Saturday, July 21, 2007

Eyemed Vision is a scam. Part II

Vision Insurance is a Scam! Part II

In case you missed part one, I will do a quick recap for you. For starters, I am probably a big dumb ass for paying for Eyemed Vision coverage through my place of employment. So are you if you signed up for it. It is a scam that only allows you to use your full “benefit” towards the retail price of eyeglasses & frames at most Optometry shops. Let’s look closer at this and see how the scam works exactly.

One of the first things I did was to look at the Eyemed website. Here are a few little gems I discovered. This quote is from the Provider Resources page on their site: http://www.eyemedvisioncare.com/provrec/benefits.html

“…EyeMed is committed to supporting your ability to profitably prescribe to your patients needs and wants,…”

Wow. They are looking to help my provider (local eyeglasses shop) make money when they sell me glasses. Hmmmm—already I am thinking that these guys are not looking out for my best interests. The way they provide “benefits” is certainly a dead giveaway.

Just who IS EyeMed Vision? On the phone, I had asked the customer service person if Eyemed Vision is a publicly traded company or not. She didn’t even know what that means (I had to explain), and she didn’t know the answer. As I looked around on the net, I discovered a few things about this company and it really explained a lot.

EyeMed is owned fully by Luxottica. Yes, they are owned by Luxottica—the Italian eyeglass manufacturer. This corporation manufactures many of the major brands of eyeglasses in the world, including Ray Ban, Bvlgari, Burberry, Chanel, Dolce & Gabbana, Donna Karan, Prada, Versace and Polo Ralph Lauren. A complete listing is here: http://annual-report-2006.luxottica.com/marchi_en.asp

Luxottica has been a very hungry corporation, gobbling up companies left and right. Let’s take a look at what else Luxottica owns. One of the acquisitions was Cole National Group, which meant that Luxottica owns Pearle Vision. I know what you’re thinking—they own the “insurance” company, the manufacturing facilities, AND the retail chain? Yes they do. A little checking with the SEC shows that not all of those mergers went smoothly though. Luxottica also wholly owns the Lenscrafters and Sunglass Hut chains. In addition, they have licensed operations under these additional names, and are adding more: Sears Optical, Target Optical, and BJ’s Optical. JCPenneys Optical may also have recently fallen under this umbrella (though I could not find that specific information) as they now answer their phones as "JCPenney Optical, part of the EyeMed Vision Care Network".

I bet you thought those were all different stores, didn’t you? Well I believe you’ve been led to this assumption completely by design, since none of the websites for those different retailers tell you that they are a wholly owned subsidiary or even a licensed operation of Luxottica. Now why is that? One would think that identifying with Luxottica would be a source of corporate pride that you would want your customers to know. One would think it would instill confidence in customer purchases, knowing they are dealing with the “800 pound gorilla” of the eyeglass industry. I mean, surely a company that HUGE would be able to give the most competitive pricing to its customers—right? Unless of course your sole purpose is to deceive customers into thinking they can comparison shop between all those retailers for the best price. Is there anyone else thinking this could lead to price manipulation? Call me crazy, but I think a little disclosure would be nice.

So let’s come full-circle back to EyeMed Vision Care. Some may be thinking that I can just go to a non-Luxottica owned provider and get my glasses there. Well, I could, and I would pay through the nose for eyeglasses there, as EyeMed Vision Care has very cleverly designed restrictions on Out-of-Network Providers and the way they are reimbursed. After all—they have a vested interest in keeping me under the Luxottica umbrella through the entire purchase process—from my “insurance” to my “provider” to the manufacturer of the product I choose. Ultimately, I get an even smaller amount of “benefit” that amounts to $45 for frames and $35 for single-prescription lenses. And remember--the Out-of-Network Providers are in direct competition with the big bad corporate bully Luxottica, whose pricing practices affect the entire industry---well almost.

If there is one thing I am grateful for, it is that Al Gore invented the internet. This little adventure of mine led me to the blog of another disgruntled consumer. Since reading up there, I now have a new plan of action for dealing with the EyeMed/Luxottica scam. From the list of online eyeglass retailers on his blog site, I will be purchasing the exact same glasses for a fraction of the cost, AND I will have the pleasure of sticking EyeMed Vision Care for a big percentage chunk of the cost.

