Participant Rights and Responsibilities
Upon Transfer or Termination


Table of Contents

Page contents:



Discontinuation of Participation

Rights and Privileges After Participation Ends

Participant Responsibilities

Customer Service


Indiana University

Participant Rights and Responsibilities Upon Transfer or Termination

Section I.
Insurance Plans

Group Life Insurance Coverages

Group Life Insurance Plans Summary

Basic Life Insurance. Indiana University provides Basic Life Insurance to eligible employees. The amount of coverage is two times the employee's budgeted base annual salary up to a maximum of $50,000 (1.3 times base annual salary at the age of 65). Dependent coverage is $3,000 for an eligible spouse and $1,000 for each eligible child. Indiana University pays the cost of this coverage.

Basic Accidental Death and Dismemberment (AD&D) Insurance. The university provides Basic AD&D Insurance to eligible employees in an amount equal to the employee's Basic Life benefit.

Supplemental Life Insurance. Employees who are eligible for Basic Life Insurance may purchase Supplemental Life Insurance. This insurance is generally equal to 1, 2, 3, or 4 times the employee’s budgeted base annual salary. The cost of Supplemental Life Insurance is deducted from the employee's paycheck.

At age 70, Supplemental Life Insurance amounts and maximums are reduced by 35 percent.


All full-time Academic and Staff employees are provided Basic Life Insurance. A dependent is a legal spouse or unmarried child through age 20, or age 24 if the child continues to be the employee's or employee's spouse's Federal income tax dependent.

Discontinuation of Participation

Participation by the employee in both Basic and Supplemental Life Insurance ends on the date that the employee:

A dependent's coverage terminates:

Rights and Privileges After Participation Ends

When employee group life coverage ends or reduces at age 70, employees and their covered dependents may apply to continue their group life insurance coverage as an individual policy with the policy underwriter Standard Insurance. No proof of insurability is required.

Two continuation options are available and each has its own rates and eligibility criteria:

The amount of insurance that is purchased under the portability and conversion options may not exceed the amount for which you or your dependents were insured on the day before your group life insurance coverage ended.

Application for conversion or portability must be mailed to Standard Insurance, with the required premium payment, within 31 days after the group life insurance ends.

Participant Responsibilities

Summary of actions the participant must take to convert or buy portable Life Insurance:

  • When your group life insurance ends, review the details of the conversion and portability applications:
  • Complete either the portability or the conversion life insurance application. Please note your group policy number 135262.
  • Upon your request, the Employer Statement of the application will be completed by Robin L. Reynolds Sr. Specialist, Group Insurance. To request completion of the Employer Statement, please contact Robin via email or call (812) 855-2007. To expedite completion, please provide her with your employee ID number and the continuation option you have selected (portability or conversion).
  • Mail your completed application with your premium payment to the policy underwriter, Standard Insurance. Robin will submit the Employer Statement portion of your application directly to Standard Insurance. For this reason, the Employer Statement does not need to be included in your mailing. The mailing address for Standard Insurance is noted on the top left corner of page 1 of the application. Your application and payment must be received within 31 days from the date your group coverage ended.
  • Pay subsequent premium payments on time. All payments must be submitted directly to Standard Insurance.
  • Notify Standard Insurance of any future address, beneficiary changes and name changes.

Customer Service

For additional assistance with portability and conversion of group life insurance, please call Standard Insurance 1-800-378-4668 ext. 6785 and reference group policy number 135262.