Forms for Washington (District of Columbia)

These forms must be viewed with Acrobat Reader. Click here to download the reader.
   
Employee Enrollment Form COBRA Document
Employer Enrollment Form (12/12) * Agent Data Sheet
Employer Enrollment Form (12/24) * Enrollment Change Form
Out Of Network Claims Form  
Request Login for OptiCare's Online Eye Health Manager - For Employers only

* Refers to the time of contract validity. 12/12 is a contract renewable every year and 12/24 is a contract renewable every two years. Please select the one that your contract is signed for.


Forms for Maryland

     
Request Login for OptiCare's Online Eye Health Manager - For Employers only
ASO and Section 125 Vision benefits are available
For further information, please contact
OptiCare at 1-877-615-7732 or agentcontact@opticare.net for more information.