Vision Service Plan—Large & Small Groups

Vision Service Plan offers multiple vision plans for businesses with 2 to 1,000 employees. A $15 administrative fee is charged each month to all VSP groups.*

Enrollment Forms:

Please be advised that CoPower has discontinued the use of the Remittance Report and has replaced it with the following forms, effective immediately:

• VSP Individual Application
• VSP Enrollment/Change Form
  (for additions/changes to CoPower’s VSP policies)
• Termination Form
  (for terminations from any of CoPower’s policies)

For more information, please read our Notice to CoPower groups regarding these changes.

• VSP Waiver Form

Brochures:

Signature Plans:

• Vision Service Plan A $25 Coverage at a Glance
• Vision Service Plan B $10 Coverage at a Glance
• Vision Service Plan B $10 Voluntary Coverage at a Glance
• Vision Service Plan B $0/$20 Coverage at a Glance
• Vision Service Plan B $25 Coverage at a Glance
• Vision Service Plan C $10 Coverage at a Glance
• Vision Service Plan C $10 Voluntary Coverage at a Glance
• Vision Service Plan C $0/$20 Coverage at a Glance

Value Plans:

• Vision Service Plan A $20 Coverage at a Glance
• Vision Service Plan A $25/$25 Coverage at a Glance
• Vision Service Plan B $20/$20 Coverage at a Glance

General Information:

• Using VSP
• VSP Member Card
• FAQs
• VSP Out-Of-Network Reimbursement Form
• VSP Grievance System

CoPower Information:

Third Party Administration Details:

• Maintaining Your Vision Plan
• Important Notice to CoPower Groups
• New Hires, Additions & Terminations and COBRA Employees
• When to Use Your CoPower ID & Group Claim Number

Manuals:

• Vision Service Plan Manual (for Voluntary Plans)
• Vision Service Plan Manual (for Non-Voluntary Plans)