How to File Extended Health Claims

Prescription Drug Claims

On February 1, 2013, the Reimbursement Drug Benefit was replaced by the Prescription Drug Card Benefit. When you drop off a prescription, present your Prescription Drug Card to the pharmacist.

If you have any difficulties using the Prescription Drug Card, please contact Benefit Plan Administrators at either 905-275-6466 or toll free at 1-800-867-5615. Your Unique ID Number which appears on the card is the reference ID number to be used when making inquiries. It replaces the Social Insurance Number (SIN) previously used. 

All paper-based prescription drug claims will continue to be processed through Benefit Plan Administrators Limited.

Other Major Medical Claims

Before submitting the claim form, ensure that all questions, have been answered that you have signed your name and clearly identified yourself by full name, return mailing address, and your employer and 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.

When you are sure that all of the above has been completed, forward the form and all attachments to the Claims Office. Your benefit cheque will be mailed directly to you. Assignment of benefits is not permitted and all cheques will be made payable to you as the insured Member.

Each expense should be listed separately, by insured individual, on the appropriate claim form. Submit claims together with originals of bills or receipts, no more than once a month or every 2 to 3 months if bills are small. Claiming more frequently for small amounts ties up service for everyone and delays payment on larger claims where there is a real need for timely benefits.

Bills and receipts must be complete. Each bill, or receipt, other than for drugs, must show the:

  1. patient's full name
  2. date(s) the service was rendered or purchase made
  3. nature of the sickness or injury
  4. Physician's written recommendation itemized charges.

Each drug or medicine bill or receipt must show the:

  1. patient's full name
  2. prescription number, name of medication, quantity, and strength
  3. date of purchase, dispensing fee and the total charge for each item
  4. Drug Identification Number (DIN) 

Covered Services and Drugs

You can refer to the Health Care section of this website, or you may also contact BPA (see below) for a benefit booklet which will outline your coverage. This website and your Benefit booklet may not list specific drugs that may be covered, so you can call a BPA Claims Administrator (see below) for the information that you require.

You must mail in your complete claim form to BPA office (see below).

 

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

Note:

Failure to list drug expenses separately will result in your form being returned to you for proper completion.

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