Common use of Non-Medical Benefits Clause in Contracts

Non-Medical Benefits. a. In the case of non-medical premiums, the Board shall pay the entire premium effective upon ratification and execution and shall not under any circumstances require the Board to provide the described benefits. b. Dental: Class I: 80% Class II: 80% Class III: 80% Annual Max: $1,500 Class IV: 80% Class IV/ Lifetime Max: $1,500 Riders: 2 Cleanings Dental – Coordination of Benefits Class I: 50% Class II: 50% Class III: 50% Annual Max: $1,500 Class IV: 50% Class IV/ Lifetime Max: $1,300 Riders: 2 Cleanings c. Vision: Co-payment - None Participating Provider Non-Participating Provider Examination Once Every Plan Year Covered 100% Reimbursed Amount Up to $35 (OD) Up to $45 (MD) Lenses Once Every Plan Year • Single Vision • Bifocal • Trifocal • Lenticular • Oversized Lenses Covered Up to $38 Up to $60 Up to $72 Up to $108 Not Covered Frame Once Every Plan Year Retail Allowance Up to $135 Up to $55 Contact Lenses Once Every Plan Year Elective Contact Lenses In lieu of Lenses & Frame Up to $130 Retail In lieu of Lenses & Frame Up to $115

Non-Medical Benefits. a. In the case of non-medical premiums, the Board shall pay the entire premium effective upon ratification and execution and shall not under any circumstances require the Board to provide the described benefits. b. Dental: Class I: 80% Class II: 80% Class III: 80% Annual Max: $1,500 Class IV: 80% Class IV/ Lifetime Max: $1,500 Riders: 2 Cleanings Dental – Coordination of Benefits Class I: 50% Class II: 50% Class III: 50% Annual Max: $1,500 Class IV: 50% Class IV/ Lifetime Max: $1,300 Riders: 2 Cleanings c. Vision: Co-payment - None Participating Provider Non-Participating Provider Examination Once Every Plan Year Lenses Once Every Plan Year • Single Vision • Bifocal • Trifocal • Lenticular • Oversized Lenses Covered 100% Reimbursed Amount Up to $35 (OD) Up to $45 (MD) Lenses Once Every Plan Year • Single Vision • Bifocal • Trifocal • Lenticular • Oversized Lenses Covered Up to $38 Up to $60 Up to $72 Up to $108 Not Covered Frame Once Every Plan Year Retail Allowance Up to $135 Up to $55 Contact Lenses Once Every Plan Year Elective Contact Lenses Retail Allowance Up to $135 In lieu of Lenses & Frame Up to $130 Retail Up to $55 In lieu of Lenses & Frame Up to $115

Non-Medical Benefits. a. In the case of non-medical premiums, the Board shall pay the entire premium effective upon ratification and execution and shall not under any circumstances require the Board to provide the described benefits. b. a. Dental: Class I: 80% Class II: 80% Class III: 80% Annual Max: $1,500 Class IV: 80% Class IV/ Lifetime Max: $1,500 Riders: 2 Cleanings Dental – Coordination of Benefits Class I: 50% Class II: 50% Class III: 50% Annual Max: $1,500 Class IV: 50% Class IV/ Lifetime Max: $1,300 Riders: 2 Cleanings c. b. Vision: Co-payment - None Participating Provider Non-Participating Provider Examination Once Every Plan Year Covered 100% Reimbursed Amount Up to $35 (OD) Up to $45 (MD) Lenses Once Every Plan Year • Single Vision • Bifocal • Trifocal • Lenticular • Oversized Lenses Covered Up to $38 Up to $60 Up to $72 Up to $108 Not Covered Frame Once Every Plan Year Retail Allowance Up to $135 Up to $55 Contact Lenses Once Every Plan Year Elective Contact Lenses In lieu of Lenses & Frame Up to $130 Retail In lieu of Lenses & Frame Up to $115

Non-Medical Benefits. a. In the case of non-medical premiums, the Board shall pay the entire premium effective upon ratification and execution and shall not under any circumstances require the Board to provide the described benefits. b. Dental: Class I: 80% Class II: 80% Class III: 80% Annual Max: $1,500 Class IV: 80% Class IV/ Lifetime Max: $1,500 Riders: 2 Cleanings Dental – Coordination of Benefits Class I: 50% Class II: 50% Class III: 50% Annual Max: $1,500 Class IV: 50% Class IV/ Lifetime Max: $1,300 Riders: 2 Cleanings c. Vision: Co-payment - None Participating Provider Non-Participating Provider Examination Once Every Plan Year Covered 100% Reimbursed Amount Up to $35 (OD) Up to $45 (MD) Lenses Once Every Plan Year • Single Vision • Bifocal • Trifocal • Lenticular • Oversized Lenses Covered Up to $38 Up to $60 Up to $72 Up to $108 Not Covered Frame Once Every Plan Year Retail Allowance Up to $135 Up to $55 Contact Lenses Once Every Plan Year Elective Contact Lenses In lieu of Lenses & Frame Up to $130 Retail In lieu of Lenses & Frame Up to $115

Non-Medical Benefits. a. In the case of non-medical premiums, the Board shall pay the entire premium effective upon ratification and execution and shall not under any circumstances require the Board to provide the described benefits. b. Dental: Class I: 80% Class II: 80% Class III: 80% Annual Max: $1,500 Class IV: 80% Class IV/ Lifetime Max: $1,500 Riders: 2 Cleanings Dental – Coordination of Benefits Class I: 50% Class II: 50% Class III: 50% Annual Max: $1,500 Class IV: 50% Class IV/ Lifetime Max: $1,300 Riders: 2 Cleanings c. Vision: Co-payment - None Participating Provider Non-Participating Provider Examination Once Every Plan Year Covered 100% Reimbursed Amount Up to $35 (OD) Up to $45 (MD) Lenses Once Every Plan Year •  Single Vision •  Bifocal •  Trifocal •  Lenticular •  Oversized Lenses Covered Up to $38 Up to $60 Up to $72 Up to $108 Not Covered Frame Once Every Plan Year Retail Allowance Up to $135 65 Up to $55 Contact Lenses Once Every Plan Year Elective Contact Lenses In lieu of Lenses & Frame Up to $130 115 Retail In lieu of Lenses & Frame Up to $115

Non-Medical Benefits. a. In the case of non-medical premiums, the Board shall pay the entire premium effective upon ratification and execution and shall not under any circumstances require the Board to provide the described benefits. b. a. Dental: Class I: 80% Class II: 80% Class III: 80% Annual Max: $1,500 Class IV: 80% Class IV/ Lifetime Max: $1,500 Riders: 2 Cleanings Dental – Coordination of Benefits Class I: 50% Class II: 50% Class III: 50% Annual Max: $1,500 Class IV: 50% Class IV/ Lifetime Max: $1,300 Riders: 2 Cleanings c. b. Vision: Co-payment - None Participating Provider Non-Participating Provider Examination Once Every Plan Year Covered 100% Reimbursed Amount Up to $35 (OD) Up to $45 (MD) Lenses Once Every Plan Year •  Single Vision •  Bifocal • Trifocal • Lenticular • Oversized Lenses Covered Up to $38 Up to $60  Trifocal  Lenticular  Oversized Lenses Up to $72 Up to $108 Not Covered Frame Once Every Plan Year Retail Allowance Up to $135 65 Up to $55 Contact Lenses Once Every Plan Year Elective Contact Lenses In lieu of Lenses & Frame Up to $130 115 Retail In lieu of Lenses & Frame Up to $115