Michelle’s Law to Extend Coverage for Students on Medical Leave of Absence

A new law signed by President Bush in October will allow seriously ill college students that are covered dependents under a group health plan to continue coverage for up to one year while on a medically necessary leave of absence. This new legislation is dubbed Michelle’s Law after the college student in New Hampshire who was diagnosed with cancer but continued her studies on a full-time basis in order to avoid losing health coverage under her parents' plan. The law is effective for plan years beginning on or after October 9, 2009 (calendar-year plans must comply beginning January 1, 2010) and to medically necessary leaves of absence beginning during such plan years. The following is a brief summary of the law’s key components:

Conditions and Length of Continued Coverage
The extension of coverage applies to a dependent child's leave of absence from, or any other change in enrollment at, a postsecondary educational institution (i.e. college, university) because of a serious illness or injury that would otherwise result in a loss of dependent status. The child must be enrolled as a dependent under a health plan and qualify for coverage as a student at a postsecondary educational institution before the leave of absence.

Under these conditions, the student’s coverage will continue until either (a) one year from the start of the medically necessary leave of absence or (b) the date on which the coverage would otherwise terminate under the terms of the health plan, whichever comes first. Also, the dependent child is entitled to the same level of benefits during the leave of absence as the child had prior to taking the leave. If any changes are made to the health plan during the leave, the child would be eligible to receive the changed coverage as any other covered dependent.

Physician Certification Required
According to the law, written certification must be provided by the child’s treating physician certifying that the child is suffering from a serious illness or injury that would require a medically necessary leave of absence.

Employer Notice
The employer (or health insurance issuer providing coverage in connection with a health plan) is required to provide notification describing the terms of the continued coverage available under Michelle’s Law. This description should be included with any notice regarding certification of student status for coverage under the plan.

For more information, you can view the entire text of Michelle’s law or simply visit Michelleslaw.com. If you have any questions about this new law, please contact our office at 919-403-1986.

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December 17, 2008

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