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Group Vision Care Provision Care for LifeEVIDENCE OF COVERAGE & DISCLOSURE FORM Provided by:VISION SERVICE PLAN 3333 Quality Drive, Rancho Cordova, CA 95670 (916) 8515000 (800) 8777195THIS EVIDENCE
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Additional benefit is an extra advantage or reward that is received in addition to regular benefits.
Those who have received additional benefits or rewards are required to file for them.
To fill out additional benefits, one must provide all necessary information and follow the specific instructions given by the provider.
The purpose of additional benefits is to provide recipients with extra advantages or rewards beyond their regular benefits.
All relevant information regarding the additional benefits received must be reported on the form.
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