Of course, when purchasing online you have to know exactly what you are ordering and how to order to fit properly. The cool thing is that the eyeglass package that cost $199 at JCPenneys Optical (including my Eyemed "benefits") were found online by my wife for $73, with another $39 for the lenses. Add in UPS shipping and subtract my Eyemed Vision Care Out-of-Network Provider benefit amounts, and we are getting these glasses in name-brand frames for about $41 delivered, or a $158 savings vs JCPenneys Optical.


So since I actually AM going to get reimbursed from Eyemed Vision Care, does that mean the insurance is not a good purchase decision? Well, that depends on how much you are paying for it and how you use it. If your employer provides this to you at no extra cost —that’s great. My employer leaves this as a cryptic combined benefits entry on my pay stub, and I will need to find out what it costs me exactly and crunch the numbers. Using the discount online retailers definitely changes the game a bit, and may even make the Out-of-Network benefit actually pay off in the long run—provided you use it. You will have to crunch those numbers for your situation.

If you DO have EyeMed Vision Care coverage, don’t walk into a regular optical shop assuming you can use your Eyemed insurance and get an incredible deal. That is amplified tenfold if you walk into a Luxottica owned or operated retailer, as they are out to get your money from you at every step of the transaction, all the while NOT disclosing to you that you are just dealing with another corporate division of Luxottica.

At best, these are questionable business practices designed to obscure the relationships between the Luxottica divisions from consumers. Since EyeMed regularly pushes its customers towards the Luxottica retailers, one would think they should be required to disclose the relationships they have as a corporate stepchild of Luxottica. It is mind boggling to me that we have divisions within a company that purposely do not tell their customers of their relationship to each other. That is unethical. Luxottica as an insurance provider through EyeMed should be compelled to disclose this fact. When consumers are lead to believe that EyeMed is representing their best interests in obtaining Vision Care, and then pursue corporate practices that cast a pall of doubt over that relationship, then I think it is safe to say we have a corporation that engages in practices that are simply unethical with an extreme conflict of interest that the majority of their customers simply do not know exists.

Personally, I am going to milk every last drop out of my Eyemed Vision Care benefits--and i can guarantee you my money won't be spent at any Luxottica affiliated store.

47 comments:

Ira said...

Great stuff. Leonardo Del Vecchio has virtually cornered the eyewear market.

I've been doing my best to let people know that there are options. It's amazing the anger I've gotten from the independent optical store owners. I think they might want to redirect some of their anger -- perhaps towards the FTC.

sdkid said...

Indeed. Eyemed never once disclosed to me the relationship they have as corporate divisions with those retailers. They acted as though they were completely independent operations. Of course, what they were actually doing is ensuring the profit margins of the Luxottica retail divisions.

It's really more like I bought a coupon book--only good for full retail--and only from some retailers.

Gabby EBD said...

Yep, pretty much a lot of insurance companies do have absurd insurance plans and claims where you get to go through a lot of red tape and hassle just to get your money. One of the main reasons is because how much mark-up big eyeglass companies make just for selling a pair of eyeglasses.

I work in a company where we offer good quality and affordable eyeglasses at the same (or even better) standards as the ones you see in Lenscrafters. The reason why we get to sell them at a low price is because since we're an internet based company, our overhead is substantially low. You should read Ira's blog, he has the down low on most of the online retailers available

Jenny said...

Well, folks.....if you haven't seen the documentary, "Sicko," in my opinion it's a must see for anyone age 10 and older. Your experience is just another example of the ills of our health care/insurance system here in the good 'ol U.S. of A.

Ferdamshur said...

Yet another example of vertical integration, leaving me feeling like just another hapless grape on the vine, being plucked and sucked for all my juice.

B. Fred said...

Really good comment and information.

Thanks!

Anonymous said...

Hi. I would also like to comment on Pearle Vision. I have slight problems with eyesight and decided to apply for help until it is too late. I went to Pearle Vision, a chain of eyeglasses stores, to buy eyeglasses for protection against computer. It is a great company. It is not only about the USA, the Pearle chain has about thousand of stores in Europe in such countries as the Netherlands, Germany, Austria, Poland, Belgium and other. I learned about it from this great site www.pissedconsumer.com.

