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.

A properly completed Vision Care claim form including the original prescription is required for each insured family member. Original Paid receipt of purchase must be attached as well.

 Claim Form

You may print out your the claim form Insulators Local 95 Vision Claim form

You can also contact a BPA Claims Administrator (see box below) to obtain a copy of the form.

 Each Vision Care claim must show the:

  1. Patient's full name
  2. Charge for lenses
  3. Charge for frames
  4. Charge for miscellaneous items
  5. Optometrist’s prescription

For covered cervices, you can refer to the Vision Care section of this website, or you may also contact a BPA Claims Administrator (see below) for a copy of a benefit booklet which will outline your coverage.

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

Corporate Address
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

Proof of Loss 
Written proof stating the occurrence, character and extent of loss must be submitted to the Administrative Agent within 12 months after the date of the loss, but not more than 3 months after the date coverage terminates, for Vision Care Benefits.

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