Doctors of BC Health Benefits Trust Member Agreement with Trustees

Please note: this application will require your banking information. If we do not already have the account details on file, you will need to upload a void cheque or attach a direct deposit authorization form. 

FIRST YEAR PREMIUM DISCOUNT ELIGIBILITY

Doctors of BC offers a 50% premium discount for the first 12 months of participation in the HBTF plan for physicians who are just starting their career.

To qualify, both statements below must be true.

Schedule A is meant to capture all employees and physicians who are working for the clinic participating in the HBTF plan. Do not include your dependents on this page.

Note 1: This e-application includes a physician enrollment form to enroll yourself. A separate HBTF Enrollment Form from each eligible employee and participating physician (other than yourself) is required. Additional information may be required by the HBTF Plan Administrator or by the insurance company during the application process; and

Note 2 (COST-PLUS): The Income Tax provisions for an ELHT(Section 144.2(2) (d) allows the Trust to provide Cost-Plus benefits to the employee, the employee’s spouse or common-law Partner, and an individual who is related to the employee and either a member of the employee’s household or financially dependent on the employee for support. (ie. child, grandchild, parent, grandparent, sibling, niece, nephew etc). This amount will include covered expenses for your eligible dependents as defined under the Income Tax Act. Please ensure you discuss the Optional Cost Plus Plan with your Accountant or Financial Advisor prior to selecting Cost Plus to ensure your eligibility.

Note 3 (Insurance): The insurance portion of the HBTF plan is only available to spouses and dependent children of the insured member. This personal information is being collected and used in order for the eligible employees and participating physicians to qualify for and receive benefits from the Fund.

• The applicant (and dependents) must be covered under a Provincial Health Care Plan (ie BC MSP) to be eligible to participate in this plan.
• All applicants must be under age 65 at time of enrollment.
• Applicants must be actively working at time of enrollment

1. A reference in this agreement to:

(a) “I” or to “me” or to “Member” or to “Employer” means the physician described above, whether an individual, corporation or partnership, and if I am not an employer then “I” or “me” refers to me as a physician who is participating in the HBTF Benefits plan;

(b) The “Administrator” shall mean the Doctors of BC as administrator of the Health Benefits Trust Fund;

(c) The “HBTF Plan” means:

(i) for a physician who is participating in the HBTF Plan, the extended health care and dental benefits provided by the Trustees, plus the optional Cost-Plus Portion of the Plan; and

(ii) for Eligible Employees of the Physician (excluding however an employee who is a physician), the extended health care, dental, life, disability and accident benefits apply; and the Cost-Plus Portion of the Plan is optional, but if elected, must apply to all Eligible Employees;

(d) “Cost-Plus Portion of the Plan” means, in reference to the HBTF Plan:

(i) the maximum annual reimbursement allowed under the applicable legislation, or what the physician has set out in Schedule “A”, whichever is lower, for each physician who is participating in the HBTF Plan; and

(ii) the maximum annual reimbursement which the physician has set out in Schedule “A” (if no amount is specified, then the amount is $500 in a calendar year for each Eligible Employee of the physician for which Cost-Plus Portion of the Plan has been added; and if Cost-Plus Portion of the Plan has not been added or if no employees of the physician are listed in the list of Eligible Employees, then the amount is nil).

e. “Eligible Employees” shall have the meaning as set out in the HBTF Plan Booklet of the Trust Fund in effect from time to time.

2. I understand that this is a legal agreement between the Trustees and me. I apply to Doctors of BC Health Benefits Trust Fund (the “Fund” or “Trust Fund”) to participate in the HBTF Plan. This Member Agreement sets out the terms and conditions under which I, as a physician, may participate in the HBTF Plan provided by the Fund.

3. The participation of each Eligible Employee and the physician in the benefit plans offered from time to time by the Fund is effective from the first day of the month immediately following receipt and acceptance of this Member Agreement and all other required enrolment forms, or on such later date as is determined by the Trustees. I understand that there may be medical evidence requirements to obtain some of the benefits in the HBTF Plan, and satisfactory completion of those medical evidence requirements may be necessary for an Eligible Employee or physician to participate in those benefits.

 

8. I have completed Schedule “A” of this Member Agreement listing the Eligible Employees (if any), the participating physician(s) and the other necessary information that the Fund needs.

10. I understand that the Plan Summary/Details brochure of the Trust Fund and the HBTF Plan Booklet, which may be updated, revised, replaced or supplemented in the future by the Trustees, and the rest of this Member Agreement sets out other terms and conditions of the agreement between the Trustees and me, as the physician. I will also consult with my tax or other professional advisor for other important information, details and restrictions which may apply to me, as an employer.

GENERAL TERMS

By participating in the Doctors of BC Health Benefits Trust Fund, I agree that:

1. I have received a copy of the Fund’s Trust Agreement (or I have reviewed a copy on the Doctors of BC website). I am familiar with the terms and conditions of the Fund’s HBTF Plan and the Fund’s Trust Agreement.
2. I will abide by all terms and provisions of the HBTF Plan, the Fund’s Trust Agreement and the decisions of the Trustees.
3. I will pay the required Trust Fund benefit plan premiums on behalf of myself, my spouse, dependents and participating Eligible Employees.
4. If I am enrolling Eligible Employees in the HBTF Plan, I confirm that all of my Eligible Employees are listed on Schedule “A”. By not listing employees on Schedule “A”, I confirm that I do not have any Eligible Employees or have chosen not to enroll any employees in the plan. 
5. I will promptly notify the Fund in writing should the employment of any participating Eligible Employee terminate for any reason, if I employ new Eligible Employees, or if the Sponsoring Physician of a clinic changes.
6. I am aware that upon approval by the Trustees, this Member Agreement will come into effect on the date specified by the Fund through its Administrator, provided this Member Agreement and the Plan application forms are complete. I also understand that to be eligible for some of the benefits, the insurer must also give its approval. I understand the Trustees may terminate this Member Agreement by written notice to me. I agree to continue participation in the Fund and the HBTF Benefits Plan until such date that the Trustees process a written request of termination or the physician is no longer an active member of Doctors of BC. I will send a request of termination by fax or email to:
    

Fax:       (604) 638-2909
Email:    insurance@doctorsofbc.ca 

In any event that either party changes address, written notice shall be given to the other party.

Please click Submit when you are ready. An HBTF administrator will review your application for completeness and send you a DocuSign envelope for your final review and signature.