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Individual Financial ServicesVision Care
Paper Claims
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.
- patient's full name
- charge for lenses
- charge for frames
- charge for miscellaneous items
- Optometrist’s prescription
Mail Vision Claims to:
Attn: Claims Department
BENEFIT PLAN ADMINISTRATORS LIMITED
P.O. Box 3071, Station A
Mississauga, Ontario L5A 3A4
Or via email at: claims@bpagroup.com
Help
For questions or assistance, please contact BPA by phone at either 905-275-6466 or Toll Free at 1-800-867-5615, or by email:
Administration: otcadmin@bpagroup.com
Claims: claims@bpagroup.com
VISION CARE BENEFITS |
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| Lenses & Frames – Adults Or Contact Lenses |
$350 every 24 months (includes one eye exam to a maximum of $50) | |
| Safety Glasses – Adults |
$300 every 24 months (for Active Members Only) | |
| Lenses & Frames – Children (Under 18) | $350 every 12 months | |
Vision Care charges for one pair of glasses (lenses and frames) or contact lenses, or safety glasses (for Active Members only), when prescribed by a legally qualified Ophthalmologist or Optometrist.
No amount is payable for replacement of lost or stolen glasses, broken glasses or duplicate glasses.
Members choosing to purchase disposable contact lenses should note that only one claim is allowed in any 24 month period (12 month if under 18), and therefore should consider buying in quantity.
OHIP covers eye exams for children and seniors. Proof of Loss Written proof stating the occurrence, character and extent of loss must be submitted for each benefit to the administrator within 12 months after the date of the loss, but not more than 3 months after the date coverage terminates, for Vision Care Benefits.
MRI/CAT Benefit
If your physician or specialist prescribes diagnostic services such as an MRI or CT scan for conditions which are deemed to be medically necessary, the Ontario Health Insurance Plan (OHIP) would provide the coverage. Although the wait times have improved, there is still a possibility of waiting up to six months for such procedures, resulting in individuals choosing instead to frequent private clinics for more timely service.
Effective January 1, 2013, a member or eligible dependent may have an MRI or CAT scan on an elective basis with 50% of the cost covered by the Trust, up to a maximum of $500.00 per lifetime, per member or eligible dependent. For example, an MRI or CT scan could be scheduled in a private clinic within less than 10 days and may range in cost from $800 to $1300 for both the scan and the report that you can then forward to your doctor. Please contact the Claims Manager at Benefit Plan Administrators for more details. Please note that this is not an insured Benefit through Great West Life, it is a benefit provided by the Trust.