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_ _...,..,? .,:..,, <br />? F. Special or unusual procedures or treatments such as <br />orthoptics, tonography, vision training, subnormal <br />vision aids, aneseikonic lenses, disease, infection or <br />inj ury <br />G. Replacement of lost eye wear <br />H. Payment to medical doctors <br />I. Charges for rimless mounting, faceting or edge <br />polishing <br />J. Non-Network Coverage - Charges for services provided at <br />locations other than Union Eye Care Center <br />K. Spectacle or contact lens examination or material fees <br />to the extent that they exceed the plan benefit amounts <br />as indicated in Sections IV. A <br />L. Taxes on materials <br />VIII.NON-COVERED OPTIONS <br />A. Because of the cosmetic nature of eyewear, the <br />eligible person may select lenses, lens t ints and/or <br />frames that include options not provided for under <br />"Covered Vision Services." Frames or contact lenses <br />exceeding the maximum allowance are consi dered an <br />option. The eligible person will pay the difference <br />between the actual cost and the maximum allowable. <br />B. Additional vision examination services; i.e., <br />perimetry, contact lens examinations and follow-up <br />care, are not covered under the definition of this <br />agreement and any fees associated with these procedures <br />are the responsibility of the eligible person. <br />4 <br />Rev. 11/28/06