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Indiana University
Benefits Change Connection

Enroll in or Change Supplemental Life Insurance

Supplemental Life Insurance is an elected benefit that is paid for by the employee. Basic Life Insurance coverage is provided to eligible employees without cost, courtesy of Indiana University.

  1. Review the Supplemental Life Insurance section of the Group Life Insurance Plan booklet.
  2. Complete the Supplemental Life Insurance Enrollment/Change/Termination Form (PDF) and return it to your local campus Human Resources office.

    Note:
    1. Eligible employees can add supplemental coverage by completing a written election form within 30 days of becoming eligible for Basic Life Insurance (generally 30 days from date of hire).
    2. If an election for supplemental coverage is made after the initial 30 day period, a Medical History Statement form will be required. For processing, please mail the completed Medical History Statement together with your Supplemental Life Insurance Enrollment/Change/Termination form to: Standard Insurance Company ATTN: Medical Underwriting 900 SW Fifth Avenue Portland OR 97204.
    3. If an increase in supplemental coverage is elected after the initial 30 day period, a Medical History Statement form will be required. For processing, please mail the completed Medical History Statement together with your Supplemental Life Insurance Enrollment/Change/Termination form to: Standard Insurance Company ATTN: Medical Underwriting 900 SW Fifth Avenue Portland OR 97204.
    4. Employees may decrease or terminate supplemental coverage at any time. To process a decrease or termination of supplemental coverage, please complete the Supplemental Life Insurance Enrollment/Change/Termination Form (PDF) and return it to your local Human Resources office.