1. Supplemental Insurance Protection
Premiere Vision
Vision Insurance Preferred Provider Organization (PPO) Policy
Form CH IP (1/12) OON, or its state variation.
State Availability: AR, FL, GA, ID, IL, KS, MD, MO, MT, NC, NM, NV, OH, OK, PA, TX and UT
SB PREMIERE SENIOR NON SENIOR VISION 112 OON
Approval Date:
Approval Code:
©2012 SureBridge® Product Training Materials | Proprietary and Confidential.

2. Introduction
This is a brief description of the SureBridge® Premiere Vision plan. SureBridge® is a brand name used for insurance products underwritten and administered by The Chesapeake Life Insurance Company®.
For more plan details, refer to the product materials.
The benefits described in this presentation are subject to all provisions, terms, definitions, and limitations and exclusions of the applicable policy.
Supplemental plans serve a specific purpose in the insurance market. These plans are not intended as substitutes for accident and sickness health insurance and should not be construed as such.
©2012 SureBridge® Product Training Materials | Proprietary and Confidential.

3. Vision Insurance Preferred Provider Organization (PPO) Policy Form CH IP (1/12) OON, or its state variation.
©2012 SureBridge® Product Training Materials | Proprietary and Confidential.

4. Premiere Vision Markets
Senior Market
Maximum Issue Age: 65-99
−Dependent Issue Age: 0-99
Application:26109-APP SRM D/V (01/12)
Non-Senior Market
Maximum Issue Age: 0-64
− Dependent Issue Age: 0-64
Application: APP (04/11) or (9/12)
©2012 SureBridge® Product Training Materials | Proprietary and Confidential.

5. Premiere Vision Examination
Georgia: Network Provider Benefits are revised for : Comprehensive Eye Examination to read: 100% up to $30. Net Provider Benefits are revised for: Corrective Spectacle Lenses to read: Single vision lenses 100% up to $35, Bifocal lenses 100% up to $55, and Trifocal lenses 100% up to $90; Non-Network provider benefits are revised for: Frames to read: 100% up to $84.
Network Provider Benefits
Non-Network Provider Benefits
Examination
100 % Comprehensive Eye Examinations per Insured Person
Includes eye exam, refraction and dilation as necessary
Limited to one exam every 12 months from last date of service, per insured person
Examination
100 % up to a maximum of $30 per Comprehensive Eye Examination, per Insured Person
Includes eye exam, refraction and dilation as necessary
Limited to one exam every 12 months from last date of service, per insured person
©2012 SureBridge® Product Training Materials | Proprietary and Confidential.

6. Premiere Vision Corrective Spectacle Lenses
Network Provider Benefits
Non-Network Provider Benefits
Corrective Spectacle Lenses (standard, uncoated plastic lenses)
Co-pay $10 (per insured person)
Limited to one purchase every 12 months from the last date of service, per insured person
In lieu of corrective contact lenses
Single Vision Lenses paid at 100% up to $35
Bifocal Lenses paid at 100% up to $55
Trifocal Lenses paid at 100% up to $90
Corrective Spectacle Lenses (standard, uncoated plastic lenses)
Co-pay $10 (per insured person)
Limited to one purchase every 12 months from the last date of service, per insured person
Single Vision Lenses, Bifocal Lenses and Trifocal Lenses
In lieu of corrective contact lenses
Paid at 100%
©2012 SureBridge® Product Training Materials | Proprietary and Confidential.

7. Premiere Vision Frames
Network Provider Benefits
Non-Network Provider Benefits
Frames
Co-pay $10 (per insured person)
Limited to one purchase every 12 months from the last date of service, per insured person
In lieu of corrective contact lenses
Paid at 100% up to $120
Frames
Co-pay $10 (per insured person)
Limited to one purchase every 12 months from the last date of service, per insured person
In lieu of corrective contact lenses
Paid at 100% up to $60
©2012 SureBridge® Product Training Materials | Proprietary and Confidential.

8. Premiere Vision Corrective Contact Lenses
Network Provider Benefits*
Non-Network Provider Benefits*
Corrective Contact Lenses
Co-pay $10 (per insured person)
Limited to one purchase every 12 months from the last date of service, per insured person
In lieu of corrective spectacle lenses and frames
Paid at 100% up to $120
*Contact lens fitting and follow-up visits are not covered.
Corrective Contact Lenses
Co-pay $10 (per insured person)
Limited to one purchase every 12 months from the last date of service, per insured person
In lieu of corrective spectacle lenses and frames
Paid at 100% up to $120
*Contact lens fitting and follow-up visits are not covered.
©2012 SureBridge® Product Training Materials | Proprietary and Confidential.

9. Premiere Vision Exclusions & Limitations
Benefits will not be provided under the policy for expenses associated with the following:
Orthoptic or vision training and any associated supplemental testing
Plano lenses
Lens coating
Two pair of glasses, in lieu of bifocals or trifocals
Medical or surgical treatment of the eyes
Any type of corrective vision surgery, including LASIK surgery
Any eye examination, or any corrective eyewear, required by an employer as a condition of employment
Any services or supplies when paid under any Workers’ Compensation or similar law
No-line bifocal or progressive lenses
Photochromic, transition, or polycarbonate lenses
Lenticular lenses
©2012 SureBridge® Product Training Materials | Proprietary and Confidential.

