safety & Standard Progressives $80.00 Oversize lenses. Polycarbonate lenses for Premium Progressive Retail Less 35% children 16 years and under. Polarized Lenses: $85.00 TINTS & COATINGS: Cosmetic & Rx Sunglass Tint. UV & Scratch Resistant coating.** Coatings: Standard Anti-Reflective $25.00 Premium Anti-Reflective Retail Less 35% OR INSTEAD OF EYEGLASSES... Progressives: CONTACT LENSES: *Premium Progressives (i.e. Varilux Comfort) $90.00 3 month supply (2 Boxes, 12 Premium Plus Progressives Retail Less 35% Lenses) of Basic Disposable Contact Lenses. *No charge with Doctors Prescription *Member offices will offer a frame selection up to $100. ** 1.60 indicates the thinness of a lens ** UV & Scratch resistant coatings are not included at member offices. Any additional services that surpass the benefit are the responsibility of NOTE: The above surcharges are subject to change. the patient. Eyeglass loss insurance is available for a fee. Eyeglasses are warranteed up to one year against manufactures defects. GVS will notify PSC CUNY Welfare fund of any changes Account # 6747/6747M within 30 days notice

Plan 2: DEPENDENT CHILDREN ONLY: OFF year eyeglasses benefit for dependent children, please refer to account #6753.

For Eligibility and to Utilize Your Vision Benefit: Contact your fund office at 212-354-5230 to inquire about eligibility, then call any of the listed stores for a convenient eye exam appointment. General Vision Participating Provider Locations Please call 1-800-VISION-1 for Additional Locations and Information

NEW YORK Cohen’s Fashion Optical Wizard of Eyes 177 E. 86th St. 165-01 Jamaica Avenue MANHATTAN (212) 426-1222 (718) 523-0730 Chelsea General Vision @ Specs For Less Middle Village Cohen’s Fashion Optical 1904 Third Ave./105 St. MMJ Jeweler 275 7th Ave. (25th Street) (212) 831-3162 66-26 Metropolitan Avenue (212) 691-1709 (718) 366-8193 Cohen’s Fashion Optical Downtown 1369 Third Avenue Richmond Hill General Vision (212) 988-8505 General Vision @ 52 Duane St. Cohen’s Fashion Optical (Btwn Bdwy & Lafayette St.) Upper West Side 115-10 Liberty Ave. (212) 513-0115 Cohen’s Fashion Optical (718) 323-6410 167 W. 72nd St. Pacific Optometry (212) 362-4110 Ridgewood 87-89 Elizabeth St General Vision Express (212) 219-8260 Cohen’s Fashion Optical 57-52 Myrtle Ave. 2933 Broadway (718) 497-2020 East Side (212) 662-0400 Cohen’s Fashion Optical Woodside 106 East 23rd Street Cohen’s Fashion Optical CN Vision Care (Between Park and 2565 Broadway 45-55 46th Street Lexington Ave.) (212) 666-2615 (718) 392-1244 (212) 677-3707 Ultimate Spectacle Cohen’s Fashion Optical BROOKLYN 4250 Broadway Bayridge Bellevue Hospital (212) 795-5640 462 First Ave. Lens Lab Express (bet. 27th and 28th St) 482 86th St. Lens Lab Express (718) 921-5488 (212) 689-9601 1420 Saint Nicholas Avenue (212) 795-7780 Smith Optometry Bedford Stuyvesant Seymour Optical 303 Fifth Avenue West Side (212)532-3210 1480 Cohen’s Fashion Optical (347) 770-8330 225 W. 34th Street Harlem (212) 239-6999 Cohen’s Fashion Optical Bensonhurst 86 West 125th St. Cohen’s Fashion Optical (212) 996-2676 General Vision 2167 86th Street 20 West 14th St. (718) 946-3647 (212) 229-1410 Inwood Superior Vision Center Mega Vision Center Added Value Savings 4767 Broadway QUEENS 187 Ave. U (212) 567-9351 Astoria (718) 373-2020 These services are not covered by your vision plan. General Vision Lower East Side 30-42 Steinway St. Brownsville Cohen’s Fashion Optical (718) 726-5503 Cohen’s Fashion Optical 33 Maiden Lane Location relocated 1710 Pitken Avenue (212) 232-0065 All patient files will be at (718) 342-5500 Cohen’s Fashion Optical Cohen’s Fashion Optical 30-95 Steinway Street Caesar’s Bay 117 Orchard Street (718) 274-3500 General Vision (212) 674-1986 8949 Bay Parkway Eyewear Discounts Cohen’s Fashion Optical 718-372-1212 Cohen’s Fashion Optical 22-19 31st St. 133 Second Avenue (718) 777-7678 Canarsie (212) 254-0246 Perfect Eye Care % Bayside 1944 Ralph Ave. 30 Discount Off Midtown East Cohen’s Fashion Optical (718) 763-2020 Cohen’s Fashion Optical Bay Terrace any complete pair of glasses or contact lenses for 545 Fifth Avenue. 211-51 26th Ave. Crown Heights (212) 697-0915 (718) 631-3699 Franklin Primary Eye Care yourself or family members not covered by your plan. 847 Franklin Avenue Cohen’s Fashion Optical Eye Supply of Bayside (718) 604-1002 50 East 42nd St. 39-25 Bell Blvd. (212) 697-1838 (718) 279-2020 Downtown $ 00 General Vision @ Cohen’s Fashion Optical Corona Court Street 5 Discount Off 385 Fifth Avenue Lens Lab Express of Corona 66 Court Street comprehensive eye examinations, for yourself (212) 510-8601 37-40 Junction Blvd. (btwn Joralemon & (718) 507-8114 Livingston St.) or family members not covered by the plan. Midtown West (718) 625-0025 Cohen’s Fashion Services Elmhurst 603 6th Avenue Cohen’s Fashion Optical East (212) 924-1390 Eyesite Vision II Account # 9475 90-15 Queens Blvd. 1125 Liberty Ave. 293 368 Cohen’s Fashion Optical (718) 592-5200 (718) 235-7900 77% 100% 539 8th Ave. (37th St) (212) 792-8133 Far Rockaway Flatbush Emani and Divine Eyes General Vision @ General Vision 1058 Beach 20th Street Flatbush Avenue 330 West 42nd St. (718) 474-0064 2504 Flatbush Ave. (bet. 8th/9th Ave.) Across from Mall (212) 594-2831 Flushing (718) 253-7700 Excel Optical Cohen’s Fashion Optical 43-48 Colden Street Cohen’s Fashion Optical 132 West 57th Street (718) 961-5060 1704 Church Avenue (212) 581-4967 (718) 684-5000 Bayside Fashion Optical Union Square 58-47 Francis Lewis Blvd. Lens Lab Express of Flatbush Cohen’s Fashion Optical (718) 224-5500 972 Flatbush Ave. 841 Broadway (718) 826-0005 Mail Order Contact Lenses (b/w 13th & 14th Street) The Eye Shop (212) 475-0999 29-30 Union Street Fort Greene (718) 359-7401 Family Vision Center Upper East Side 1023 Church Ave. % Ultimate Spectacle Forest Hills (718) 826-1234 789 Lexington Ave General Vision @ 15 OFF (bet. 61st/62nd Sts.) Cohen’s Fashion Optical Sterling Optical (212) 792-8123 116-53 Queens Blvd. 524 Clarkson Ave. (718) 261-3540 (718) 778-3036 Every Contact Lens Purchase General Vision @ Metropolitan Hospital Jackson Heights Kings Highway 1901 First Ave. Cohen’s Fashion Optical Kings Highway Vision Center Room 1D18-1st Fl. 37-33 82nd St. 1302 Kings Highway (212) 423-0665 (718) 458-8800 Corner of E. 13th Street 