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| "A Community of 21st Century Learners" |
| 53 West Mill Road, Long Valley, NJ 07853 | P: 908.876.4172 F: 908.876.9392 |
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VSP VISION PLAN Optional, Employee-Paid Vision Benefits
MEMBER SERVICES (800) 877-7195
LINKS Click here for a link to the VSP Vision Plan website
FORMS V1. VSP Enrollment/Change Form & Salary Reduction Agreement click to view These two forms must be submitted within 31 days of a qualifying life event. Failure to submit the Salary Reduction Agreement along with the Enrollment/Change form will result in a taxable premium deduction. V2. VSP Plan Description click to view Summary of the VSP Signature vision plan.
V3. VSP Claim Form click to view To be used for out-of network claim submissions.
There is no ID card for the VSP vision plan but this wallet card, which contains contact information for VSP, can be printed and cut to keep in your wallet.
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