vsp

enrollment kit - vsp (vision)

X

0

Forms Selected

Email

Download


Clear Selection

Download Forms & Documents

You've selected 10 Form(s). Choose your download option from the button below.

Form Name
Carrier
State
Group Type
Effective Date

Email Forms & Documents

You are sharing 10 selected form(s). You can send an email to all listed recipients. You can also customize the email body before sending.

Form Name
Carrier
State
Group Type
Effective Date

Form Name

Effective Date

Current As Of

"Current As Of" signifies the latest date on which a Word & Brown Team Member confirmed that the Forms/Document available for download represents the most up-to-date and recently revised version accessible.

This checklist is provided as a guide. The carrier may require additional items and documentation. Please refer to the carrier's underwriting guidelines for a complete list of requirements. Please use the latest version of forms.
 
Our goal is to process your new group enrollment easily and efficiently in order to provide you and your client with a quick approval.  The following list outlines VSP’s case submission requirements.
 
  • ​No binder check in needed.  VSP will bill for the first month’s premium.
  • Census Enrollment Spreadsheet
  • VSP Client Application​ – please advise the correct rating option, based on the following carrier guidelines:
    • ​​If the employer contributes 75% or more for all eligible employees and dependents, or pays 75% of the overall cost of the plan, the carrier will consider the plan “Core” and requires only a minimum of 5 enrolling.
    • If the employers contributes less than 75% of the overall cost, and the group does not select the “must match” option, the carrier will consider the plan “Voluntary” and only requires a minimum of 10 enrolling.
    • In order to offer Core Employee/Voluntary Dependent rates, the carrier requires a minimum of 10 employees enrolling.
 
After approval, prior carrier termination letter must be submitted by the employer or broker.​
 ​​​

​​For other useful or older documents, please refer to the Forms database.