Effective April 1, 2018, Plan Members and Dependents who use insulin to manage their diabetes are eligible for FreeStyle Libre Flash glucose monitor and sensors. For more information Click here

How Do I

Claim Forms

Before submitting the claim form, ensure that all questions have been answered and that you have signed your name and clearly identified yourself by full name, return mailing address, your employer, and your Union. Faulty or missing information will only result in a delay in processing your claim.

If the claim is for your Dependent, provide the Dependent’s first name, date of birth and relationship to you.

Claim Form

You may print out a claim form here Insulators Local 95 Dental Claim form

Your dentist’s office may have a supply of generic dental claim forms that are also acceptable, or you may contact a BPA Claims administrator (see box below) to obtain a copy of the form.

When you are sure that all of the above has been completed, forward the form to the BPA Claims Office(see box below).

Submitting Claim Forms


Original, signed claim forms must be mailed to the BPA Claims office at:  

 
Mailing Address
Attn: Claims Department
BENEFIT PLAN ADMINISTRATORS LIMITED
P.O. Box 3071, Station A
Mississauga, Ontario L5A 3A4

Corporate Address
BENEFIT PLAN ADMINISTRATORS LIMITED
90 Burnhamthorpe Road West, Suite 300
Mississauga, Ontario L5B 3C3
Attn: Claims Department
Tel: (905) 275-6466 or 1-800-867-5615
Fax: (905) 275-6462
claims@bpagroup.com

Insulators Local 95 Benefit Trust Fund c/o Benefit Plan Administrators 
90 Burnhamthorpe Road West, Suite 300 Mississauga, Ontario L5B 3C3