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The completed Declaration Form and a letter from your employer confirming your lost wages must be mailed to the administrator's office.

Declaration Forms You may print out a Declaration Form here.
Or, You can also contact BPA Claims Department (see box below) to obtain a copy of the form.


BENEFIT PLAN ADMINISTRATORS

Mailing Address
Attn: Claims Department
BENEFIT PLAN ADMINISTRATORS LIMITED
P.O. Box 3071, Station A
Mississauga, Ontario L5A 3A4
claims@bpagroup.com
Forms & Brochures
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