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Group Vision Care PolicyVision Care for Regroup Name:
Group Number:
Effective Date:NATIONAL INSURANCE SERVICES OF WISCONSIN, INC.
30060016
SEPTEMBER 1, 2015Evidence of CoverageProvided by:VISION SERVICE
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01
Write your name, date of birth, and Social Security Number in the designated boxes.
02
Select your vision plan option from the available choices.
03
Fill in any additional information required by the form, such as your address or contact information.
04
Review the completed form for accuracy and sign and date it before submitting.
Who needs nis vsp block vision?
01
Employees who are eligible for vision benefits through their employer may need to fill out the nis vsp block vision form in order to enroll in the vision plan.
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What is nis vsp block vision?
NIS VSP Block Vision is a mandatory report filed by certain entities involved in the VSP block vision program.
Who is required to file nis vsp block vision?
Entities participating in the VSP block vision program are required to file NIS VSP Block Vision.
How to fill out nis vsp block vision?
NIS VSP Block Vision can be filled out online through the designated portal provided by the relevant authority.
What is the purpose of nis vsp block vision?
The purpose of NIS VSP Block Vision is to report information related to the VSP block vision program.
What information must be reported on nis vsp block vision?
The report must include details of the entities participating in the VSP block vision program and their relevant information.
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