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Plan Brochure:

Mandatory Student Health Insurance Plan Brochure (PDF)

Mandatory Student Dental Insurance Plan Brochure
(PDF)

Forms:

IU Health Center Claim Form (PDF)

Medical Enrollment Form for Dependents (PDF)

Dental Enrollment Form for Dependents (PDF)

Spring/Summer Continuation form (PDF)

Temporary ID card (PDF)

Resources:

Aetna Student Health information - Medical DocFind, Enrollment, Emergency Travel

Student Academic Appointees (SAAs) and Fellowship Recipients
Mandatory Student Health Insurance 2009-2010

The plan is administered by Aetna Student Health. All information on rates, plan benefits, claim procedures and exclusions are stated in the Mandatory Student Health Insurance Plan brochure (PDF).

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Eligibility

Participation in the Student Health Insurance Plan is mandatory for Indiana University Student Academic Appointees and Fellowship Recipients unless proof of comparable coverage is presented, and a waiver is filed by the waiver deadline. Student Academic Appointees and Fellowship Recipients are automatically enrolled in the student insurance plan each semester and the cost of the student premium is paid by the university.

All Student Academic Appointees (SAAs) appointed with 37.5% FTE or above for the corresponding semester, Fall and/or Spring and all Fellowship recipients with an award of $3,262 or more per semester are automatically enrolled in this Insurance Plan which is fully subsidized by the university or external funding agency. All graduate students on an academic appointment at or above 37.5% FTE must enroll in six credit hours or G901 each semester on appointment (summer excluded). Fellowship recipients must be enrolled in a minimum of six credit hours per semester.

Home study, correspondence, and television courses do not fulfill the eligibility requirements. If and whenever Aetna Student Health discovers the eligibility requirements have not been met, its only obligation is refund of premium; less any claims paid.

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Coverage Period

 

	Coverage Period
Annual	August 15, 2009 - August 14, 2010
Fall Semester	August 15, 2009 - December 31, 2009
Spring/Summer Semester	January 1, 2010 - August 14, 2010

 

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Enrollment Deadlines for Dependents

Eligible students may also insure their dependents. Eligible dependents are the spouse/same-sex domestic partner (residing with the Insured student) and unmarried children under the age of 24. Dependent eligibility is effective and expires concurrently with that of the insured student. Enrollment applications for dependents must be received by Aetna Student Health no later than the dates in the chart below. If the deadline has passed your dependents may not enroll for coverage until the next coverage period, unless there has been a significant life change (i.e., marriage, birth, loss of prior coverage). If the enrollment form is submitted within 30 days of the qualifying event, coverage will be backdated to begin on the date of the qualifying event. If the enrollment form is submitted after the 30 days of the qualifying, it will not be accepted, and the student and his/her dependents will have to wait until the next annual open enrollment period to enroll. Please contact the Student Health Coordinator for more information, 812-856-4650.

	Dependent Enrollment Deadline
Annual	September 15, 2009
Fall Semester	September 15, 2009
Spring Semester*	January 31, 2010

*Spring enrollment is only available for students newly enrolling to the University

Dependent Enrollment Forms

• Medical Enrollment Form for Dependents (PDF)
• Dental Enrollment Form for Dependents (PDF)

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Premiums

Medical Premiums

	Student*	Spouse	Child(ren)
Annual	$1,829	$4,370	$3,316
Fall	$   695	$1,665	$1,255
Spring/Summer	$1,134	$2,704	$2,060
*Premiums for qualifying SAAs and Fellowship Recipients are fully paid by the University or external granting agency. No Enrollment Form is required for the Mandatory Student Health Insurance Plan for SAAs and Fellowship Recipients.

 

Dental Premiums

	Student*	Spouse	Child(ren)
Annual	$246.60	$295.52	$443.88
Fall	$  93.71	$112.45	$168.67
Spring/Summer	$152.89	$183.47	$275.21
*Premiums for qualifying SAAs and Fellowship Recipients are fully paid by the University or external granting agency. No Enrollment Form is required for the Mandatory Student Health Insurance Plan for SAAs and Fellowship Recipients.

 

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Summary of Benefits Chart

• Download a PDF chart of medical benefits (this chart is a part of the Plan brochure).
• Download a PDF of the Student Dental Insurance Plan Brochure
  

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Continuation

All Insured Persons who have been continuously insured under the school's regular student policy for at least 6 consecutive months and who no longer meet the Eligibility requirements under the Policy are eligible to continue coverage by purchasing an independent continuation plan directly from Aetna Student Health for a period of at least six months under the school's policy in effect. You may print the enrollment form from this page and mail it directly to Aetna Student Health.

Continuation Enrollment Deadlines
Fall	September 15, 2009
Spring/Summer	January 31, 2010
Continuation Premiums	Student	Spouse	Child(ren)
Monthly	$227	$542	$413

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Additional Questions?

Refer below for questions about enrollment, enrollment forms, plan booklets, coverage and claims.

Aetna Student Health
Telephone: 877-437-6512
Web: Plan website for Indiana University

Aetna Dental
Telephone: 877-238-6200
Web: Plan website for Indiana University

IU Bloomington Campus Contact
812-856-4650
Poplars E165
Email:

IUPUI Campus Contact
812-856-4650
Education & Social Work Building, 2126
902 W. New York St.
Email:

 

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Benefit plan information on these web pages is in a summary format and is not intended to replace actual plan documents. Indiana University reserves the right to amend or terminate all or any part of any benefit plan.