Very much the old boy network (using the term generically; VSP has many women in management and leadership which is great). The same people get promoted to higher and higher roles; many of them have never worked anywhere else other than VSP so having outside perspectives among senior leadership is difficult to impossible. Re-orgs are pretty common, but barely anyone ever gets let go in these processes. They just change the job titles and shuffle people around to give the impression of innovation and response to market change. Meanwhile, business never changes. Your job will likely be to work on larger scale projects that are well-funded and staffed, completed competently, and then recommendations passed up the chain to senior management, never to be heard from again.
After I began to notice the most talented employees get promoted to mid-level management but no further, and then take what they had learned and move into REAL health care/insurance (i.e. away from ancillary benefits), I realized this is the path for the worthy. Anyone who can do better does.
As many have mentioned, VSP uses a measure of "total compensation" to make you believe you are paid a market wage. Here's what I'd say about that: Look, you're not killing yourself here. Most folks are EASILY working their job on less than 40 hrs per week. So, look at your salary according to how much you are there, and realize all the stress you are avoiding by working here. Many folks love the culture and will stay forever. If you want to get paid more and innovate a product or service, probably best to look elsewhere.