www.vsp.com Open in urlscan Pro
65.9.25.69  Public Scan

Form analysis
2 forms found in the DOM

<form novalidate="" vspvalidationcontainer="" class="header-search-input-form ng-untouched ng-pristine ng-invalid"><label class="hidden-accessible" id="site-search-label" for="site-search-input">Search</label><input placeholder="Search" name="query"
    minlength="3" maxlength="2048" pattern="^((?!(\d{9}|\d{3}-\d{2}-\d{4})).)*$" required="" tabindex="-1" class="form-control header-search-input ng-untouched ng-pristine ng-invalid"
    id="site-search-input"><!----><a href="" tabindex="-1"><i title="Close Search" class="d-none icon-close header-search-close"></i></a></form>

<form novalidate="" vspvalidationcontainer="" class="ng-untouched ng-pristine ng-invalid">
  <div class="vsp-form"><vsp-ssn-and-member-id>
      <fieldset>
        <legend class="form-section-header ng-star-inserted">SSN or Member ID</legend><!---->
        <div ngmodelgroup="ssnOrMemberIdGroup" class="row ng-untouched ng-pristine ng-invalid"><vsp-form-group label="Last 4 of SSN" class="col-md-3">
            <div class="form-group vsp-form-group form-group-animation-empty">
              <div><input id="ssn" name="ssn" required="" vspvalidatenumbersonly="" maxlength="4" minlength="4" placeholder="Last 4 of SSN" class="form-control ng-untouched ng-pristine ng-invalid"><vsp-tool-tip label="SSN Tooltip"
                  class="ng-star-inserted">
                  <div form-group-icon="">
                    <!----><i role="button" container="body" class="icon-tooltip d-none d-md-block" tabindex="0" aria-label="SSN Tooltip"></i><!----><i role="button" triggers="click:blur" container="body" class="icon-tooltip d-md-none" tabindex="0" aria-label="SSN Tooltip"></i><!---->
                  </div>
                </vsp-tool-tip><!----></div><label class="vsp-form-group-label" id="ssn-label" for="ssn"> Last 4 of SSN </label><!----><vsp-validation-message id="ssn-validation" class="ng-star-inserted"><!----></vsp-validation-message><!---->
            </div>
          </vsp-form-group>
          <div class="create-account-input or-label">OR</div><vsp-form-group label="Member ID" class="col-md-4">
            <div class="form-group vsp-form-group form-group-animation-empty">
              <div><input id="member-id" required="" name="memberId" vspvalidatealphanumericonly="" maxlength="30" placeholder="Member ID" class="form-control ng-untouched ng-pristine ng-invalid"><vsp-tool-tip label="Member ID Tooltip"
                  class="ng-star-inserted">
                  <div form-group-icon="">
                    <!----><i role="button" container="body" class="icon-tooltip d-none d-md-block" tabindex="0" aria-label="Member ID Tooltip"></i><!----><i role="button" triggers="click:blur" container="body" class="icon-tooltip d-md-none" tabindex="0" aria-label="Member ID Tooltip"></i><!---->
                  </div>
                </vsp-tool-tip><!----></div><label class="vsp-form-group-label" id="member-id-label" for="member-id"> Member ID </label><!----><vsp-validation-message id="member-id-validation"
                class="ng-star-inserted"><!----></vsp-validation-message><!---->
            </div>
          </vsp-form-group>
        </div><vsp-validation-message class="d-block create-account-ssn-member-validation-message ng-star-inserted"><!----></vsp-validation-message><!---->
        <div class="row ng-star-inserted">
          <div class="col-md-12">
            <p>Please enter the last 4 digits of the primary member's social security number OR their member ID number. If your employer, health plan, or VSP Individual Plan has provided you an identification number, please use this as your member ID
              number.</p>
          </div>
        </div><!---->
      </fieldset>
    </vsp-ssn-and-member-id></div>
  <div class="vsp-form">
    <fieldset>
      <legend class="form-section-header">Primary Member Information</legend>
      <div class="row"><vsp-form-group label="First Name" class="col-md-4">
          <div class="form-group vsp-form-group form-group-animation-empty">
            <div><input id="first-name" name="firstName" required="" vspvalidatestandardtext="" maxlength="65" placeholder="First Name" class="form-control ng-untouched ng-pristine ng-invalid"></div><label class="vsp-form-group-label"
              id="first-name-label" for="first-name"> First Name </label><!----><vsp-validation-message id="first-name-validation" class="ng-star-inserted"><!----></vsp-validation-message><!---->
          </div>
        </vsp-form-group><vsp-form-group label="Last Name" class="col-md-4">
          <div class="form-group vsp-form-group form-group-animation-empty">
            <div><input id="last-name" name="lastName" required="" vspvalidatestandardtext="" maxlength="65" placeholder="Last Name" class="form-control ng-untouched ng-pristine ng-invalid"></div><label class="vsp-form-group-label"
              id="last-name-label" for="last-name"> Last Name </label><!----><vsp-validation-message id="last-name-validation" class="ng-star-inserted"><!----></vsp-validation-message><!---->
          </div>
