VSP Certified Platform Partners Registration

If you're already a licensed agent of BenefitMall or already registered to sell directly through VSP, you still need to register here to start earning commissions on your VSP Individual Plan sales through BenefitMall. It's easy; just fill out the form below to get started.

To offer VSP in Florida or Washington, there is a $35 appointment fee for each state. Mail your $35 check per state with “VSP Broker Appointment Fee” on the memo line to:

Vision Service Plan
ATTN: Bookkeeping
PO Box 997100
Sacramento, CA 95899-7100

Payee Information

Do you want payment for your individual sales to be made out to an agency using a Federal Tax ID # or to an independent agent SSN number? Whichever you choose (SSN or Fed TIN), please ensure you register how you want to be paid as the agent of record on the link above.

Agency Information

Centerstone Insurance & Financial Services Inc., dba BenefitMall
BenefitMall
12404 Park Central Drive, Suite 400S, Dallas, TX 75251
818.348.1200
tiffany.stiller@benefitmall.com
VSP Agency ID: A30015464

Selling Agent/Licensed Producer Information

Name and Tax ID must match what is on file with the IRS.

State & Licenses
  • Please provide all state license information where you will be doing business
  • To register for more than 10 states, enter the first 10 here and submit. Then email ASCA@vsp.com with your additional states and license numbers.

State:

W-9 Information

Name and SSN/TIN must match what is on file with the IRS in order to complete registration:

Under penalties of perjury, I certify that:

  1. The number shown on this electronic form is my correct Taxpayer Identification Number (or I am waiting for a number to be issued to me), and
  2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and
  3. I am a U.S. citizen (including a U.S. resident alien).

Agent Agreements

Please review the Agent Agreements.