[110th Congress Public Law 381]
[From the U.S. Government Printing Office]
[DOCID: f:publ381.110]
[[Page 122 STAT. 4081]]
Public Law 110-381
110th Congress
An Act
To amend the Employee Retirement Income Security Act of 1974, the Public
Health Service Act, and the Internal Revenue Code of 1986 to ensure that
dependent students who take a medically necessary leave of absence do
not lose health insurance coverage, and for other purposes. <<NOTE: Oct.
9, 2008 - [H.R. 2851]>>
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled, <<NOTE: Michelle's
Law.>>
SECTION 1. <<NOTE: 42 USC 201 note.>> SHORT TITLE.
This Act may be cited as ``Michelle's Law''.
SEC. 2. COVERAGE OF DEPENDENT STUDENTS ON MEDICALLY NECESSARY
LEAVE OF ABSENCE.
(a) Amendments of ERISA.--
(1) In general.--Subpart B of part 7 of title I of the
Employee Retirement Income Security Act of 1974 (29 U.S.C. 1185
et seq.) is amended by adding at the end the following:
``SEC. 714. <<NOTE: 29 USC 1185c.>> COVERAGE OF DEPENDENT STUDENTS
ON MEDICALLY NECESSARY LEAVE OF ABSENCE.
``(a) Medically Necessary Leave of Absence.--In this section, the
term `medically necessary leave of absence' means, with respect to a
dependent child described in subsection (b)(2) in connection with a
group health plan or health insurance coverage offered in connection
with such plan, a leave of absence of such child from a postsecondary
educational institution (including an institution of higher education as
defined in section 102 of the Higher Education Act of 1965), or any
other change in enrollment of such child at such an institution, that--
``(1) commences while such child is suffering from a serious
illness or injury;
``(2) is medically necessary; and
``(3) causes such child to lose student status for purposes
of coverage under the terms of the plan or coverage.
``(b) Requirement To Continue Coverage.--
``(1) In general.--In the case of a dependent child
described in paragraph (2), a group health plan, or a health
insurance issuer that provides health insurance coverage in
connection with a group health plan, shall not terminate
coverage of such child under such plan or health insurance
coverage due to a medically necessary leave of absence before
the date that is the earlier of--
``(A) the date that is 1 year after the first day of
the medically necessary leave of absence; or
[[Page 122 STAT. 4082]]
``(B) the date on which such coverage would
otherwise terminate under the terms of the plan or
health insurance coverage.
``(2) Dependent child described.--A dependent child
described in this paragraph is, with respect to a group health
plan or health insurance coverage offered in connection with the
plan, a beneficiary under the plan who--
``(A) is a dependent child, under the terms of the
plan or coverage, of a participant or beneficiary under
the plan or coverage; and
``(B) was enrolled in the plan or coverage, on the
basis of being a student at a postsecondary educational
institution (as described in subsection (a)),
immediately before the first day of the medically
necessary leave of absence involved.
``(3) Certification by <<NOTE: Applicability.>> physician.--
Paragraph (1) shall apply to a group health plan or health
insurance coverage offered by an issuer in connection with such
plan only if the plan or issuer of the coverage has received
written certification by a treating physician of the dependent
child which states that the child is suffering from a serious
illness or injury and that the leave of absence (or other change
of enrollment) described in subsection (a) is medically
necessary.
``(c) Notice.--A group health plan, and a health insurance issuer
providing health insurance coverage in connection with a group health
plan, shall include, with any notice regarding a requirement for
certification of student status for coverage under the plan or coverage,
a description of the terms of this section for continued coverage during
medically necessary leaves of absence. Such description shall be in
language which is understandable to the typical plan participant.
``(d) No Change in Benefits.--A dependent child whose benefits are
continued under this section shall be entitled to the same benefits as
if (during the medically necessary leave of absence) the child continued
to be a covered student at the institution of higher education and was
not on a medically necessary leave of absence.
``(e) Continued Application in Case of Changed Coverage.--If--
``(1) a dependent child of a participant or beneficiary is
in a period of coverage under a group health plan or health
insurance coverage offered in connection with such a plan,
pursuant to a medically necessary leave of absence of the child
described in subsection (b);
``(2) the manner in which the participant or beneficiary is
covered under the plan changes, whether through a change in
health insurance coverage or health insurance issuer, a change
between health insurance coverage and self-insured coverage, or
otherwise; and
``(3) the coverage as so changed continues to provide
coverage of beneficiaries as dependent children,
this section shall apply to coverage of the child under the changed
coverage for the remainder of the period of the medically necessary
leave of absence of the dependent child under the plan in the same
manner as it would have applied if the changed coverage had been the
previous coverage.''.
