Claim forms may be obtained from the Trust Fund’s administrator or the Claims Office or from the Benefit Plan Administrators website: http://www.bpagroup.com.
Prescription Drug Claims
After January 1, 2013, you may use your Prescription Drug Card to purchase prescription drugs directly from your pharmacist. If you have any difficulties using the 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 SIN. All paper prescription drug claims will continue to be processed through Benefit Plan Administrators Limited. When submitting prescription drug claims, make sure that each receipt shows the- patient’s full name
- prescription number, name of medication, quantity, and strength
- date of purchase, dispensing fee and the total charge for each item
- Drug Identification Number (DIN)
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 and have indicated your 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.
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, except for vision care, must show the
- patient’s full name
- date(s) the service was rendered or purchase made
- nature of the sickness or injury
- itemized charges
- physician’s written recommendation
CASH REGISTER RECEIPTS OR LABELS FROM CONTAINERS ARE NOT ACCEPTABLE.
