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  • Wy Vsp Enrollment Form

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In effect for TWO YEARS and cannot be changed without a qualifying event. Employee Only Plan B - Eye Exam and lenses every 12 months and frames every 24 months Employee Plus One Plan C - Eye Exam and lenses every 12 months and frames every 12 months Employee Plus Two or More Employee Information Agency Name & Number Date of Birth: Employee Name: SSN: Complete Address (including City, State, & Zip code): Date of Hire: Home Phone Number: Work Phone Number: Decline Coverage I do not want.

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With thousands of choices, getting the most out of your benefits is easy at a VSP Premier Edge™ location. Shop online and connect your benefits. Eyeconic® is the preferred VSP online retailer where you can shop in-network with your vision benefits.

Designed with you in mind, Premier Edge invests in your practice with cost-saving benefits and business-building tools, resources, and training to support you and your staff. Ready-to-use and customized marketing campaigns, social media content, and tips to help market your practice more effectively.

For an additional premium, VSP Premier offers enhanced eyeglass and contact benefits. Under either plan, you can choose a VSP network doctor or a non-VSP provider. If you use a VSP network provider you will have lower out-of-pocket costs for covered services.

How do I add dependents? Within the Member Details screen click the Update button in the Dependents section of the member. Select an Add action on any blank row. Enter the data for the blank fields in the row.

You can choose from three vision plans: VSP Vision Core: A lower-cost vision plan with higher copays and lower allowances for vision correction materials. VSP Vision Buy-Up: A vision plan with higher benefits, including lower copays and higher allowances for vision correction materials.

The Premier Program connects you with a VSP doctor where you'll receive the personalized attention you deserve while maximizing your benefits. Because we are a VSP Premiere provider, you'll find those extra touches that you just won't find anywhere else: GREAT CHOICE IN EYEWEAR.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232