Forms

Insurance Forms

Here you’ll find a consolidated list of all insurance forms for members.

Please note that some of these forms are fillable PDFs which are only compatible with Google Chrome or Internet Explorer browsers.

Health & Dental

• Enrollment Package - Physicians

• Enrollment Package - MOA

• HBTF - Direct Debit Banking Authorization and Change Form

• Request for Change

• Termination of Coverage

• Dental Claim Form (Canada Life)

• Health Claim Form (Canada Life)

• Cost-Plus Claims Guide

• Cost-Plus Claim Form

• HBTF - Annual Dependent Declaration for Cost-Plus Entitlement

All Individual Insurance Plans

• All Insurance Plans Application (except Health & Dental (HBTF)

• Direct Debit Banking authorization and change form

• How to pay your premium

• Request for Termination or Reduction in Benefits

Life & Critical Illness Insurance

• Life Insurance Application
• Critical Illness Insurance Application
• Critical Illness (Child Rider) Application
• Life Beneficiary Designation

Disability, Professional Expense and Physicians’ Disability Insurance (PDI)

• Disability INCOMEprotect™ Application

• Physicians Disability Insurance Application

• Disability GIB Application

• Professional Expense GIB Application

• FAQ - How to Complete GIB Applications

Accidental Death and Dismemberment

• AD&D Enrollment Form

• AD&D Beneficiary form

Resident Forms

• Resident Life Application without proof of good health

• Resident Transition to Practice Options Form - within 90 days of completing residency/fellowship

• Instructions & FAQ - Resident Transition to Practice Options online form

• Resident Disability Application (Without Proof of Good Health)

• Resident Disability Application (With Proof of Good Health)

Student Forms

• 1st Year Student Membership & Insurance Application

• Student Insurance Application

• Student Disability - 4th Year $4,000 Option Form

• Medical Graduate Form