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Individuals experiencing actual or threatened violence frequently establish new addresses and phone numbers to protect their health and safety.
Effective July 1, 2013 Insurance Regulation 168 (11NYCRR 244) pursuant to New York State Insurance Code, Section 2612, requires VSP Vision Service Plan to provide Confidentiality Protocols for Victims of Domestic Violence and Endangered Individuals. Upon notification VSP will accommodate a reasonable request made by a requestor for a covered individual to receive communications of claims-related information from VSP by alternative means or at alternative locations.
Except with the express consent of the requestor, VSP shall not disclose to the policyholder or another insured covered under the policy: (1) the address, phone number, or any other personally identifying information of the covered individual or any child residing with the covered individual; (2) the nature of the health care services provided to the covered individual; (3) the name, address, and phone number of the provider of the covered health care services; or (4) any other information from which there is a reasonable basis to believe the foregoing information could be obtained.
You may request participation in this confidentiality program to provide an alternate method of contact by following these steps:
VSP Legal Department 3333 Quality Drive
Rancho Cordova, CA, 95670
or you may fax it to 916.851.4851
Please call VSP at 800.877.7195 if you require assistance in completing the form.
For more information on New York domestic violence services, you can contact the NYS Domestic and Sexual Violence Hotline at:
For a listing of domestic violence hotlines by county, go to the NYS Coalition Against Domestic Violence Website New York State Domestic Violence Programs County Listing.