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October 12, 2008

Health Coverage Rights for Students on Medical Leave: “Michelle’s Law”

On October 9, 2008, President Bush signed a law (H.R. 2851) that requires individual and group health plans to extend health coverage to dependent college students who take a medically-necessary leave of absence due to a serious illness or injury. This law was enacted as a result of the death of a seriously-ill college student forced to retain full-time student status in order to maintain much needed health coverage.

To be eligible for the extension, the dependent child must be covered by the plan, and enrolled in a postsecondary educational institute. The student may maintain the extended coverage until the earlier of:

  • Twelve months from the date of medical leave; or
  • The date coverage would otherwise end under the plan.

The determination of the ‘medically-necessary leave of absence’ must be made by written certification of the attending physician.

During the leave of absence, there can be no change in benefits under the health plan, including cost of such benefits.

A notice explaining the right to this leave of absence must be given to plan participants.

The right to COBRA would arise at the end of the medical leave, if the individual does not otherwise meet the definition of dependent under the plan.

These provisions apply to all individual and private and public sector group health plans, whether insured or self-funded. The law becomes applicable to plan years beginning on or after October 9, 2009. For calendar year plans, this means January 1, 2010.

 

The information contained in this Benefit Beat is not intended to be legal, accounting, or other professional advice, nor are these comments directed to specific situations.

As required by U.S. Treasury rules, we inform you that, unless expressly stated otherwise, any U.S. federal tax advice contained in this Benefit Beat is not intended or written to be used, and cannot be used, by any person for the purpose of avoiding any penalties that may be imposed by the Internal Revenue Service.

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