• Residency/Fellowship Completion Options Form

    Submission Deadline: 90 days from completing residency or fellowship

  • Policy #59999

    This form will instruct Doctors of BC on what insurance coverage options you want to carry into practice. This form is for members who enrolled as a student or resident in the INCOMEprotect program prior to July 1, 2025. (INCOMEprotect for Residents Legacy Plan)

    Need help completing this form?


    Read FAQ and instructions here. To get information on your existing coverage, log into the Member's portal of the Doctors of BC website. If you require further assistance, call 604-736-5551 or 1-800-665-2262, or email insurance@doctorsofbc.ca. Plan details, brochures, and rates can be found here.

     

  • 1. Personal Information

  • Date of Birth*
     - -
    2 digit day, 2 digit month, 4 digit year
  •  -

  • 2. Residency or Fellowship Program Details

  • Program Completion Date*
     - -
    2 digit day, 2 digit month, 4 digit year

  • 3. INCOMEprotect Disability

  • Do you wish to continue with your INCOMEprotect Disability in Practice?*

  • You can apply for INCOMEprotect Disability coverage. 

    Click here for more information about the plans and links to the applications. 

  • Elimination Period

  • Optional Riders

  • Your current INCOMEprotect for Resident coverage includes the following features:

    • Own Occupation Rider
    • Guaranteed Insurability Benefit Rider (GIB)
    • Cost of Living Adjustment Rider - 3% 

    These become optional riders as you transition to practice. By default, these riders are included on your INCOMEprotect for Practicing Physicians. If you wish to customize your coverage, please indicate your changes in the Optional Rider section below. 

  • Own Occupation Rider ⓘ*
  • Guaranteed Insurability Benefit Rider (GIB) ⓘ*
  • Cost of Living Adjustment Rider (COLA) ⓘ*
  • Retirement Protection Rider (RPP) ⓘ*

  • 3b. Doctors of BC INCOMEprotect Disability Surrender Request & Acknowledgement

  • Please read the following information carefully. By ticking each box, you are confirming your understanding of each point as it relates to the cancellation of Doctors of BC INCOMEprotect disability coverage.

    If you wish to speak with a Doctors of BC Insurance Advisor, please schedule an appointment here.

  • I understand my Doctors of BC INCOMEprotect Disability insurance coverage is an important aspect of my financial plan and terminating it may have consequences. I wish to terminate coverage effective June 30 (or the first of the month following this request) and am aware of the following (please check ALL bullets):*

  • 4. Other Disability Coverage

  • Do you have other disability coverage in place or are you intending to apply for other personal disability coverage (excluding employer mandatory disability and Doctors of BC coverage)?*
  • Upon approval of Doctors of BC INCOMEprotect for Practicing Physicians, I will*

  • 5. Life Insurance Options

  • Life Insurance ⓘ*

  • 6. Critical Illness

    You are eligible for $50,000 of Critical Illness coverage without proof of good health if you apply within 90 days of completing residency and have not obtained coverage without proof of good health previously.
  • Critical Illness Insurance*

  • 7. Professional Expense Insurance (PEI)

  • Professional Expense Insurance*

  • 7a.Professional Expense Insurance (PEI) - Transitioning Resident Member Offer

    If you are age 40 or under, you are eligible for up to $2,000 of Professional Expense coverage without proof of good health if you apply within 90 days of completing residency and have not obtained coverage without proof of good health previously. You may increase your monthly coverage further by up to $2,000 within the next 5 years without proof of good health.
  • Professional Expense Insurance*

  • 7b.Professional Expense Insurance (PEI) - Transitioning Resident Member Offer

    If you are between the ages of 41 and 60, you are eligible for up to $1,000 of Professional Expense coverage without proof of good health if you apply within 90 days of completing residency and have not obtained coverage without proof of good health previously. You may increase your monthly coverage further by up to $1,000 within the next 2 years without proof of good health.
  • Professional Expense Insurance*

  • 8. Physicians' Disability Insurance (PDI) Options

    Physicians in BC who will be earning sessional, MSP and/or service contract income in the next 12 months are eligible to apply for the government-paid disability insurance PDI. If you held $2,000/month in Doctors of BC IncomeProtect for Residents 12 months prior to starting practice, you are eligible to enrol in PDI coverage without proof of good health.
  • Physicians' Disability Insurance*

  • 9. Health & Dental Coverage

    Your employer Health & Dental plan terminates upon graduation. Doctors of BC provides a special offer for Health & Dental coverage for you (and your family). If you apply within 90 days of completing residency or fellowship, there are no medical questions and you receive a 50% discount on your first 12 months' of premiums. The deadline for this offer is 90 days from completing residency.
  • Health and Dental Option (HBTF Plan)*

  • 10. Request for Insurance Appointment

  • I would like a complimentary insurance review with a Doctors of BC licensed non-commissioned Insurance Advisor.*

  • 11. Authorization

  • I understand that Doctors of BC will use this form to make changes to my existing disability insurance. Changes will take effect on the completion date of my residency or fellowship, with premiums being charged from the 1st of the following month. 

    I understand if I cancel any of the above insurance programs and wish to reapply at later date, coverage will not be automatic and I will be required to provide proof of good health at that time.

    I declare that my answers on this application are true and complete and I understand that concealment, misrepresentation and false declaration  concerning this application will cause the insurance to be void.

    As a member of Doctors of BC or the Yukon Medical Association, for the addition of coverage using the GIB option, I understand and agree that (a) if approved, the GIB option amount will become effective on the date the application is received by Doctors of BC, but not prior to the date of the application Option period, (b) the new coverage will have the same exclusion(s) as specifically excluded from the Guaranteed Insurability
    Benefit Rider under the original coverage (c) the new coverage shall be subject to the terms of the Rider under which this option is being exercised.

    For application to the Physicians’ Disability Insurance Plan, I certify I am a member of the College of Physicians and Surgeons of British Columbia, that I receive remuneration from the Medical Services Plan on either a fee-for-service and/or sessional and/or non-salaried service contract basis and that I am aware of the terms and conditions of the Physicians’ Disability Insurance plan for which I am applying. I agree that any insurance issued in consequence with this application shall not take effect unless, on the date the insurance would be effective, I am actively engaged in my regular occupation.

    Electronic Signature Authorization

    By signing below, you are confirming that you are the member named in this form and you acknowledge that you are signing this document electronically. You agree your electronic signature is the legal equivalent of your manual/handwritten signature on this document. 

  • Date of Signature*
     - -
    2 digit day, 2 digit month, 4 digit year
  • Should be Empty: