Request a Quote

Request a Quote
Name or person requesting the quote (broker/HR professional)

First NameLast Name
Email
example@example.com
Phone Number

Area CodePhone Number
Agency Name (if applicable)
Name of Group/Company Name requesting Vision Plan Quote
How many eligible employees?
Group Effective Date

MonthDayYear
Date
Select desired frame allowance

$100$110$130$140$160$170$210
Exam benefits

Include eye examNo exam (hardware only)Provide quote for both options
Premium Contribution

Voluntary Employee PaidContributory Employer PaidProvide Quote with Both Options
If contributory, what percent of the premium is the employer paying?
Does this employer currently offer a vision plan?

YesNo
If possible, please upload this group’s current vision plan and rates.

Browse Files

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Demographic/Geographic Details: What other states (non-Utah) do the employees reside? What percent are in each geography? If 100% in Utah you can leave this section blank.
What level of involvement would you like from us?

Return quote in 24 hoursSchedule a meeting with agent/brokerZoom/In-person presentation to employerFull RFP to ComeZoom/phone call with Opticare repOther
Are you appointed with Opticare Vision Services (Opticare of Utah)?

YesNo
Enter any additional details
To confirm this quote or to provide other information please call the sales office at 801-869-2020 or email sales@opticarevisionservices.com.
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