Amandasinging said...

holy crap! I had no idea. I'm just looking for a pair of glasses covered by eyemed. and I stumbled on this. I think I'm going to check out that website and see if I can work the system as well you did

Keith said...

I'm so glad I ran across your blog on this! I'm in the middle of a dispute with Shopko and Eyemed. Shopko miss billed Eyemed, trying to charge both my wife and my glasses on the same authorization.

I tried working with Shopko to fix their mistake, but instead of listening to me they sent my account to a collection agency.

When I had talked to an Eyemed representative previously he had told me the authorization was still open and Shopko had only to bill them. Today I received an letter from Eyemed claiming Shopko had not made a mistake.

WFT? Why all of the sudden did Eyemed turn on me?

Now I understand. They aren't on my side, they are on the retailers side. I don't know how I'll win against them, but at least now I know who I'm fighting.

Unknown said...

As an independent optician for 21 years I have seen a great change in the optical industry and how we have to deal with insurance. Rarely do I see patients who walk in with CASH and buy glasses. Get use to the Eyemeds and Avesis' and Davis visions, until medicine in the U.S. changes.

As for buying glasses on the internet you are a FOOL. When that independent optical you walk into to get your glasses adjusted is closed because everyone is buying glasses on the internet, I hope you like getting them adjusted at Lens Crafters. No store front = cheaper and no responsibility as to the fit and the accuracy of your glasses. We are regulated by the FDA just like your MD and Pharmacist are. You throw your money to an unknown entity on the internet 'cause it's cheap. That's a smart move.

Eyemed is not the first HMO out there. They bought a company called Eye Care Plan Of America ECPA who worked almost the same way in the '90's. I make less because I have to charge what they dictate. Then I have to wait to be reimbursed from the funded plans they have. They are the 800 lb gorilla and we have to deal with them. I take Eyemed and I don't like them either.

Unknown said...

So why is this is a scam? Businesses are in business to make money, otherwise they would be non-profit organizations. I'm not at all surprised to see a statement (read: value proposition) on how they want to make their more business more profitable.

Just like anything else, imo, the balance is finding somewhere the benefit I receive for the insurance outweighs the cost put into it. If the benefit works for me (I save money) and the retailer still makes money, it's a good situation for both. Welcome to capitalism.

I dont doubt you feel this is some sort of injustice, but I think it's far from fair to call it a scam - look at how easily you found all the informaiton mentioned in this blog post and how easily you linked to the information. Would a 'real' scam be this easy to track down?

Just my $0.02...

Adriana said...

"Why is it a scam?" because the insurance company has a vested interest in the suppliers downstream. And those suppliers are socking it to their customers by charging more than double what a full-service operation like Costco charges...

I would not be surprised if Eyemed PAYS companies to "enroll" in their vision care plan so that they have a captive group of suckers to prey on.

It looks to me that this is exactly why doctors are not allowed to own pharmacies and monopolies are not good for society.

Bob said...

Interesting read.

Some research turned up the frames/lenses I want for half the price on the 'net rather than getting them @ Pearle (who was kind enough to write out all the measurements I need...)

A little more searching turned up an online vendor who takes eyemed insurance. Still at half the price.

So, in the end, I'm getting the same glasses, made in the same place.

But I don't think I'll walk into a Pearle again.

Adriana said...

I bought my frames at Eyemed for list price, which cost me $35n out of pocket after the Eyemed allowance. Then I walked across the street and got my progressive lenses filled by Costco for $139, less than half of what Lensecrafters quoted me. Then I filed for reimbursemnt from Eyemed for the lenses under the Out of Pocket provision (which they initally denied because nobody read it...)

Anonymous said...
This comment has been removed by a blog administrator.
Anonymous said...

My 2 cents:

Most people don't get their eyes checked until they actually have a vision problem. EyeMed makes this an affordable benefit. EyeMed is a TPA, they are not an insurance company. They encourage utilization... with ID cards (don't you wonder why other vision carriers do not supply vision cards? they want you to forget about it!), with EOB's (no other vision carriers offer an Explanation of how the are Benefits paid!), with benefit summaries sent with the ID cards... and yes, Luxottica is the parent of this. This allows people to get better frame discounts and selection (on the frames that they want), it also allows them to shop in more retail locations -rather than limiting them to independent networks. In return, the rates for this vision coverage, which can be payroll deducted pre-tax for just a dollar a week in most cases, makes eye care very affordable. The Luxottica network is huge. I learned about it from EyeMed! They aren't keeping it a secret!

