Indiana University
Student Academic Appointees, Appointed
Pre or Postdoctoral Fellows, & Fellowship Recipients

Dependent Enrollment Form
2026-2027 Academic Year

Eligible Student Academic Appointees (SAA), Appointed Pre or Postdoctoral Fellows, and Fellowship Recipients enrolled in the plan may insure their dependents, including their spouse and children under age 26.

TO CONTINUE THE ENROLLMENT PROCESS, PLEASE FILL OUT THE REQUIRED FIELDS BELOW: