Get Download Late Entrant Application - Oma Insurance

This guide provides detailed guidance on how to accurately complete the Download Late Entrant Application for OMA Insurance online. By following these steps, users can ensure they provide all necessary information correctly.

Follow the steps to complete the application with ease.

1. Click ‘Get Form’ button to obtain the application form and open it in the editor.
2. Begin with Section A, where you will need to provide your personal information. Fill in your first name, middle initial, last name, former/maiden name (if applicable), date of birth, country and province of birth, preferred mailing address, telephone number, fax number, and email address. Clearly indicate if you are a smoker or non-smoker, and check the appropriate box regarding your tobacco use in the past 12 months.
3. In Section A, also indicate your coverage choice under Government subsidized PHBP benefits. Choose from options available for under age 65 or age 65 and over, indicating if you are selecting single, couple, member plus one dependent child, or family coverage. Additionally, specify if you are applying for health insurance and/or critical illness insurance.
4. Proceed to Section B, where personal health information is required. Fill in your height, weight, and any changes in weight over the last 12 months. Document reasons for any weight changes and provide details of your last consultation with a physician.
5. Complete medical history sections by providing information about your family history with specific diseases. Also, disclose any treatments or medications taken recently along with conditions for yourself, your spouse, and your dependents.
6. In the payment information section, select your payment schedule for any self-funded options you are applying for. Attach a blank cheque marked void to authorize Pre-Authorized Debit (PAD) payments.
7. Review the Application for Subsidy section and choose whether you or your professional corporation is applying for the OMA subsidy. Sign and date this section as applicable.
8. Finalize your application by signing the declaration and authorization section, confirming that your answers are accurate. Ensure you include your spouse’s signature if relevant.
9. Once all sections are filled out correctly, save your form changes. You can download, print, or share the completed application for submission.

Complete your application online today to secure your benefits.