If I've learned one thing over the years, it's this: There are two sides to every story. People will interpret situations in favor of their own limited worldview... I say 'open your eyes!'

Anonymous said...
This comment has been removed by a blog administrator.
Patches said...

My husband and I just went to fill our prescriptions today for our glasses. We have BC/BS of South Carolina through his employer. According to all of the paperwork they have sent us, we are given an allowance of $110.00 on frames with us paying 20% of anything over that amount, lenses don't cost us anything, and add-ons (non-glare coating, transition lenses, etc.) will cost us no more than $65.00. Before we walked out of the store, we had plunked down $401.00. My lenses alone, no line bifocals, cost us $141.00. How the hell did that happen?!? The transition/progressive crap cost us $80.00. My husband's plain lenses cost us $48.00 (and again, I say, "WHAT?!?) and the transition stuff was an additional $32.00. What the hell just happened here? We have actually allowed BC/BS of SC to take out an additional amount for this "insurance"...we'll be calling them in the morning to have this removed from our premiums.

MenagerieMayhem said...

i just had my yearly exam at Sears Optical using Eyemed...

after the exam (which had a $10 co-pay), I had $120 to use towards lenses. My lenses cost roughly that much.

Not a scam.

I did, however, have a bigger problem last year when I went to Pearle Vision. Somehow I ended up paying several hundred bucks for my new pair of glasses.

Anonymous said...
This comment has been removed by a blog administrator.
Hondaddy said...
This comment has been removed by the author.
Hondaddy said...

I too have been screwed by Eyemed. Trying to get help is fruitless as they own the insurance company, eyeglass mfr. co., vision exam/sales centers. They are lining their pockets with our money every step of the way.

I have found it would be cheaper to get my free (included in my insurance) eye exam and then take the prescription to a local discount eyeware provide and pay cash... using no insurance!

When I questioned strange charges on my last Eyemed purchase at Target Optical, they just danced around the question, insulted my intelligence, and caused me to file a complaint through my union benefits office. Apparently this is common and they might lose service rights with our 75,000 members and their families.

However Dr. Kathy Phan was very good and is the only shining star in this mess.

Eyeglasses said...

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GrandmaRoz said...

I am surprised my office has now gone back to Eyemed. When I used them to buy glasses at Lenscrafters, the store had a so-called 50% off sale (of their overpriced glasses). Eyemed allowed me 40% off the RETAIL price, which was less than the 50% off. So, basically, I paid monthly and got nothing in return except the exam (which they paid most of). One does best using them for the exam, then taking the information someplace that sells glasses at a more favorable rate than Lenscrafters or other "in-network" (i.e., owned by Luxottica) stores.

Unknown said...

today my mother went in for an exam to get new prescription since her last one was back in 07 and her benefits allow an exam every 3 years.. welll her copay is only 10 bucks, and she not think anything about it, during the exam the optomitrist said she has the very start of cataracts and said probly have to see her in a year. then went on with rest of the exam. at the end she paid with debit card. then went and paid for glasses and they told her was going to be $90. thats not the problem. left the store and got home and checked the reciept from the exam and it was for $139 WTF??? called and saind since she had a medical condition she be charged full price... this was not told to her at the time or before the exam... called eyemed and said it was they regulations ... i mean if a person had perfect vision they not need an exam or glasses.. luckily had the extra money for the exam. what about peoplpe living on an extremely fixed income where $100 + would mean the diffrence for eating forthe month, able to get meds, and everything else. and they could say anything to make it a medical problem that would not be insured.. after all oops your far / near sighted. ya have a pimple on your eyelid.

what crap that is

John Wilson said...

