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VISION BENEFITS OF AMERICA ENROLLMENT FORM 874 SUBGROUP COVERAGE EFFECTIVE DATE / / INSTRUCTIONS FOR EMPLOYEE: 1. 2. COMPLETE SECTION BELOW AND SIGN. RETURN COMPLETED FORM TO YOUR BENEFITS OFFICE.
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Vision Benefits of America is a vision insurance provider that offers coverage for eye exams, glasses, and contact lenses.
Employers who offer vision benefits to their employees are required to file vision benefits of America.
To fill out vision benefits of America, employers must provide information about the coverage offered, the number of employees enrolled, and the premiums paid.
The purpose of vision benefits of America is to provide affordable vision care for employees and their families.
Information such as the number of employees enrolled, coverage details, and premiums paid must be reported on vision benefits of America.
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