718-627-8900 Cohen’s Fashion Optical Jamaica Promotion Code: GVS15OFF 830 Third Avenue (50th St.) Lens Lab Express/GVS Kings Plaza Mall (212) 750-9005 163-34 Jamaica Ave. Cohen’s Fashion Optical (718) 526-2332 5171 Kings Plaza Mall Cohen’s Fashion Optical (718) 951-9800 767 Lexington Ave (60th St.) Eyecare Express Call: 1-800-ANY-LENS (212) 751-6652 221-05 Jamaica Ave. Park Slope (718) 465-9500 Cohen’s Fashion Optical Cohen’s Fashion Optical 298 7th Ave. Or Visit: www.1800anylens.com 681 Lexington Ave. (718) 768-3939 (212) 317-0067 General Vision Participating Provider Locations Please call 1-800-VISION-1 or visit www.generalvision.com for Additional Locations in NY, NJ, CT & FL and Information

Sheepshead Bay Forest Avenue Greenport WESTCHESTER MORRIS PORT CHARLOTTE Vogue Optical Shopping Center Greenport Eyeworks Peekskill Rockaway Port Charlotte 3723 Nostrand Ave. Specs For Less 137 Third St. Dr. Vernon Peryea Cohen’s Fashion Optical Progressive Optical (718) 646-6200 1489 Forest Ave. (631) 477-1800 1865 Main Street Rockaway Town Square Mall 21178 Olean Blvd. (718) 727-5059 (914) 737-0437 (973) 366-2072 (941) 629-1211 Sunset Park Hampton Bays Cohen’s Fashion Optical Greenridge Plaza South Fork Optical Center White Plains PASSAIC ST LUCIE 5202 5th Ave. Specs For Less 1 Jackson Avenue South Cohen’s Fashion Optical (718) 492-0515 3245 Richmond Ave. (631) 728-1525 Paterson Port St. Lucie The Galleria Eye Contact Optical St. Lucie Vision Center (718) 605-4102 (914) 428-0300 Williamsburg Holbrook 165 Main St. 10077 South Federal Highway (973) 278-1838 (772) 398-3244 Lens Lab Express Southshore Commons Sterling Optical Yonkers of Graham Ave. Specs For Less 5801 Sunrise Hwy Sterling Optical 28 Graham Ave. 2935 Veterans Road West (631) 567-4411 Passaic MASSACHUSETTS Cross County Crystal Lens Optical (718) 486-0117 (718) 967-2869 Shopping Center BRISTOL Huntington Station 670 Main Avenue (914) 968-6600 (973) 773-2020 Fairhaven BRONX NASSAU Sterling Optical Cohen’s Fashion Optical General Vision @ Bellmore 259 Walt Whitman Rd. Yonkers Eyewear Optical 33 Berdon Way Lincoln Hospital New Location (631) 427-7300 442 South Broadway UNION (508) 990-2020 234 East 149th St. Vision People (914) 294-0320 Elizabeth Room 2-A3 2766 Sunrise Highway Islandia Cohen’s Fashion Optical ESSEX (718) 665-0611 (516) 826-2020 Sterling Optical Designer Optical 651 Kapkowski Road Islandia Shopping Center Jersey Gardens Mall Swampscott 1 Palisades Avenue Advanced Vision Center Bainbridge Garden City 1744 Veterans Memorial Hwy. (914) 226-8706 (908) 354-1599 (631) 348-4545 423 Paradise Road Bainbridge Optical Cohen’s Fashion Optical (339) 440-5105 3120 Bainbridge Avenue Roosevelt Field Yorktown Heights Lens Lab Express 718-665-6040 Shopping Center Lake Grove Sterling Optical of Elizabeth Cohen’s Fashion Optical 1167 Dickinson St. Peabody (516) 294-0011 650 Lee Blvd. Cohen’s Fashion Optical Broadway Smithhaven Mall 914-245-8111 (908) 351-6277 (631) 361-7310 Northshore Mall Broadway Eyecare Freeport 210 Andover Street, Suite E135 5571 Broadway Eyeworld Optical SOMERSET (978) 573-3222 (718) 543-2020 185 West Merrick Road Lindenhurst Bridgewater (516) 