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Indiana University

University Human Resources

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.

    Notes:
    1. If enrolling within 30 days of becoming eligible for Basic Life Insurance (generally 30 days from date of hire) complete the Enrollment/Change/Termination Form and send it to your campus HR office.
    2. Employees may decrease or terminate supplemental coverage at any time. To process, complete the Supplemental Life Insurance Enrollment/Change/Termination Form and return it to your local Human Resources office.
    3. A Medical History Satement is required if:
      • Enrolling after the initial 30 day period.
      • Enrolling in or changing to the Maximum Coverage option at any time, even within the initial 30 day period.
      • Increasing coverage after the initial 30 day period.

    For processing, 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.

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Page updated: August 2016
UNIVERSITY HUMAN RESOURCES
Contact Benefits: • (812) 855-2172