        </vsp-form-group><vsp-date-picker label="Date of Birth" id="birth-date" name="birthDate" class="col-md-4 ng-untouched ng-pristine ng-invalid" required="">
          <div class="date-picker-container"><vsp-form-group>
              <div class="form-group vsp-form-group form-group-animation-empty">
                <div><input type="text" name="date" ngbdatepicker="" maxlength="10" outsidedays="collapsed" placeholder="Date of Birth" id="birth-date-datepicker" class="form-control ng-untouched ng-pristine ng-invalid"
                    required=""><!----><vsp-tool-tip label="Tooltip" class="date-picker-tooltip">
                    <div form-group-icon="">
                      <!----><i role="button" container="body" class="icon-tooltip d-none d-md-block" tabindex="0" aria-label="Tooltip"></i><!----><i role="button" triggers="click:blur" container="body" class="icon-tooltip d-md-none" tabindex="0" aria-label="Tooltip"></i><!---->
                    </div>
                  </vsp-tool-tip></div><label class="vsp-form-group-label" id="birth-date-datepicker-label" for="birth-date-datepicker"> Date of Birth </label><!---->
                <div form-group-icon=""><a role="button" aria-label="Toggle Calendar" aria-selected="true" aria-current="true" class="icon-calendar" href=""></a></div><vsp-validation-message id="birth-date-datepicker-validation"
                  class="ng-star-inserted"><!----></vsp-validation-message><!---->
              </div>
            </vsp-form-group></div>
        </vsp-date-picker><vsp-form-group label="Email" class="col-md-4">
          <div class="form-group vsp-form-group form-group-animation-empty">
            <div><input id="email" name="email" required="" email="" placeholder="Email" class="form-control ng-untouched ng-pristine ng-invalid"></div><label class="vsp-form-group-label" id="email-label" for="email"> Email
            </label><!----><vsp-validation-message id="email-validation" class="ng-star-inserted"><!----></vsp-validation-message><!---->
          </div>
        </vsp-form-group><vsp-form-group label="Confirm Email" class="col-md-4">
          <div class="form-group vsp-form-group form-group-animation-empty">
            <div><input id="confirm-email" name="confirm-email" required="" placeholder="Confirm Email" class="form-control ng-untouched ng-pristine ng-invalid"></div><label class="vsp-form-group-label" id="confirm-email-label" for="confirm-email">
              Confirm Email </label><!----><vsp-validation-message id="confirm-email-validation" class="ng-star-inserted"><!----></vsp-validation-message><!---->
          </div>
        </vsp-form-group><vsp-form-group label="Mobile Phone (optional)" class="col-md-4">
          <div class="form-group vsp-form-group form-group-animation-empty">
            <div><input vspphonenumber="" id="mobile-phone-number" name="mobile-phone-number" placeholder="Mobile Phone (optional)" type="tel" class="form-control ng-untouched ng-pristine ng-valid"></div><label class="vsp-form-group-label"
              id="mobile-phone-number-label" for="mobile-phone-number"> Mobile Phone (optional) </label><!----><span form-group-before-validation-text="">Text and data rates may apply.</span><vsp-validation-message id="mobile-phone-number-validation"
              class="ng-star-inserted"><!----></vsp-validation-message><!---->
          </div>
        </vsp-form-group><vsp-form-group label="Preferred Language" messages="Preferred Language is required." class="col-md-4">
          <div class="form-group vsp-form-group form-group-animation-empty">
            <div><ng-select role="listbox" id="preferred-language" name="preferredLanguage" required="" bindvalue="value" class="ng-select ng-select-single ng-select-searchable ng-untouched ng-pristine ng-invalid">
                <div class="ng-select-container">
                  <div class="ng-value-container">
                    <div class="ng-placeholder">Preferred Language</div><!----><!---->
                    <div class="ng-input"><input role="combobox" type="text" autocorrect="off" autocapitalize="off" autocomplete="a2e902098d27" id="preferred-language-ng-select-filter-input" aria-expanded="false"></div>
                  </div><!----><!----><span class="ng-arrow-wrapper"><span class="ng-arrow"></span></span>
                </div><!---->
              </ng-select></div><label class="vsp-form-group-label" id="preferred-language-label" for="preferred-language-ng-select-filter-input"> Preferred Language </label><!----><vsp-validation-message id="preferred-language-validation"
              class="ng-star-inserted"><!----></vsp-validation-message><!---->
          </div>
        </vsp-form-group></div>
    </fieldset>
  </div>
  <div class="vsp-form">
    <fieldset>
      <legend class="form-section-header">Username and Password</legend>
      <div class="row"><vsp-form-group label="Username" class="col-md-4">
          <div class="form-group vsp-form-group form-group-animation-empty">
            <div><input id="username" name="username" required="" maxlength="50" pattern="^[A-Za-z0-9!@#$%&amp;'*+\-=?^_`.{|}~]+$" placeholder="Username" class="form-control ng-untouched ng-pristine ng-invalid"><vsp-tool-tip label="Username Tooltip">
