2019 OMA Insurance offers up to $100,000 of critical illness insurance through the OMA Ontario Priority Insurance Program (OPIP) insurance plan non-medically and up to $250,000 of group critical illness insurance with regular underwriting. Both plans are with Sun Life.
OPIP critical illness insurance is issued non-medically includes a 24-month pre-existing condition amendment. The first $50,000 is partially subsidized by the government, the second $50,000 is voluntary and funded by the individual.
OMA group critical illness insurance rates increase every 5 years and insurance expires at age 70.
Physicians and spouses will be able to replace their OMA critical illness insurance as follows:
First $50,000 of OPIP critical illness insurance. As the first $50,000 of OPIP critical illness insurance is subsidized by the government through Ontario Physicians Services Inc. (OPSI), we recommend that you maintain this insurance until the OSA group benefits plan has been put in place (anticipated summer 2019). At that time, you can replace your OPIP $50,000 critical illness insurance. The OSA has had initial discussions with the Ontario government about extending parity subsidy to OSA specialists.
Second $50,000 of voluntary OPIP critical illness insurance and group critical illness insurance. The second part of OPIP critical illness (voluntary $50,000) and your group critical illness insurance will be replaced with the RBC Guaranteed Renewable Critical Illness Recovery PlanTM Level Premium to Age 75 policy. Policies are guaranteed renewable, insurance is available to age 75 and the RBC Insurance plan is convertible to long-term care insurance (the OMA critical illness plan is not convertible to long-term care insurance). With respect to the pre-existing condition amendment on OMA OPIP policies being replaced; a 24-month pre-existing condition limitation will only run in cases when a policy is less than 24-months old and will only be effective from the date of the original OMA OPIP policy.
In order to be eligible for OMA insurance, OMA members must be in good standing, which means they must be up to date on their membership fees. With the OSA, there is no reference to being in good standing or membership fees in order to qualify or maintain your insurance.
Neither the OSA insurance companies nor the Association (the OSA) can cancel or change your insurance.
Example: You have $50,000 of critical illness insurance under OPIP and an additional $100,000 of OMA group critical Illness Insurance. The member leaves the OMA to join the OSA. You are eligible for critical illness insurance, if you can answer yes to question 1 (or no to question 1 and yes to question 2) and no to question 4 on the RBC OSA Insurance application.
You will receive $100,000 RBC Guaranteed Renewable Critical Illness Recovery PlanTM Insurance to replace your OMA group critical illness insurance. Product provided is the RBC Insurance Individual Critical Illness Recovery Plan, Level Premium to Age 75, guaranteed renewable to age 75. Benefit amounts will match the combined critical illness benefit under all of the member’s OMA critical illness coverage being replaced (up to a maximum of $350,000). Policies will be issued with a pre-authorized monthly debit and a 10% discount.
With respect to your $50,000 of OPIP critical illness insurance, you will maintain this at the OMA. Once the OSA group benefits plan has been put in place (anticipated summer 2019), you can replace your OPIP $50,000 critical illness insurance. The OSA has had initial discussions with the Ontario government about extending parity subsidy to OSA specialists.
COMPARISON OF OMA LIFE INSURANCE VS. RBC LIFE INSURANCE When doing a comparison across insurance products, we compared the policy provisions and cost differences after rebate OMA Group Insurance vs. RBC Individual Insurance.
Cost comparison: OMA vs. RBC Insurance
The OMA plan offers coverage to age 70 whereas the RBC Insurance policy offers coverage to age 75. In most cases, there is a cost savings to age 70 with RBC Insurance. The RBC Insurance policy is convertible to long term care coverage, your policy provisions are guaranteed and you own and control your insurance. The difference in cost depends on when you start your plan.
Below is a rate comparison for illustration purposes of $100,000 RBC Guaranteed Renewable Critical Illness Recovery PlanTM Insurance Level Premium to Age 75 vs Sun Life OMA term to age 70.
Source: OMA website, RBC Insurance, Nov 2018 E&OE. Comparison assumes coverage to 70
WHAT IS YOUR INDIVIDUAL COST TO REPLACE YOUR OMA INSURANCE? Attached is the cost summary that illustrates the monthly cost by gender, age and insurance by product (life, disability, critical illness and office overhead insurance).
FREQUENTLY ASKED QUESTIONS:
RBC Life Insurance Company.
