Benefits Change Connection

Enroll in or Change Long Term Disability (LTD) Plan Insurance

All Indiana University full-time employees are eligible for the Long Term Disability Plan.

---

1. Review the Long Term Disability Insurance Plan booklet and choose a level of coverage. (You may use the Premium Estimator to determine what your monthly premium will be.)
2. Complete the Long Term Disability Insurance enrollment form and return it to the campus Human Resources office.

Note:

1. Initiation of plan participation must be made within 60 days after becoming an eligible employee, by submitting an application form to the campus Human Resources Office.
2. Application for enrollment or change in coverage option after the first 60 days of eligibility must be accompanied by a Medical History Statement. See below.

 

Forms and Publications

Long Term Disability Insurance enrollment form

Premium Estimator for Long Term Disability Insurance

Employee's Medical History Statement for Indiana Residents

Employee's Medical History Statement for Indiana Non-Residents

Long Term Disability Insurance Plan booklet