[[Page 122 STAT. 4083]]
(2) Conforming amendment.--The table of contents in section
1 of such Act is amended by inserting after the item relating to
section 713 the following new item:
``Sec. 714. Coverage of dependent students on medically necessary leave
of absence.''.
(b) Amendments to the Public Health Service Act.--
(1) Group markets.--Subpart 2 of part A of title XXVII of
the Public Health Service Act (42 U.S.C. 300gg-4 et seq.) is
amended by adding at the end the following new section:
``SEC. 2707. <<NOTE: 42 USC 300gg-7.>> COVERAGE OF DEPENDENT
STUDENTS ON MEDICALLY NECESSARY LEAVE OF
ABSENCE.
``(a) Medically Necessary Leave of Absence.--In this section, the
term `medically necessary leave of absence' means, with respect to a
dependent child described in subsection (b)(2) in connection with a
group health plan or health insurance coverage offered in connection
with such plan, a leave of absence of such child from a postsecondary
educational institution (including an institution of higher education as
defined in section 102 of the Higher Education Act of 1965), or any
other change in enrollment of such child at such an institution, that--
``(1) commences while such child is suffering from a serious
illness or injury;
``(2) is medically necessary; and
``(3) causes such child to lose student status for purposes
of coverage under the terms of the plan or coverage.
``(b) Requirement To Continue Coverage.--
``(1) In general.--In the case of a dependent child
described in paragraph (2), a group health plan, or a health
insurance issuer that provides health insurance coverage in
connection with a group health plan, shall not terminate
coverage of such child under such plan or health insurance
coverage due to a medically necessary leave of absence before
the date that is the earlier of--
``(A) the date that is 1 year after the first day of
the medically necessary leave of absence; or
``(B) the date on which such coverage would
otherwise terminate under the terms of the plan or
health insurance coverage.
``(2) Dependent child described.--A dependent child
described in this paragraph is, with respect to a group health
plan or health insurance coverage offered in connection with the
plan, a beneficiary under the plan who--
``(A) is a dependent child, under the terms of the
plan or coverage, of a participant or beneficiary under
the plan or coverage; and
``(B) was enrolled in the plan or coverage, on the
basis of being a student at a postsecondary educational
institution (as described in subsection (a)),
immediately before the first day of the medically
necessary leave of absence involved.
``(3) Certification by <<NOTE: Applicability.>> physician.--
Paragraph (1) shall apply to a group health plan or health
insurance coverage offered by an issuer in connection with such
plan only if the plan or issuer of the coverage has received
written certification by a treating physician of the dependent
child which states that the child is suffering from a serious
illness or injury
[[Page 122 STAT. 4084]]
and that the leave of absence (or other change of enrollment)
described in subsection (a) is medically necessary.
``(c) Notice.--A group health plan, and a health insurance issuer
providing health insurance coverage in connection with a group health
plan, shall include, with any notice regarding a requirement for
certification of student status for coverage under the plan or coverage,
a description of the terms of this section for continued coverage during
medically necessary leaves of absence. Such description shall be in
language which is understandable to the typical plan participant.
``(d) No Change in Benefits.--A dependent child whose benefits are
continued under this section shall be entitled to the same benefits as
if (during the medically necessary leave of absence) the child continued
to be a covered student at the institution of higher education and was
not on a medically necessary leave of absence.
``(e) Continued Application in Case of Changed Coverage.--If--
``(1) a dependent child of a participant or beneficiary is
in a period of coverage under a group health plan or health
insurance coverage offered in connection with such a plan,
pursuant to a medically necessary leave of absence of the child
described in subsection (b);
``(2) the manner in which the participant or beneficiary is
covered under the plan changes, whether through a change in
health insurance coverage or health insurance issuer, a change
between health insurance coverage and self-insured coverage, or
otherwise; and
``(3) the coverage as so changed continues to provide
coverage of beneficiaries as dependent children,
this section shall apply to coverage of the child under the changed
coverage for the remainder of the period of the medically necessary
leave of absence of the dependent child under the plan in the same
manner as it would have applied if the changed coverage had been the
previous coverage.''.
(2) Individual market.--Subpart 3 of part B of title XXVII
of such Act (42 U.S.C. 300gg-51 et seq.) is amended by adding at
the end the following new section:
``SEC. 2753. <<NOTE: 42 USC 300gg-54.>> COVERAGE OF DEPENDENT
STUDENTS ON MEDICALLY NECESSARY LEAVE OF
ABSENCE.
