Indiana University
Benefits Change Connection
change of status. A Change of Status event is a significant family or employment change, such as, marriage, divorce, death of a dependent, birth of a child, spouse's termination or commencement of employment, and termination or commencement of leave without pay. Such events are defined by the IRS.
Enroll in or Change Medical Plan
A qualified change of status will allow you to make changes to a plan outside of Open Enrollment. Any changes must be made within 30 days from the date of the change in status.
- Complete the Change of Status form and return it to the campus Human Resources office. (This step is required by the IRS.)
- Upon receipt of the Change of Status form, the campus Human Resources office will send you a personalized benefit enrollment form to change your plan or coverage, or you may arrange to pick it up.
- Review Medical plan information and decide what changes you will make to your plan.
For each eligible dependent you add, you will need to provide:
- Full name
- Date of birth
- Social Security Number
