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University Human Resource Services

Indiana University
Benefits Change Connection

Moved Residence

The actions you can take regarding a change in residence apply to medical and dental plans enrollment only. Plan changes are allowed when your move causes you to gain or lose eligibility for a plan, e.g., you move outside of an HMO service area or arrive in or depart from the USA.

To make changes to any of the plans listed immediately below, you will need to complete Step 1 the Change of Status form and Step 2 the subsequent personalized benefit enrollment form. Step-by-step instructions appear on the respective plan pages below. You must make the change within 30 days.

  Medical plan 

Dental plan


You will also need to complete the Personal Data Change form listed below.

   Personal Data Change Form

 

Forms

Change of Status form
  - Online
  - PDF

Personal Data Change form (PDF)