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New Group Application 

Start a new application or complete an in-progress application. For Clients with 500+ employees, contact your VSP representative.

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IN PROGRESS APPLICATIONS

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Please register under one of the following.  

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I AM AN INDEPENDENT BROKER

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In-Progress Group Applications

Select a group application to edit below.  
START NEW APPLICATION

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Call Out: Single

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Call Out: Single

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Card: Single

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Card: Two Across 

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Card: Three Across 

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Primary Plan Cards

VSP Signature Plan

VSP provider network
Covers Full WellVision Exam 
VSP Primary EyeCare Plan Included 

Average 15% off or 5% off VSP Laser Vision Care

Covers Full Basic Lenses

Covers all Lens Enhancements with a copay, saving an 35-40% on average

$130 retail allowance towards Frames; 20% off any amount over 

Covers full Standard and Premium fit contacts with a copay

Prescription Contact Lens covered in full up to $130. 

VSP Signature Plan

VSP provider network
Covers Full WellVision Exam 
VSP Primary EyeCare Plan Included 

Average 15% off or 5% off VSP Laser Vision Care

Covers Full Basic Lenses

Covers all Lens Enhancements with a copay, saving an 35-40% on average

$130 retail allowance towards Frames; 20% off any amount over 

Covers full Standard and Premium fit contacts with a copay

Prescription Contact Lens covered in full up to $130. 

VSP Signature Plan

VSP provider network
Covers Full WellVision Exam 
VSP Primary EyeCare Plan Included 

Average 15% off or 5% off VSP Laser Vision Care

Covers Full Basic Lenses

Covers all Lens Enhancements with a copay, saving an 35-40% on average

$130 retail allowance towards Frames; 20% off any amount over 

Covers full Standard and Premium fit contacts with a copay

Prescription Contact Lens covered in full up to $130. 

Carousel

Spread

Need help building your book of Business?

Need help building your book of Business?

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TABLES

Application List 

Client
Date Effective
 Last Saved
Stephanie Doe 
January, 5 2018 
February 7, 2018
John Doe
January, 5 2018 
February 7, 2018
Harley Doe
January, 5 2018 
February 7, 2018
Jane Doe 
January, 5 2018 
February 7, 2018
Suzanne Doe 
January, 5 2018 
February 7, 2018

Quote Review 

Rate Type

Employee Only
Employee + One
Employee + Children
Employee + Family
Base Rate
$12.14
$19.43
CD
CD
Anti Reflective Coating
$1.35
$2.15
$2.19
$3.53
Progressive Lenses
$1.87
$2.99
$3.06
$4.93 

TOTAL PREMIUM

$15.36
$1.87
$1.87
$1.87

Small Table  

Lens Enhancement
Single Vision
Multifocal
Anti-reflective coating 
$37 
$37 
Polycarbonate
$23 
$28 
Progressive
N/A 
$50 
Photochromatic
$62 
$76 
Scratch Resistant 
$15 
$15 

ACCORDION

Plans

Does VSP handle clients with less than 10 employees?

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Does VSP have a 100% voluntary plan?

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Does VSP offer laser vision correction coverage?

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Does VSP offer a plan to individuals?

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Client Support

Does VSP handle clients with less than 10 employees?

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Does VSP have a 100% voluntary plan?

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Does VSP offer laser vision correction coverage?

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Does VSP offer a plan to individuals?

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New Group Applications 

Does VSP handle clients with less than 10 employees?

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Does VSP have a 100% voluntary plan?

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Does VSP offer laser vision correction coverage?

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Does VSP offer a plan to individuals?

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Commission

Does VSP handle clients with less than 10 employees?

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Does VSP have a 100% voluntary plan?

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Does VSP offer laser vision correction coverage?

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Does VSP offer a plan to individuals?

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HIPAA

Does VSP handle clients with less than 10 employees?

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Does VSP have a 100% voluntary plan?

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Does VSP offer laser vision correction coverage?

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Does VSP offer a plan to individuals?

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Pull Quote 

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