Fellowship Recipients
Eligibility and Enrollment Guidelines

On this page: Eligible Fellowship Recipients | Eligible Dependents | Coverage Period | Continuation Opportunities

Eligible Fellowship Recipients

Fellowship Recipients with an award of $6,750 or more each semester, Fall and/or Spring, and enrolled in a minimum of six credit hours, or G901 thesis/dissertation equivalent each semester (summer excluded) will be automatically enrolled in the benefit program. New enrollees will receive one ID card from Anthem for medical (including vision and prescription) and dental coverage. If you do not receive an ID card, please verify that your home address is correct.

Eligible Dependents

Dependents that are eligible for medical and dental care coverage are:

  • The Fellowship Recipient’s spouse* and/or
  • Children who meet all of the following criteria:
    • The child has one of the following relationships to the Fellowship Recipient, or spouse:
      • A biological child; or
      • A lawfully adopted child; or
      • A stepchild of the Fellowship Recipient; or
      • A child for whom the Fellowship Recipient or spouse has been legally appointed sole guardian for an indefinite period of time; and
    • The child is age 25 or under (eligibility ends at the end of the month in which the child reaches age 26), or qualifies for Disabled Child Eligibility.
  • A child for whom the Fellowship Recipient is legally required to provide health care coverage under a Qualified Medical Support Order, as defined by ERISA or an applicable Indiana state law.
  • When an adoption is in the legal process, coverage for such child may begin from the point the child is placed with the Fellowship Recipient (granted custody) for the purpose of adoption.
  • Proof that an individual is a qualified dependent (marriage or birth certificate, guardianship orders, as applicable) is required at the time of initial enrollment and periodically thereafter. Failure to provide proof of dependent eligibility within 30 days of the university's written request for such proof may result in termination of health plan coverage.

* A spouse means one by marriage, either opposite-sex or same-sex, legally entered into in one of the 50 states, the District of Columbia, or a U.S. territory or a foreign country.

Disabled Child Eligibility
A Fellowship Recipient’s covered dependent child's medical coverage may be continued beyond the maximum age for coverage if the child is "fully disabled." For the purposes of determining eligibility for IU-sponsored medical and dental coverage, a dependent child qualifies for disabled dependent eligibility if they are:

  • fully disabled, that is, incapable of self-sustaining employment because of a mental, intellectual or physical impairment; and
  • primarily dependent on the Fellowship Recipient for support and maintenance and does not have personal resources sufficient to be fully self-supporting (for example, trust funds or settlements); and
  • unmarried; and
  • covered under the employee’s IU-sponsored health plan at the time he/she reaches age 26.

Notification that the child is fully disabled and meets the above criteria for disabled dependent eligibility must be submitted in writing to the University no later than 30 days prior to the date that dependent coverage would have ceased under an IU-sponsored medical and dental coverage due to age. Dependent coverage ceases at the end of the month in which the child reaches age 26. 

Further written documentation and medical certification must be provided within 120 after the Dependent would normally become ineligible. The university has the right to require proof that the child continues to meet the requirements for disabled dependent eligibility.  Failure to provide this information could result in termination of a child’s coverage.

Newborn Eligibility
Newborn children are covered automatically from the moment of birth for a period of 31 days if (1) you are covered under an IU-sponsored healthcare plan on the child's date of birth, and (2) the newborn meets the definition of eligible dependent.

However, for claims to be processed for that 31 day period and for continued coverage beyond the first 31 days, you must enroll the child in your IU-sponsored coverage within 30 days after the child's birth by (1) submitting applicable forms to IU Human Resources office, and (2) providing proof that the newborn is a qualified dependent, and (3) pay any contributions for the newborn child to continue as a covered dependent.

Adding and Dropping Dependents Mid-Year
Outside of the announced Open Enrollment period, a dependent can be dropped or added only if the Fellowship Recipient experiences an IRS-defined Life Event Change, for example: marriage, divorce, or loss of coverage under the spouse's health plan. Changes must be made within 30 days of the date of the Life Event Change. After that time, the Fellowship Recipient must wait until the next Open Enrollment.

Dual Coverage
No individual may be eligible for benefits under more than one IU-sponsored health plan. Ineligible coverage includes an individual covered as:

  • the Employee/Fellowship Recipient on more than one plan, or
  • as both an Employee/Fellowship Recipient and a Dependent, or
  • a Dependent of more than one Employee/Fellowship Recipient.

Duty to Notify of Ineligibility
The Fellowship Recipient is responsible for notifying the University in writing of any change that affects the Fellowship Recipient’s dependent eligibility, for example, marriage or divorce. A medical or dental plan enrollee ceases to be a covered dependent on the date the enrollee no longer meets the definition of a dependent, regardless of when notice is given to the University. The Fellowship Recipient is responsible for notifying the University in writing within 30 days.

Coverage Period

Fall Coverage Period: August 1 through December 31
Spring Coverage Period: January 1 through July 31

Coverage is not activated until the Fellowship Recipient’s award information has been approved in the system. This may take time at the beginning of each semester to process. Eligibility is determined solely by the department and must be verified with the department if there are any eligibility questions. Until health plan coverage is activated, the Fellowship Recipient may need to pay health care costs out-of-pocket and file claims once coverage is activated.

Fellowship Recipient coverage will terminate when the Fellowship Recipient ceases to be a member of the eligible class for coverage. Dependent coverage ends on the date the dependent no longer meets the criteria for dependent eligibility.

Continuation Opportunities

For information on continuation of coverage in the event of loss of health care coverage, please refer to the information on COBRA.