                <div form-group-icon="">
                  <!----><i role="button" container="body" class="icon-tooltip d-none d-md-block" tabindex="0" aria-label="Username Tooltip"></i><!----><i role="button" triggers="click:blur" container="body" class="icon-tooltip d-md-none" tabindex="0" aria-label="Username Tooltip"></i><!---->
                </div>
              </vsp-tool-tip></div><label class="vsp-form-group-label" id="username-label" for="username"> Username </label><!----><vsp-validation-message id="username-validation" class="ng-star-inserted"><!----></vsp-validation-message><!---->
          </div>
        </vsp-form-group><vsp-form-group label="Password" class="col-md-4 vsp-form-group__with-password-meter">
          <div class="form-group vsp-form-group form-group-animation-empty">
            <div><input type="password" id="password" name="password" autocomplete="off" required="" vspvalidatepassword="" placeholder="Password" maxlength="30" class="form-control ng-untouched ng-pristine ng-invalid"></div><label
              class="vsp-form-group-label" id="password-label" for="password"> Password </label><!----><vsp-password-strength form-group-before-validation-text="" id="password-strength"><!----></vsp-password-strength><vsp-validation-message
              id="password-validation" class="ng-star-inserted"><!----></vsp-validation-message><!---->
          </div>
        </vsp-form-group><vsp-form-group label="Confirm Password" class="col-md-4">
          <div class="form-group vsp-form-group form-group-animation-empty">
            <div><input type="password" id="confirm-password" name="confirm-password" autocomplete="off" required="" maxlength="30" placeholder="Confirm Password" class="form-control ng-untouched ng-pristine ng-invalid"></div><label
              class="vsp-form-group-label" id="confirm-password-label" for="confirm-password"> Confirm Password </label><!----><vsp-validation-message id="confirm-password-validation" class="ng-star-inserted"><!----></vsp-validation-message><!---->
          </div>
        </vsp-form-group></div>
      <div class="row">
        <div class="col-md-12"><vsp-password-requirements-text>
            <p>Your password must be at least 8 characters long and include at least 3 of the 4 elements:</p>
            <ul>
              <li>An uppercase letter</li>
              <li>A lowercase letter</li>
              <li>A number</li>
              <li>A special character</li>
            </ul>
            <p>You cannot use your existing password, nor the previous ten passwords.</p>
            <p>Passwords shouldn't contain your name or username</p>
            <p>The word 'password' is not permitted</p>
            <p><strong>Security tip:</strong> for added protection, select no if the web browser asks to store your password.</p>
          </vsp-password-requirements-text></div>
      </div>
    </fieldset>
  </div>
  <div class="d-flex justify-content-end mt-3"><vsp-re-captcha>
      <div id="recaptcha" data-callback="handleReCaptchaSubmit" data-size="invisible" class="g-recaptcha" data-sitekey="6Ldgje4aAAAAAFj7m3Yo68-WqbGpug1i728iHeak">
        <div class="grecaptcha-badge" data-style="bottomright"
          style="width: 256px; height: 60px; display: block; transition: right 0.3s ease 0s; position: fixed; bottom: 14px; right: -186px; box-shadow: gray 0px 0px 5px; border-radius: 2px; overflow: hidden;">
          <div class="grecaptcha-logo"><iframe title="reCAPTCHA"
              src="https://www.google.com/recaptcha/api2/anchor?ar=1&amp;k=6Ldgje4aAAAAAFj7m3Yo68-WqbGpug1i728iHeak&amp;co=aHR0cHM6Ly93d3cudnNwLmNvbTo0NDM.&amp;hl=de&amp;v=Gg72x2_SHmxi8X0BLo33HMpr&amp;size=invisible&amp;cb=1apsc22kqo76" width="256"
              height="60" role="presentation" name="a-cimf6vr2eirj" frameborder="0" scrolling="no" sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox"></iframe></div>
          <div class="grecaptcha-error"></div><textarea id="g-recaptcha-response" name="g-recaptcha-response" class="g-recaptcha-response"
            style="width: 250px; height: 40px; border: 1px solid rgb(193, 193, 193); margin: 10px 25px; padding: 0px; resize: none; display: none;"></textarea>
        </div><iframe style="display: none;"></iframe>
      </div>
    </vsp-re-captcha><button type="submit" vspvalidationmessagetrigger="" id="create-account-cta" class="btn btn-primary btn-extra-padding button-loader">Create An Account</button></div>
  <div class="vsp-form-no-background">
    <div class="row"><vsp-checkbox-wrapper class="d-block col-md-12 mt-4">
        <div class="form-check form-check-checkbox"><input type="checkbox" id="email-opt-in" name="email-opt-in" class="ng-untouched ng-pristine ng-valid form-check-input"><label class="form-check-label" for="email-opt-in">I'd like to receive
            essential information about my vision benefits, exclusive savings, eyewear trends, and tips to keep my eyes healthy.</label></div><!---->
      </vsp-checkbox-wrapper></div>
  </div>
</form>

