OMA Priority Insurance Program (OPIP)
Learn about OPIP, created just for OMA members.
OPIP is designed to ensure that Ontario physicians have access to the type of benefits that many Ontarians receive as part of an employee benefits program, providing you and your family with unique protection solutions.
What’s included in the OMA Priority Insurance Program?
Coverage |
Plan features |
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Health |
Prescription drugs, hospitalization, paramedical services, assistive devices and more. $2-million emergency out-of-country travel coverage3. A Health Spending Account is available to those members who opt out of health insurance if they have health coverage elsewhere. If you wish to upgrade your coverage at additional cost, Health Plus and Dental coverage is also available. |
Critical Illness benefit |
Tax-free lump sum payment1 of $50,000 after 30 days of surviving a diagnosis of one of 25 covered serious illnesses. Members under age 65 can also purchase an additional $50,000 each for coverage for themselves and their spouse. |
Legal Expense Insurance |
Protects you, your spouse and children living at home from unexpected legal issues and costs. Unlimited access to a Legal Helpline. |
Optional upgrades |
OMA Insurance recognizes doctors sometimes want their coverage to go beyond basic protection and offer more comprehensive coverage that includes enhanced benefits for themselves and their family. For this reason, we offer exclusive optional upgrades that, when added to OPIP, go beyond basic coverage to offer more protection. |
Eligibility
To access OPIP without having to answer medical questions, you must enrol within 90 days (about three months) of your initial OPIP offer. If you do not choose to participate in OPIP within 90 days of receiving your initial offer, you can apply at any time with medical evidence.
If you are an eligible physician, the government-subsidized Physician Health Benefit Program (PHBP) helps pay the cost of your Critical Illness Insurance and Health coverage (or HSA if you opt out of the Health coverage) provided through OPIP.
You are an eligible physician if you are:
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A member in good standing of the Ontario Medical Association or, if not a member, have paid all dues and assessments owed under the Ontario Medical Association Dues Act, 1991
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Registered with the College of Physicians and Surgeons of Ontario and have acquired an independent practice license
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Actively engaged in providing medical services2 in the province of Ontario for at least 15 hours per week on average and is remunerated by the Ministry through OHIP, including Alternate Payment Plans and/or Alternate Funding Plans; or by an employer for providing insured clinical services
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Residing in Canada. Residents of Quebec are eligible if they practice in Ontario, the enrolment/application form is signed in a province or territory other than Quebec, and they agree that the certificate of insurance and all other communications will be delivered in a province or territory other than Quebec
Affordability
The cost of OPIP is funded through a combination of government subsidy, OPIP reserves and member premiums.
The actual cost of your OPIP coverage is much higher than your annual contribution and is calculated based on sex at birth, family status, age, and smoking status. The difference between the actual cost of OPIP and your annual contribution is paid for in two ways: government subsidy and OPIP reserve.
Need advice? Our expert insurance advisors are here to help.
Important forms
How much will it cost?
1 Based on the current tax laws, the cash benefit from a group critical illness insurance plan will not presently be taxed when the premiums are paid for by you and the benefit is payable to you. Diagnosis of a critical illness, such as cancer, heart attack or stroke, must occur after the effective date of coverage and you must complete a survival period (usually 30 days).
2 Medical services include the provision, study and administration of medical care, and include but are not limited to physicians in medical practice, laboratory physicians, company medical directors, insurance company physicians, OHIP and WSIB (Workplace Safety and Insurance Board) physicians, hospital and medical clinic administrators, medical schoolteachers, medical researchers and hospital committee work.
3 Emergency out of province/country travel medical coverage is only available with Health/Health Plus insurance.
OMA Priority Insurance Program is underwritten by Sun Life Assurance Company of Canada. Sun Life Assurance Company of Canada is the insurer of this product and is a member of the Sun Life group of companies. For inquiries, please call Sun Life’s Client Care Centre at 1-800-758-1641, Monday to Friday, 8 a.m. to 8 p.m. ET. or visit www.sunlife.ca.
For complete details regarding coverage, please see the terms and conditions of Policies 50130 and 50131. If there is any conflict between this document and the wording of the policies (or the certificate), the wording of the policies will govern. A copy of the policy may be requested.
Premium rates and discounts are not guaranteed and are subject to change upon notice.
Exclusions and limitations may apply.
Important Notice: Effective February 1, 2023, Canadian Premier Life Insurance Company (“Canadian Premier”), acquired the Association and Affinity business of Sun Life Assurance Company of Canada (“Sun Life”). Any reference you see to “Sun Life” on this website or on insurance documents you may receive, should be considered referring to “Canadian Premier”.