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Important News for OPIP Participants

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OMA Insurance
8/8/2018
Important News for OPIP Participants

On January 1, 2019 the OMA Priority Insurance Program (OPIP) is changing from a flat, annual contribution to an annual contribution plus a monthly subsidized premium.

​Since 2008, the member cost for OPIP health and critical illness insurance (the core benefits) was reduced significantly for eligible members by a subsidy from the Ontario government. Ten years later, with substantial increases in claims, increased numbers of insured members and with rising health care costs, the cost of these two coverages exceeds the government subsidy. Simply increasing the annual contribution is not covering this gap. It is time to address this funding need in a more fundamental manner. 

OPIP includes

Health and/or Health Spending Account coverage
Critical Illness Insurance
Legal Expense Insurance
Security Evacuation Coverage

Based on projected costs, starting January 1, 2019, each member's premium for the health/health spending account and critical illness will be subsidized by at least 70% with the remainder paid by the member. 

On January 1st we will also be introducing monthly premium payments by pre-authorized debit from members' bank accounts.

The 2019 government subsidy will be at least 70%.

Members tell us that OPIP continuing to be available into the future is important to them. For this to happen, we must address the financial sustainability of OPIP. This has been accomplished without having to make benefit changes.


Member Contributions for 2019

In September, all OPIP members will receive a personalized letter containing a breakdown of the estimated 2019 cost of their core OPIP benefits. This letter will also show the monthly premium that will be charged starting on January 1, 2019 and the subsidy each member will receive. We're doing this to let participants know in advance what they will be paying at the January renewal and to give them time to compare with other market offerings.

Self-funded options, if any, will continue to be paid fully by the member on a monthly basis— this includes Health Plus/Dental/Dental Plus and any optional Critical Illness insurance.

In addition to your member share of premium, each OPIP participant will continue to pay a flat annual OPIP contribution of $180, due each January.  

Here are a few examples of annual OPIP coverages for 2019. 

Single Adult Single + 1 Couple Family
Female, Age 34, Non-smoker Male, Age 43, Non-smoker Female, Age 36, Non-smoker Male, Age 49, Non-smoker
Premium Health $495.84 $683.04 $1,085.76 $1,875.24
Critical Illness $98.52 $150.84 $123.96 $258.48
Less 70% Government Subsidy -$416.04 -$583.68 -$846.84 -$1,493.64
OPIP Contribution1 $180.00 $180.00 $180.00 $180.00
Member Pays2 $358.32 $430.20 $542.88 $820.08
1 The annual OPIP Contribution of $180 is due on January 1st or on the first day of the month upon joining OPIP.
2 The member premium (less $180) will be withdrawn in twelve equal monthly installments through pre-authorized debit.
Member Monthly Cost $14.86 $20.85 $30.24 $53.34


Health Spending Account Participants

The new annual cost for members with a Health Spending Account is $230— this amount is due on January 1, 2019.  Members with Critical Illness will have their annual premium withdrawn from their bank account in 12 monthly payments. 


Thinking about your alternatives?

OPIP has been designed to provide flexibility and choice for our members. If you are considering changing your insurance provider, take a minute to understand how your protection could be affected.

OMA Insurance is committed to doing its best to ensure OPIP meets the needs of our members, now and in the future. Our staff are here to help you make informed decisions about all your insurance coverages. Even with this change in how members pay for OPIP, the value of OPIP and the protection offered makes this program one-of-a-kind: nowhere else offers this unique combination of coverage and cost. OPIP is only available to OMA members through OMA Insurance and has been specifically created for Ontario's doctors.