Text Content

 * Members
   

 * Members

Log In / Create an Account

Choose Language

 * 
   
 * 
   
 * 
   
   

Search


 * FIND A DOCTOR
   
 * BENEFITS
   
 * OFFERS
   
 * EYEWEAR AND WELLNESS
   
 * PLAN OPTIONS
   
 * SHOP
   
   





CREATE AN ACCOUNT

Why create a VSP account?

Create an account for instant access to your personal benefit information. Check
out your coverage, find an eye doctor, see past visits, manage your account, and
more.

To create a vsp.com account, you must be the primary VSP subscriber that is
eligible for benefits. Once the account is created, you have access to coverage
details for you and your dependents. If your covered dependents wish to access
their benefit information online, you will need to provide them with your
username and password. If you are in open enrollment, recently changed
employers, or signed up for a VSP Individual Plan, your account may not be
accessible until you are eligible for benefits.

SSN or Member ID

Last 4 of SSN
OR

Member ID

Please enter the last 4 digits of the primary member's social security number OR
their member ID number. If your employer, health plan, or VSP Individual Plan
has provided you an identification number, please use this as your member ID
number.

Primary Member Information

First Name

Last Name

Date of Birth


Email

Confirm Email

Mobile Phone (optional) Text and data rates may apply.
Preferred Language

Preferred Language
Username and Password

Username

Password

Confirm Password

Your password must be at least 8 characters long and include at least 3 of the 4
elements:

 * An uppercase letter
 * A lowercase letter
 * A number
 * A special character

You cannot use your existing password, nor the previous ten passwords.

Passwords shouldn't contain your name or username

The word 'password' is not permitted

Security tip: for added protection, select no if the web browser asks to store
your password.


Create An Account
I'd like to receive essential information about my vision benefits, exclusive
savings, eyewear trends, and tips to keep my eyes healthy.

--------------------------------------------------------------------------------

CONTACT

 * Contact Us
 * Call Member Services
 * Email Member Services
 * GRIEVANCE FORM
 * FAQs
   

LEGAL AND PRIVACY

 * Legal
 * Non-Discrimination Statement
 * 
 * 
 * Notice of Privacy Practices
 * Patient Rights
 * Terms and Conditions
 * Accessibility
 * Natural Disaster Resources
   

RELATED SITES

 * VSP Direct
 * VSP Vision
 * Eyeconic
 * Provider Hub
 * Eyes of Hope
 * Global Access Plan
   

ABOUT

 * About This Site
 * About VSP
 * Become a VSP Provider
 * Careers
 * Frame Gallery
 * Sitemap
   

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ܣܘܼܪܸܬ݂
© 2023 Vision Service Plan. All rights reserved.
© 2023

Vision Service Plan.

All rights reserved.