10. Premiere Vision Exclusions & Limitations, continued
Sub-normal vision aids or non-prescription lenses
Services rendered or supplies purchased outside the U.S. or Canada, unless the insured person resides in the U.S. or Canada and the charges are incurred while on a business or pleasure trip
Eyeglasses when the change in prescription is less than .5 Diopter
Experimental or investigational or non-conventional treatment or device
Eyeglass lens treatments, including “add-ons”, UV coating, anti-reflective coating, scratch resistant coating, tinting, edge polishing
Oversized lenses
High index lenses of any material type
Fitting for contact lenses
Follow-up visits
Charges incurred after the policy has terminated or coverage has ended
*For EyeMed Exclusions & Limitations, please see brochure
©2012 SureBridge® Product Training Materials | Proprietary and Confidential.

11. Premiere Vision Renewability
The policy is guaranteed renewable, subject to the Company’s right to discontinue or terminate the coverage as provided in the TERMINATION OF COVERAGE section of the policy.
Eligible Dependents covered under the policy may continue coverage until age 26, subject to the termination provisions of the policy.
©2012 SureBridge® Product Training Materials | Proprietary and Confidential.

12. Premiere Vision Marketing Guidelines for the Senior Market
Medicare Advantage plans may contain benefit provisions that could potentially duplicate the Premiere Vision policy benefits.
If you are offering the Premiere Vision policy in the senior market, you must determine if the potential applicant has existing vision coverage (refer to the application question regarding other coverage).
Do not offer a Premiere Vision policy to a customer who has an existing Medicare Advantage plan with vision benefits or other existing vision coverage.
©2012 SureBridge® Product Training Materials | Proprietary and Confidential.

13. Premiere Vision State Variations
[Arkansas: Non-Network Provider Benefits are revised for: Comprehensive Eye Examinations, and Corrective Spectacle Lenses to pay 75%. Non-Network Provider Benefits are revised for: Frames to pay 100% up to $90.]
[Florida: Network Provider Benefits are revised for : Comprehensive Eye Examination to read: 100% up to $30. Net Provider Benefits are revised for: Corrective Spectacle Lenses to read: Single vision lenses 100% up to $35, Bifocal lenses 100% up to $55, and Trifocal lenses 100% up to $90 Renewability is revised to read: “The policy is conditionally renewable, subject to the Company’s right to discontinue or terminate the coverage as provided in the TERMINATION OF COVERAGE section of the policy”.]
[Georgia: Network Provider Benefits are revised for : Comprehensive Eye Examination to read: 100% up to $30. Net Provider Benefits are revised for: Corrective Spectacle Lenses to read: Single vision lenses 100% up to $35, Bifocal lenses 100% up to $55, and Trifocal lenses 100% up to $90; Non-Network provider benefits are revised for: Frames to read: 100% up to $84.
[Illinois: Revised renewability updating age requirements: Eligible Dependent means Your lawful spouse and Your natural and adopted children, including children placed in your custody for placement of adoption , step-children and grandchildren (if the grandparents have obtained an interim-court order that vests temporary custody of said grandchildren), who are under 30 years of age (the limiting age).]
[Kansas: Renewability is revised to read: “The policy is conditionally renewable, subject to the Company’s right to discontinue or terminate the coverage as provided in the TERMINATION OF COVERAGE section of the policy.”]
[Kentucky: Renewability is revised to read: “The policy is conditionally renewable, subject to the Company’s right to discontinue or terminate the coverage as provided in the TERMINATION OF COVERAGE section of the policy.”]
©2012 SureBridge® Product Training Materials | Proprietary and Confidential.

14. Premiere Vision State Variations, continued
Maryland: Renewability is revised to read: “The policy is conditionally renewable, subject to the Company’s right to discontinue or terminate the coverage as provided in the TERMINATION OF COVERAGE section of the policy.” Under the exclusions section, exclusion #15 is deleted entirely and exclusion #21 is revised to read “Charges incurred after this Policy has terminated or coverage has ended, subject to the Extension of Benefits.”]
[North Carolina: Under the exclusions section, exclusion #8 is revised to read: Any Injury or Sickness arising out of, or in the course of, employment for wage or profit, for which benefits are paid under the Worker’s Compensation Act, Occupational Disease Act, or similar act or law and if determined by a final adjudication of the claim, the employee, employer or Workers Compensation Carrier under such Article or by an order of the North Carolina Industrial Commission, is liable/responsible for such charges, unless the Insured is self-employed;
[Texas: Renewability is revised to read: The policy is renewable, subject to the Company’s right to discontinue or terminate the coverage as provided in the TERMINATION OF COVERAGE section of the policy.”]
©2012 SureBridge® Product Training Materials | Proprietary and Confidential.

15. Premiere Vision EyeMed Vision Care Network
Over 14,000 outlets
Including Lens Crafters, Pearle Vision, Sears, Target Optical, and many independent providers
Visit to verify provider participation
Choose the “Select” network option
Or call
No claim forms
The optical provider determines the exact benefits and fees that apply
©2012 SureBridge® Product Training Materials | Proprietary and Confidential.

16. Choose the “Select” Network
EyeMed Access
1. Locate Provider
Choose the “Select” Network
2. Choose the “Select” Network
3. Enter Zip Code
©2012 SureBridge® Product Training Materials | Proprietary and Confidential.

17. Premiere Vision Additional State Variations
This presentation is not inclusive of all policy provisions.
See product materials for complete details and any additional state variations regarding Termination of Coverage, Renewability, Premium Changes, Eligible Dependents, and Policy Definitions.
SureBridge® products are individual supplemental products, and are not available as group coverage.  There is no list bill and premiums may not be paid by employers for employees. 
The claim examples used in this presentation are for training purposes only and are not approved for any other use.
This material cannot be copied or used in any way for advertising or presentation purposes.
©2012 SureBridge® Product Training Materials | Proprietary and Confidential.

18. Vision Insurance Preferred Provider Organization (PPO)Policy
©2012 SureBridge® Product Training Materials | Proprietary and Confidential.