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Premiums for 2020

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New Improvements to OMA Insurance Benefits Coming in 2020
OMA Insurance
12/2/2019
OMA Insurance aims to provide best-in-class insurance programs for OMA members. This includes a wide range of benefits, including health care coverage for prescriptions, paramedical, emergency medical travel, medical equipment and hospital rooms, and dental coverage for prevention and maintenance.

​OMA Insurance has incorporated member feedback in terms of the coverage that would work best for them and their families and would like to advise you of several changes and enhancements to your insurance coverage as a result of this input.


Premiums for 2020

Members will see an overall increase to their OPIP Health and OMA Group Health renewal of 10%. This increase is attributed to:

    • Health inflation driven in part by the cancellation of OHIP+
    • Increased prescription/medication utilization; and
    • Substantive provision improvements for psychologist services (see below).

There will also be an OMA Group Dental renewal increase of 6% due to provincial fee guide increases and increased utilizations.


Enhancements to Psychologist provision

    • OMAI is making substantive changes to coverage under the Psychologist provision. This change will help physicians and their families address mental health situations to aide wellness.
    • Coverage limit for Psychologist provision will increase to $10,000 per year from $350/$500 per year. This substantial limit is not generally available from other providers in the marketplace.
    • Services of a Social Worker (MSW) will be eligible for reimbursement under the Psychologist provision. This will allow insureds to have greater choice in treatment providers, and obtain treatment more quickly in underserviced areas. The change will also permit treatment dollars to go further as the hourly rate for Social Workers is generally lower than for Psychologists.


Out of province travel covered by OMAI

    • The Ontario Ministry of Health will no longer pay for emergency medical expenses outside of the province where you live, however this will not affect OMAI plan members. Your Out of Country coverage through the OMA Health Plan will cover costs no longer reimbursed by OHIP. If you have any questions, please contact Sun Life at 1.800.361.6212.


A couple of things to remember

    • To maximize the benefits from your OMA Insurance, please ensure that your 2019 claims are submitted no later than June 30, 2020.
    • You should also carry your travel card when travelling outside of the province where you live. This will be invaluable in making sure you can quickly and easily access OMAI assistance whenever you need it.
    • Your benefits booklet will be available after December 15th by logging into your OMA account at www.oma.org/Statements. You can also call us at 1.800.758.1641, option 2 to request a copy. 


OMA Priority Insurance Program (OPIP)

The overall OPIP subsidy for OPIP Health and Critical Illness remains unchanged at 70% for 2020. Also unchanged is the Annual Contribution of $180.

OPIP Continuance Members

Effective January 1, 2020, OPIP Continuance members who are disabled are eligible to have their subsidy reinstated.  If you are receiving benefits through a private insurance plan or from Canada Pension Plan, your subsidy may be eligible for reinstatement.  Additionally, members who are on extended Parental Leave are also eligible to have their subsidy continued for up to 18 months. To arrange for the OPIP subsidy reinstatement, members must reach out to OMA Insurance at 1.800.758.1641 or email info@omainsurance.com.

OMAI is continually looking to improve all our insurance products so they respond to what you and your family need most. The plan enhancements announced today were almost entirely driven by member feedback. If you have any suggestions, please contact us care of Preya at Preya.Singh-Cushnie@oma.org.