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5. All reimbursements will be sent to the policyholder s address on file. Policyholder is responsible for updating address changes with employer. If your receipts do not reflect the information above your claim cannot be processed. Or fax form and receipts to CHARGES Single vision Bifocal Trifocal Progressives Lenticular Tint Scratch coat Anti reflective Photochromic Polycarbonate UV coating Low vision aids Elective Contacts Contact Eval/fit Lasik if covered by plan Medically required...
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