``The <<NOTE: Applicability.>> provisions of section 2707 shall
apply to health insurance coverage offered by a health insurance issuer
in the individual market in the same manner as they apply to health
insurance coverage offered by a health insurance issuer in connection
with a group health plan in the small or large group market.''.
(c) Amendments to the Internal Revenue Code.--
(1) In general.--Subchapter B of chapter 100 of the Internal
Revenue Code of 1986 (relating to other group health plan
requirements) is amended by inserting after section 9812 the
following new section:
``SEC. 9813. <<NOTE: 26 USC 9813.>> COVERAGE OF DEPENDENT STUDENTS
ON MEDICALLY NECESSARY LEAVE OF ABSENCE.
``(a) Medically Necessary Leave of Absence.--In this section, the
term `medically necessary leave of absence' means, with respect to a
dependent child described in subsection (b)(2) in connection with a
group health plan, a leave of absence of such child
[[Page 122 STAT. 4085]]
from a postsecondary educational institution (including an institution
of higher education as defined in section 102 of the Higher Education
Act of 1965), or any other change in enrollment of such child at such an
institution, that--
``(1) commences while such child is suffering from a serious
illness or injury;
``(2) is medically necessary; and
``(3) causes such child to lose student status for purposes
of coverage under the terms of the plan or coverage.
``(b) Requirement to Continue Coverage.--
``(1) In general.--In the case of a dependent child
described in paragraph (2), a group health plan shall not
terminate coverage of such child under such plan due to a
medically necessary leave of absence before the date that is the
earlier of--
``(A) the date that is 1 year after the first day of
the medically necessary leave of absence; or
``(B) the date on which such coverage would
otherwise terminate under the terms of the plan.
``(2) Dependent child described.--A dependent child
described in this paragraph is, with respect to a group health
plan, a beneficiary under the plan who--
``(A) is a dependent child, under the terms of the
plan, of a participant or beneficiary under the plan;
and
``(B) was enrolled in the plan, on the basis of
being a student at a postsecondary educational
institution (as described in subsection (a)),
immediately before the first day of the medically
necessary leave of absence involved.
``(3) Certification <<NOTE: Applicability.>> by physician.--
Paragraph (1) shall apply to a group health plan only if the
plan, or the issuer of health insurance coverage offered in
connection with the plan, has received written certification by
a treating physician of the dependent child which states that
the child is suffering from a serious illness or injury and that
the leave of absence (or other change of enrollment) described
in subsection (a) is medically necessary.
``(c) Notice.--A group health plan shall include, with any notice
regarding a requirement for certification of student status for coverage
under the plan, a description of the terms of this section for continued
coverage during medically necessary leaves of absence. Such description
shall be in language which is understandable to the typical plan
participant.
``(d) No Change in Benefits.--A dependent child whose benefits are
continued under this section shall be entitled to the same benefits as
if (during the medically necessary leave of absence) the child continued
to be a covered student at the institution of higher education and was
not on a medically necessary leave of absence.
``(e) Continued Application in Case of Changed Coverage.--If--
``(1) a dependent child of a participant or beneficiary is
in a period of coverage under a group health plan, pursuant to a
medically necessary leave of absence of the child described in
subsection (b);
``(2) the manner in which the participant or beneficiary is
covered under the plan changes, whether through a change in
health insurance coverage or health insurance issuer, a
[[Page 122 STAT. 4086]]
change between health insurance coverage and self-insured
coverage, or otherwise; and
``(3) the coverage as so changed continues to provide
coverage of beneficiaries as dependent children,
this section shall apply to coverage of the child under the changed
coverage for the remainder of the period of the medically necessary
leave of absence of the dependent child under the plan in the same
manner as it would have applied if the changed coverage had been the
previous coverage.''.
(2) Conforming amendment.--The table of sections for
subchapter B of chapter 100 of such Code is amended by inserting
after the item relating to section 9812 the following new item:
``Sec. 9813. Coverage of dependent students on medically necessary
leave of absence.''.
(d) Effective <<NOTE: 26 USC 9813 note.>> Date.--The amendments made
by this Act shall apply with respect to plan years beginning on or after
the date that is one year after the date of the enactment of this Act
and to medically necessary leaves of absence beginning during such plan
years.
Approved October 9, 2008.
LEGISLATIVE HISTORY--H.R. 2851:
---------------------------------------------------------------------------
HOUSE REPORTS: No. 110-806, Pt. 1 (Comm. on Energy and Commerce).
CONGRESSIONAL RECORD, Vol. 154 (2008):
July 30, considered and passed House.
Sept. 25, considered and passed Senate.
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