A completed Declaration Form and letter from your employer confirming your lost wages must be mailed to the administrator’s office. You may print out a Declaration Form or, you may also contact BPA Administration Department to obtain a copy of the form.

Mailing Address
Attn: Administration 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: Administration Department
Tel: (905) 275-6466 or 1-800-867-5615
Fax: (905) 275-6462
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