VSP Certified Platform Partners Registration

If you're already a licensed customer of WebInsure, you still need to register here to start earning commissions on your VSP Individual Plan sales.

Payee Information

Do you want payment for your individual sales to be made out to your agency or to you as an independent agent? Must match how you are set up with WebInsure.

 

Agency Information

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

 

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.