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Indiana University

Benefits Change Connection

Retirees
Personal Accident Insurance

An IU Retiree may convert his or her Personal Accident Insurance to an individual policy if:

Summary of actions the participant must take:

  1. To convert to an individual policy, submit the application to the designated policy underwriter at the address on the application within 31 days after the date on which group coverage terminates. The employer portion of the application form must be completed by the campus HR office.
  2. Pay the initial premium to the address on the application within 31 days after the date that group coverage terminates.
  3. Pay subsequent premium payments on time.
  4. Notify the policy underwriter if the need arises to change a beneficiary.
  5. Notify the policy underwriter of address and name changes.

 

HTML icon = complete online and print or submit. PDF icon = download PDF, print, and complete.Forms and Publications

Personal Accident Insurance Plan Booklet PDF

Participant Rights and Reponsibilities Upon Transfer or Termination