867-1213 General Vision @ BERGEN Cohen’s Fashion Optical Bruckner Cohen’s Fashion Optical Dumont 400 Commons Way MIDDLESEX Vision Quest Optical Hicksville 350 East Montauk Hwy. Dumont Eye Care (908) 725-0008 Natick 880 White Plains Rd. General Vision (near Park Ave.) 125 Washington Ave. Cohen’s Fashion Optical (718) 239-9389 232 Old Country Rd. (631) 225-5828 (201) 385-3055 Natick Mall (516) 681-3110 1245 Worcester Rd. Lens Lab Express Location relocated Patchogue Paramus FAIRFIELD (508) 651-9811 1998 Bruckner Blvd. All patient files will be at General Vision @ Lens Lab Express of Paramus Danbury (718) 430-9776 Cohen’s Fashion Optical Cohen’s Fashion Optical 193 Route 17 South Cohen’s Fashion Optical NORFOLK 210 Gateway Plaza (201) 261-8020 Danbury Fair Mall Braintree Co-Op City (516) 938-0055 499-80 Sunrise Highway 7 Backus Rd. Cohen’s Fashion Optical Bronx Eyecare (631) 289-2010 Cohen’s Fashion Optical (203) 790-1341 250 Granite Street 2075 Bartow Ave. Levittown 1 (781) 848-4481 (718) 671-5666 S.H. Laufer Vision World Port Jefferson (201) 587-0122 HARTFORD 3543 Hempstead Tpke. Eye Supply of Port Jefferson Farmington PENSYLVANIA Fordham (516) 731-1400 1092 Route 112 ESSEX Cohen’s Fashion Optical (631) 474-3937 BUCKS Bronx Eyecare East Orange 113 West Farms Mall Langhorne 2374 Grand Concourse Massapequa Dr. Spiro Antonacos (860) 521-4141 Cohen’s Fashion Optical (718) 365-6300 Cohen’s Fashion Optical Riverhead 582 Central Ave. General Vision @ Oxford Valley Mall 224 Sunrise Mall (973) 673-7700 NEW HAVEN 2300 East Lincoln Highway Hunts Point (516) 795-3030 Cohen’s Fashion Optical Riverhead Plaza Milford (215) 757-4111 Lens Lab Express Cedar Grove Cohen’s Fashion Optical 940 Southern Blvd. New Hyde Park 755 Old Country Rd. Dr. Spiro Antonacos (631) 727-3173 1201 Boston Post Road MONROE (718) 860-2323 Eye Land Vision Center 466 Pompton Ave. (203) 878-2020 Location Closed. 665 Hillside Ave. (973) 239-8381 Stroudsburg All patients can visit (516) 328-1200 Shirley Kliensorge Family Eyecare Vision Quest Optical General Vision @ Livingston FLORIDA 1619 N. 9th Street, Suite 2 880 White Plains Rd. Oceanside Cohen’s Fashion Optical Invision Eye Care BROWARD (570) 421-2332 (718) 239-9389 Vision Decision Southport Shopping Center 57 East Mt. Pleasant Ave. Coral Springs 40 Atlantic Avenue 999-3 Montauk Hwy. (973) 533-1333 Optical Eyeworks PUERTO RICO Jerome Avenue (516) 255-2020 (631) 399-6992 8124 Wiles Road HATO REY Cohen’s Fashion Optical Monroe Township (954) 757-2468 Cohen’s Fashion Optical 3416 Jerome Avenue Rockville Centre DUTCHESS Dr. Michael Hayes Plaza Las Americas (718) 325-3160 Cohen’s Fashion Optical Poughkeepsie 477 Spotswood- Margate Location 186 560 Sunrise Hwy. Cohen’s Fashion Optical Englishtown Rd Eye Care Center (787) 777-0990 Parkchester (516) 766-0550 Poughkeepsie Galleria (732) 641-2024 3181 North State Road 7 Designer Optical (845) 298-0992 (954) 974-7695 1440 Metropolitan Ave. South Farmingdale Newark CAROLINA (347) 281-4441 Eyeglass Depot Optical Urban Eyes Pembroke Pines Cohen’s Fashion Optical MONROE Plaza Carolina 60 Willow Park Center Rochester 787 Broad Street Cohen’s Fashion Optical 631-777-7283 (973) 643-3343 11401 Pines Blvd # 352 Local 245 Vision World Cohen’s Fashion Optical (787) 701-3165 1324 Metropolitan Ave. Marketplace Mall (954) 436-0966 (718) 863-3023 Valley Stream 340 Miracle Mile Drive HUDSON Cohen’s Fashion Optical (585) 475-0250 Jersey City Sedano’s Pelham Parkway 11-12 Cohen’s Fashion Optical 12538 Pines Boulevard Bronx Eye Associates (516) 825-4900 Journal Square (954) 430-4030 665 Pelham Parkway ORANGE (201) 795-3434 Suite 202 West Hempstead Middletown Plantation (718) 547-2020 General Vision @ Cohen’s Fashion Optical Union City Cohen’s Fashion Optical Cohen’s Fashion Optical Galleria @ Crystal Run Broward Mall (845) 692-5800 Crystal Lens Express South Bronx 500 Hempstead Tpke. 3907 Bergenline Ave. (954) 472-4777 Cohen’s Fashion Optical (516) 489-2262 (201) 865-8300 (formerly Eye Encounter/ Blooming Grove DADE Optic Zone) Woodbury Washington Eye Associates West New York Hialeah 2856 Third Ave. Visual Affairs 2877 Route 94 (845) 496-9999 Lens Lab Express Sedano’s (718) 585-5100 7933 Jericho Turnpike of W. New York 366 East 4th Avenue (516) 921-3937 Monroe 59-17 Bergenline Ave. (305) 888-2388 Wakefield (201) 861-0016 SAJO Optometric Care Mid-Hudson SUFFOLK Optometric Associates Miami 801 East 233rd Street Bayshore Cohen’s Fashion Optical (347) 603-7125 371 State Route 17M MIDDLESEX Sterling Optical (845) 782-3937 East Brunswick 7437 S.W. 88th Street Member offices are South Shore Mall (305) 665-1044 White Plains Crown Eyecare Center independent Doctors of 1701 Sunrise Hwy. Midstate Mall Sterling Optical Newburgh Optometry and Optical Stores (631) 666-4960 Sterling Optical 300 Rte 18 North Dr. Adina Setren-Gould 2168 White Plains Rd. 11865-A SW 26th Street who have contracted with (718) 931-0500 1401 Route 300 (732) 651-8188 Cohen’s Fashion Optical (845) 564-3522 (305) 552-9100 GVS to provide services to 1701 Sunrise Highway Woodbridge those participants outside of STATEN ISLAND (631) 665-4700 Cohen’s Fashion Optical LEE Stop & Shop Shop Center Eye Supply of Bayshore has ROCKLAND the New York Metropolitan Nanuet 460 Dr. Ft. Myers General Vision @ closed. All patient files (732) 636-2112 Sterling Optical area where frame selection Cohen’s Fashion Optical Sterling Optical are located at above location 4125 Cleveland Avenue may vary. 2748 Hylan Blvd. 164 East Route 59 (239) 936-0332 (718) 979-2200 (845) 623-8074 MONMOUTH Bellport Eatontown PALM BEACH EyeCare Center of Bellport Locations are subject to Spring Valley Cohen’s Fashion Optical Greenacres 5 Bellport Lane 180 Route 35 South Hill Lake Worth Vision change without notice. Cohen’s Fashion Optical (631) 286-4014 Eye Glasses for Less Staten Island Mall 205-4 Route 59 (732) 542-6060 6486 Lake Worth Road (718) 698-6666 (845) 371-6640 (561) 968-4942 East Northport Keyport Larkfield Optical Sterling Optical West Nyack Specs for Less of Keyport Boca Raton 516 Larkfield Road 1 Route 35 South South Shore Opticians Staten Island Mall (631) 368-2020 Cohen’s Fashion Optical Print Date: 6/11/13 (718) 698-6020 Palisades Mall (732) 264-2500 1944 N.E. Avenue Plaza Print Amount: 18.4k 2641 Drive (561) 368-2878 (845) 358-9001 Account: 6747/6747M