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Indiana University
INTERNATIONAL STUDENT & SCHOLAR
INSURANCE PLAN

Visiting Scholar Enrollment Form
2023-2024 Academic Year

Enter the 2023-2024 visiting scholar enrollment code. The international office on your campus can provide the 2023-2024 enrollment code. 

Asterisk (*) denotes required field

SCHOLAR / STUDENT INFORMATION

 (MM/DD/YYYY)

 

Student & Scholar Health Plan

Additional Information

University Health Plans Broker License # 000123936000
William E. Devine Broker License # 34773