Home > Benefits > Change > Supplemental Life Insurance

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 web page
  2. Complete the Supplemental Life Insurance Enrollment/Change/Termination Form (PDF) and return it to:

IU Human Resources
ATTN: Customer Care
Poplars E165
400 E. 7th Street
Bloomington, IN 47405-3085

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 IU Human Resources.
    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 IU Human Resources.
    3. A Medical History Statement 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