PUBLIC LAW 110–381—OCT. 9, 2008 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. 

Be it enacted by the Senate and House of Representatives of 

the United States of America in Congress assembled, 

SECTION 1. 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. 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 

29 USC 1185c. 

42 USC 201 note. 

Michelle’s Law. 

Oct. 9, 2008 

[H.R. 2851] 


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122 STAT. 4082 PUBLIC LAW 110–381—OCT. 9, 2008 

‘‘(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 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.’’. 

Applicability. 


etreine on CSHP91QD1 with PUBLIC LAWS
PUBLIC LAW 110–381—OCT. 9, 2008 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. 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 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 

Applicability. 

42 USC 300gg–7. 


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122 STAT. 4084 PUBLIC LAW 110–381—OCT. 9, 2008 

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 COV- ERAGE.—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. COVERAGE OF DEPENDENT STUDENTS ON MEDICALLY 

NECESSARY LEAVE OF ABSENCE. 

‘‘The 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. 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 

26 USC 9813. 

Applicability. 

42 USC

300gg–54. 


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PUBLIC LAW 110–381—OCT. 9, 2008 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 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 

Applicability. 


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122 STAT. 4086 PUBLIC LAW 110–381—OCT. 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. 

Æ 

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 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. 

26 USC 9813 

note. 


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