No. This is an individual insurance policy where you own and control the policy. Neither the insurance company (RBC Life Insurance Company) nor the association (the OSA) can cancel or change your insurance. Unlike the OMA which ties your insurance to OMA membership fees, neither the insurer (RBC Insurance) nor the Association (the OSA) can cancel or change your insurance.
No. There are 5 medical questions on the application.
The RBC Insurance critical illness insurance policy covers the following critical illnesses.
Aortic Surgery
Loss of Independent Existence
Aplastic Anemia
Loss of Limbs
Bacterial Meningitis
Loss of Speech
Benign Brain Tumour
Major Organ Failure on Waiting List
Blindness
Major Organ Transplant
Cancer (Life Threatening)
Motor Neuron Disease
Coma
Multiple Sclerosis
Coronary Artery Bypass Surgery
Occupational HIV Infection
Deafness
Paralysis
Dementia, including Alzheimer’s Disease Parkinson Disease and Specified Atypical Parkinsonian Disorders
Heart Attack
Severe Burns
Heart Valve Replacement or Repair
Stroke
Kidney Failure
See policy for complete definitions.
The first $50,000 of OPIP critical illness insurance is subsidized by the Ontario government through Ontario Physicians Services Inc. (OPSI). We recommend that you maintain this insurance at the OMA until the OSA group benefits plan has been put in place (anticipated summer 2019). At that time, you can replace your OPIP $50,000 critical illness insurance. The OSA has had initial discussions with the Ontario government about extending parity subsidy to OSA specialists.
RBC Insurance offers critical illness insurance for physicians with preferred underwriting and a 10% discount.
If, while the policy is in force, the insured meets the specific definition of Early Prostate Cancer, Early Breast Cancer, Early Skin Cancer, Early Stage Blood Cancer, Early Stage Intestinal Cancer, Early Thyroid Cancer or Coronary Angioplasty and completes the survival period as defined in the policy, we will pay 10% of the lump sum critical illness benefit to a maximum of $50,000. The lump sum critical illness benefit is not reduced by the payment of the early assistance benefit. The survival period before the early assistance benefit is payable is usually 30 days, unless otherwise specified in the definition. The early assistance benefit is payable only once, regardless of the number of the critical illnesses or policies the insured may have with RBC Insurance.
The policy may be converted, without evidence of good health, into a convertible Long-Term Care insurance policy then offered by RBC Insurance and made available for conversion, provided the following conditions are met: The written application for conversion is received by RBC Insurance® no earlier than the policy anniversary at the insured’s attained age fifty-five (55) and no later than the policy anniversary at the insured’s attained age sixty-five (65);
The policy has been in force at least two (2) years at the time the application for conversion is made;
The policy is in force at the time the application for conversion is made;
Premiums are not being waived under this policy if a rider providing waiver of premium benefits is shown on the Schedule of Benefits and
Premiums or any amendment to this policy;
The insured is not satisfying a survival period at the time the application for conversion is made;
A claim for the critical illness benefit is not pending or payable; and
The insured is not unable to perform two (2) or more activities of daily living at the time your application for conversion is made; and
The insured is not cognitively impaired at the time your application for conversion is made.
Activities of Daily Living are:
Bathing – the ability to wash oneself in a bathtub, shower or by sponge bath, with or without the aid of equipment.
Dressing – the ability to put on and remove necessary clothing including braces, artificial limbs or other surgical appliances.
Toileting – the ability to get on and off the toilet and maintain personal hygiene.
Bladder and Bowel Continence – the ability to manage bowel and bladder function with or without protective undergarments or surgical appliances so that a reasonable level of hygiene is maintained.
Transferring – the ability to move in and out of a bed, chair or wheelchair, with or without the use of equipment.
Feeding – the ability to consume food or drink that already has been prepared and made available, with or without the use of adaptive utensils.
Cognitive impairment is defined as mental deterioration and loss of intellectual ability, evidenced by deterioration in memory, orientation and reasoning which are measurable and result from demonstrable organic cause as diagnosed by a specialist. The degree of cognitive impairment must be sufficiently severe as to require a minimum of eight (8) hours of daily supervision. Determination of cognitive impairment will be made on the basis of clinical data and valid standardized measures of such impairments. Cognitive impairment related to all psychiatric related causes is specifically excluded.
YES. If you are incorporated, your corporation can own and pay for your critical illness insurance. In this case, should you need to make a claim, the funds will be paid tax-free into your corporation and the corporation can pay the benefit out to the insured as a taxable dividend. Please provide a corporate cheque.
