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Plan Brochure:

Voluntary Student Health Insurance Plan Brochure (PDF)

Forms:

IU Health Center Claim Form (PDF)

Voluntary Plan Enrollment form (PDF)

Spring/Summer Continuation form (PDF)

Resources:

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

Undergraduate and Graduate Students Voluntary 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 Voluntary Student Health Insurance Plan brochure (PDF).

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Eligibility

Participation in the Student Health Insurance Plan is voluntary for Indiana University undergraduate and graduate students on any campus (Bloomington, Indianapolis, Gary, Richmond, Kokomo, New Albany, and South Bend).

All domestic undergraduate students taking six or more credit hours are eligible to enroll in this insurance plan. All domestic graduate students taking three or more credit hours or registered for thesis or dissertation are eligible to enroll in this insurance plan.

Students must be enrolled at Indiana University for at least the first 31 days after the date for which coverage is purchased. 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.

Eligible students who do enroll 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.

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Enrollment

To enroll in the Plan go to www.aetnastudenthealth.com, click on “Find Your School” and enter 890423 as your Policy Number. The deadline for annual enrollment is September 15, 2009. You can also complete the enclosed Enrollment Form and mail it with the correct premium directly to Aetna Student Health by the September 15, 2009 deadline for annual coverage.

	Coverage Period	Enrollment Deadline
Annual	August 15, 2009 - August 14, 2010	September 15, 2009
Fall Semester	August 15, 2009- December 31, 2009	September 30, 2009
Spring Semester	January 1, 2010 - August 14, 2010	January 31, 2010
Summer Semester	May 1, 2010 - August 14, 2010	May 31, 2010
Summer Session 1	May 1, 2010 - June 20, 2010	May 31, 2010
Summer Session 2	June 7, 2010 - August 14, 2010	June 30, 2010

Enrollment applications must be received by Aetna Student Health no later the Enrollment Deadline dates above.

If the deadline has passed, you and 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.

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Premiums

Premiums for this plan are paid directly to Aetna Student Health and are paid in full at the time of enrollment.

	Student	Spouse*	Child(ren)*
Annual	$1,864	$7,698	$7,698
Fall	$746	$3,078	$3,078
Spring/Summer	$1,118	$4,620	$4,620
Summer	$538	$2,217	$2,217
Summer Session 1	$254	$1,049	$1,049
Summer Session 2	$347	$1,433	$1,433

*Spouse and child(ren) premiums are in addition to the student premium. For example: Annual premium for student + spouse = $9,562.

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Download a PDF of the Summary of Benefits Chart

This chart is a part of the Plan brochure.
2009 - 2010 chart (PDF)

The benefits are subject to the imposition of Policy limits and exclusions. All coverage is based on the Reasonable Charge allowance unless otherwise specified. Any charges in excess of the Reasonable Charge allowance are not covered under the Plan.

This Plan always pays benefits in accordance with any applicable Indiana Insurance Law(s).

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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	$200	$917	$917

 

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Additional Questions?

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

Aetna Student Health
Telephone: 877-375-4243
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.