Online Enrollment

Enrolling for Superior Vision

1) Plan Info

2) Member Information

3) Add a Dependent (Multiples Allowed)

Child Handicap Status

4) Completed By Employer

5) Benefit Elections (Employer determines benefits available for election)

Riders and Disclaimers

Disclaimer Text that is exclusive to each product type.

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In the past 12 months, have you had continuous group coverage providing like or similar benefits (for yourself and/or your dependents) with a prior carrier?