Wow! I hope you guys are still subscribed to this post/thread. It is so hillarious...well sort of. I'm so glad that you guys are realizing that basically this is just a bunch of crap(...like the proposed $5 fee for ATM use that Bank of America tried to pull) im glad that you guys are actually asking the question, WTF? So to keep it short I'm coming up with a solution, Glasses for less than $100 bucks, way less...and not crap ones either...all of them. its still a work in progress but please contact me if this sounds like a good solution to you. Facebook I guarantee you that I know pretty much all there is to know about eyeglasses, contacts and vision insurance. I know that statement kinda makes me sound all snooty now but im not. Just stating a helpful fact and I can prove it to you if you want. I wont be offended if you ask something like "What are the benefits of a TRIVEX lens versus one that is standard plastic or polycarbonate?" But seriously, if you are paying that much a month for vision insurance only to get taxed again at the Dr. Office and are thinking WTF? This seems crazy....i know exactly what you are talking about. Hit me with any questions or just say hi. My facebook address is www.facebook.com/Rayn143.

So since ive already rambled off let me add one more fun fact....So, if you are thinking of prescrption glasses like any other "prescription"(i.e. pills or medication) you will know all about how there is sometimes a potential for "getting hooked". (Just follow me for a sec.) When your eyecare sales person is selling you all these extra features on your lenses that are a "must have" an youre thinking to yourself “well they must be right, they are the experts”.....By the time you realize whats going on and start asking yourself WTF...I should just go with a standard pair of lenses that are cheaper...it may be too late...in a matter of speaking. Your eyes can and will get used to those “add-ons” and when you no longer want them, your eyes will have issues adjusting(which is another way to capitalize on the sale.... look it up, Google it. If im wrong let me know and I will take this down.....

Hondaddy said...

Everything bad and point of business manipulation. It continues to be true and worse. I've complained to my Union Benefits Plan office and brought the topic up on the floor at a recent Union meeting. Everyone whom had used the insurance at one time had a bad taste in their mouths. I recommend to buy glasses at near your frame stipend (mine is $110). I bought $130 glasses... so I'm spending $20. One annual eye exam is (free on my plan). Then buy the STANDARD LENSES with NOOOO!!! UPGRADES/CHARGES. You will be surprised how good the glasses are despite not buying every lens treatment or coating. I got my OAKLEYS for $20 + tax. This infuriated the salesperson, but I don't give a F that they made no commission on me. Luxotica and EyeMed both are underhanded, but use their rules to beat their system.

Jason Yunker said...

yeah, so I'm late to this thread, but I just left Lenscrafters and need to vent.

My company uses eyemed and I've been paying for it, so I figured I'd take advantage of my benefits and pick up a pair of reading glasses that I need these days. I have my prescription from a doctor I liked, and I took it in.

Cheapest available option: $183.00 That's with no coating, sale price and benefits included.

So I have a good set of frames that I've had for years and I like. I ask if they can fit new lenses into them. The tech looks them over and says she can't because the frames aren't shaped right and the lenses would pop out constantly. Which came as a surprise to me because the lenses in there don't do that now...

So I'm sour on Lenscrafters and on Eyemed in general. I've cancelled my coverage with the company and will just pay for glasses in the future using my own money, since that's the net of it with eyemed anyway.

Which brings me to my next endorsement: warbyparker.com. $95.00 frames and lenses with scratch and glare coatings. A quote from WarbyParker: "Glasses don't cost $400.00. They just don't." I ordered a pair, lenses were perfect, frame wasn't. No big deal, send it back, order a new pair. Good to go. $95.00! Eyemed can blow me.

As for Mitch on this thread who called us all fools for buying glasses on the internet, pound sand dude. A good optometrist will give you your prescription, and pupillary distance is not rocket science. (go into Lenscrafters and have them measure you and then walk out.) If anyone's going to have to get used to a new paradigm, it's glasses sellers who believe the internet isn't as good.

Don't opt for Eyemed if that's your only option. Don't pay it. Pay for the exam yourself. Get the glasses made at WarbyParker.

Bleu said...

Last year I priced out what new prescription lenses and frames would be at a local shop down my street that takes Eyemed, and even after the insurance benefits I would pay out of pocket something in the range of $350-$400 not including copays. Which of course was ridiculous -- you can get everything for less than that without "insurance" and instead just coupons or not even coupons. My employer's materials on Eyemed promote the benefits as including free new prescription lenses, glass or plastic, for single vision, bifocal, or trifocal, and upposedly a $120 benefit for the frames. I mean, if I was going to pay $350 to $400 in addition to the benefits Eyemed supposedly delivered we're talking about a new pair of glasses in the $500-$700 range.

Bleu said...

