Benefits Change Connection
Moved Residence
The actions you can take regarding a change in residence apply to medical and dental plans enrollment only. Plan changes are allowed when your move causes you to gain or lose eligibility for a plan, e.g., you move outside of an HMO service area or arrive in or depart from the USA.
To make changes to any of the plans listed immediately below, you will need to
complete 
the Change of Status form and 
the subsequent personalized benefit enrollment form. Step-by-step instructions appear on the respective plan pages below. You must make the change within 30 days.
- Change from one IU medical plan to another.
- Drop or add your spouse or children from/to your IU medical plan.
- Add coverage
- Drop or add your spouse or children from/to your IU dental plan
You will also need to complete the Personal Data Change form listed below.
Personal Data Change Form- For changes to home or mailing address
Forms and Publications
Change of Status form 
Personal
Data Change form
