```

[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.

                                  <all>
```