I did want to add that the $120 benefit for the frames in the above post is basically the amount that employees have deducted from their paychecks in one year for the insurance. (It's just under $10 a month -- by which I mean $9.97 or something).

Byrdie said...

Thanks. Couldn't understand why EyeMed would speak with the service provider but not with me...their premium paying member. After reading this blog I get it. Thanks Mr. Obama for making it affordable (ah em, profitable for the Del Vecchio's of the world). I you're really stimulating our economy (well the Italian's) while you're at it. Well done! Clearly you didn't study economics.

Anonymous said...

Can I use some of this info please?

Anonymous said...

Can I use this?

Adriana said...

Yes Ray!

Richard G said...

EyeMEd is the worst. I went "out of network" to BJ's Wholesale club where prescription sunglasses cost $99.95. EyeMed refuses to pay the $90 out of network benefit since BJ's didn't break down the cost between lenses and frames. I will keep at it until I get reimbursed.

Richard G said...

EyeMEd is the worst. I went "out of network" to BJ's Wholesale club where prescription sunglasses cost $99.95. EyeMed refuses to pay the $90 out of network benefit since BJ's didn't break down the cost between lenses and frames. I will keep at it until I get reimbursed.

Phil B said...

V.S.P. and Davis Vision are other eyeglass monopolies. Check them out.

Phil B said...

V.S.P. and Davis Vision are the "other" Optical monopolies. Check them out.

Sam Pierce said...

Let's get a class action suit going against Luxottica. What they do is really and truly unfair business practices. I know a firm that will handle it. Since most people pay with a charge or debit card, their insurance is in another state, and a good majority of the consumers are federal employees, this would be a case for federal district court, where the judges are not elected, but appointed, which means they can't be bribed and we would have a very good chance of taking "Big Lux" down! Sign up below with an email you use just for this if you are interested.

The Chief Geek said...

3 words if you aren't in their group plan: Bait & Switch!

I don't have an employer with an eye plan, so I applied on EyeMed's website for individual insurance since my OD accepts EyeMed and EyeMed offered coverage on most of my prescription needs that VSP wouldn't cover (I'm not even counting the frames).

THE BAIT:
Went online, verified my OD was on their list of network providers, called their toll-free number (their website won't allow you to pay online, even if their phone message says you can), paid my $171 and went to my OD with my new EyeMed membership card. My OD couldn't find me on the EyeMed system, I called EyeMed. EyeMed said they couldn't find my OD on the system. (I'm worked with my ODs technology and been a patient for over 15 years.)

THE SWITCH:
After an hour both me and the OD's manager "talking" to EyeMed via our perspective contacts, I discovered that EyeMed had me on a different network than they had my OD on! (This was never mentioned on their website!) And I was not allowed to get on my ODs network because I was an Individual (discriminated because I pay out of my own pockets). EyeMed has five of these "networks" but would never explain how they decide which network a provider is put on.

If I used my OD, EyeMed would consider him to be out-of-network. Under those conditions EyeMed may reimburse $50 (as opposed to them paying 80% as a network provider).

Okay, so when I go to one of the eye centers that's in "my network" (Target and LensCrafters) to see if they can fill my prescription, they can't do it! One guy looked at the script, and tried to sell me sunglasses!

Here's what I was able to find from deconstruction:
1. EyeMed uses a bunch of outsource companies, using the same phone number and domain to make it sound like a single organization. Each number on their phone menu takes you to a different outsourcer, and none of them appear to be connected to each others (which makes "playing dumb" real easy for them).
2. When you have a complaint, nobody seems to know how to contact anybody outside of their own outsourced company ("That's not our area. You need to send an eMail to EyeMed")
3. In spite of their 30-day refund window, unknown to you your membership is still active until a "review board" approves the refund, which takes 45-days.
4. The only way to contact this review board is via a generic EyeMed eMail address. They took my $171 quickly enough, but are dragging their feet giving it back.

My next stop: filing on RipOffReport.com

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Unknown said...

For me, this is gonna end up being worth it anyway. I got the cheapest EyeMed plan for $5.50/month, with no out of network benefit. That's $66 a year. My health insurance does not offer eye exams. And they are available out of pocket for about $300 in my area. Even if I only get the eye exam and I don't apply my insurance to the purchase of glasses, I'm coming out on top with a $66 exam.

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