Fellowship Recipients
Dental Plan

The dental plan is available to all eligible Fellowship Recipients, regardless of area of residence. Anthem Blue Cross Blue Shield is the plan administrator.

PPO

This is a traditional plan that provides reimbursement for dental services from a network of participating providers, or at a lower benefit, outside the network from any licensed dentist of your choice. You are required to pay the dentist for normal charges and then file a claim for reimbursement when an out of network provider is used.

Anthem Dental Complete Plan Highlights

  • Anthem’s national PPO network
  • Annual Deductible of $25
  • Annual Benefit Limit of $500
  • Two routine cleanings/exams per calendar year covered at 100%
  • Plan year begins each January; deductibles and benefit limit amounts restart annually on January 1st

Publications

Forms

Fellowship Recipient Premium

Premiums for qualifying Fellowship Recipients are fully paid by the University.

 
Fall 2023
Spring 2024
Fall 2024
Fellowship Recipient
$1,551.23
$2,592.87
$1,852.05
  • Premiums for qualifying Fellowship Recipients are fully paid by the University.
  • The premium rate includes both medical and dental coverage.
  • Fall premium is for August 1 – December 31 (5 months).
  • Spring premium is for January 1 – July 31 (7 months).

Dependent Premiums
Medical Monthly
Premium
Dental Monthly
Premium
Total Monthly
Premium
2024
Spouse*
$1,104.55
$19.75
$1,124.30
Child(ren)*
$834.98
$29.66
$864.64

If you choose to enroll your spouse or children, you are responsible for the full cost of their monthly premiums.

Review the Eligibility and Enrollment Guidelines to verify your dependent’s eligibility for coverage. Dependents can only be covered for the same period of coverage as the Fellowship Recipient.

Eligible dependents must be enrolled by submitting the following items to IU Human Resources by the enrollment deadline:

  • Complete and sign the Dependent Enrollment Form and attach the following items:
    • A copy of supporting documentation (marriage certificate, birth certificate, etc.)

Dependent Enrollment Deadlines:

  • Fall: September 30
  • Spring/Summer: January 31
  • IRS Qualifying Life Event: within 30 days of event

An IRS Qualifying Life Event includes: birth of a child, marriage, loss of other coverage, etc.

Things you can do…

  • Contact Anthem Dental customer service at 1-877-604-2142 or log in to the Anthem Web site for questions about coverage, claims, and provider networks.