Indiana University
Health Sciences Student
Insurance Plan
Qualifying Life Event Enrollment Form
2026-2027 Academic Year
Students who do not enroll themselves or their dependents during the initial enrollment period can only enroll later if they experience a qualifying life event. They must complete the qualifying event enrollment form and provide supporting documentation within 30 days of the life event.
Loss of Other Coverage:
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Required Documentation: loss of coverage letter that includes the student and/or dependent's name and last day of coverage
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Deadline: 30 days from the last day of coverage in the prior plan
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Effective Date of Coverage: the first day without coverage in the prior plan
Marriage to Student:
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Required Documentation: copy of the marriage certificate
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Deadline: 30 days from the date of marriage
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Effective Date of Coverage: date of marriage
Birth or Adoption:
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Required Documentation: official documentation of the birth or adoption
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Deadline: 30 days from the date of birth or adoption
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Effective Date of Coverage: date of birth or adoption
Change in Residence (entry into the US or moving from coverage area):
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Required Documentation: Identification page of Passport and page with U.S. entry date stamp or documentation of move from prior plan's coverage area.
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Deadline: 30 days from the entry into the US or move from the coverage area
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Effective Date of Coverage: date of entry into the US or move from the coverage are
