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)

Dental Claim Form (PDF)

Temporary ID card (PDF)

Resources:

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

Encore Health Network (Additional providers for those living in Monroe and Lawrence Counties)

Student Academic Appointees (SAAs) and Fellowship Recipients
Mandatory Student Health Insurance 2008-2009

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.

The information contained herein is intended to provide an overview of the Indiana University Student Health Insurance Plan. Students should not use this information in making decisions pertaining to health insurance coverage.

---

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 $3,230 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, internet classes (with the exception of Nursing PhD candidates) 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.

---

Coverage Period

• First Semester:  August 15, 2008 through December 31, 2008 
• Second Semester: January 1, 2009 through August 14, 2009

---

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 September 15, 2008 for the Fall Semester and January 31, 2009 for the Spring Semester. If the deadline has passed, you may not enroll your dependents for coverage until the next coverage period, provided an application and appropriate premium have been received by Aetna Student Health prior to or on the established deadline.

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

---

Premiums

Medical Premiums

	Student*	Spouse	Child(ren)
Annual	$1,666	$3,980	$3,020
Fall	$633	$1,516	$1,143
Spring/Summer	$1033	$2,463	$1,876
Quarterly	$416.50	$995	$755
*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	$295.92	$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.

 

---

Summary of Benefits Chart

• Download a PDF chart of medical benefits (this chart is a part of the Plan brochure).
• Download a PDF chart of dental benefits
  

---

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 not more than six months under the school's policy in effect. The deadline for the Fall Continuation is September 15, 2008. Contact the Student Health Plan Coordinator, 812-856-4650, for questions.

Medical Continuation Plan Premium Rates (6 month maximum)

	Student	Spouse	Child(ren)
Monthly	$207	$494	$376

---

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:

---

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.