Complete as much of this form as you are comfortable. We will do our best to respond to your questions and comments within 1 business day. You must supply an email address at the bare minimum for us to contact you.

If you are an employee of one of our clients and include your employer name it will speed your reply.

For your security please do not include sensitive personal information such as: social security number, credit card numer.

Name:
Employer:
Phone:	Ext:
Reply Method:	Email** Phone
Email:	*
Regarding:	====================================== My Flexible Spending Account My Health Reimbursement Arrangement (HRA) My Dependent Care Account(Daycare/DCAP) Reimbursement Claims I have submitted My Login/PIN for Checking Balances COBRA ====================================== My Retirement Plan(s) A Retirement Plan Distribution ====================================== BPC Online Help BPC Website Suggestion ====================================== A Service Suggestion Unsatisfactory Service Awesome Service I received ====================================== Hiring BPC for Benefit Plan Administration Hiring BPC for Retirement Plan Administration ====================================== Other Issue
Message:

* : Required Field

** Sensitive information such as: plan balances, social security number, debit card number, etc cannot be transmitted securely via email. If any of these things are applicable to this communication we will call you instead of replying via email even if you choose email as your method of communication.