scribed in subsection (a)) until the first day of 
the medically necessary leave of absence involved. 
‘‘(3) CERTIFICATION BY PHYSICIAN.—Paragraph 
(1) shall not apply to a group health plan (or health 
insurance coverage offered in connection with such a 
plan) unless certification by the child’s attending 
physician is submitted to the plan (or the issuer 
health insurance coverage in connection with the 
plan) stating that the dependent child is suffering 
from a severe illness or injury and that the leave of 
absence is medically necessary. 
‘‘(c) NO LOSS OF FULL-TIME STATUS DUE TO BREAK 
IN SEMESTER.—Any breaks in the school semester shall not 
disqualify a dependent child described under subsection (b) 
from coverage under this section. 
‘‘(d) NO CHANGE IN BENEFITS.—A dependent child 
whose benefits are continued under this section shall be enti-
tled to the same benefits as if (during the medically nec-
essary leave of absence) the child continued to be a full- 
time student at the institution of higher education and was 
not on a medically necessary leave of absence. 
‘‘(e) COVERAGE UNDER SUCCESSOR PLAN.—If a plan 
sponsor changes group health plans after the first day of 
a medically necessary leave of absence of a dependent child 
described in subsection (b) but before the date described 
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under subsection (b)(1), and such new group health plan 
offers coverage of beneficiaries as dependent children, such 
new group health plan shall be subject to this section in 
the same manner as the predecessor group health plan. 
‘‘(f) PRESUMPTION.—For purposes of administrative 
or judicial proceedings, upon certification under subsection 
(b)(3), there shall be a rebuttable presumption that the re-
quirements of paragraphs (1) and (2) of subsection (a) have 
been met.’’. 
(2) CONFORMING AMENDMENT.—The table of sec-
tions for subchapter B of chapter 100 of such Code is 
amended by inserting after the item relating to sec-
tion 9812 the following new item: 
‘‘Sec. 9813. Coverage of dependent students on medically necessary leave of ab-
sence.’’. 
(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 enact-
ment of this Act and to medically necessary leaves of ab-
sence beginning during such plan years. 
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Union Calendar No. 522 
110TH CONGRESS 
2D SESSION 
H. R. 2851 
[Report No. 110–806, Part I] 
A BILL 
To amend the Employee Retirement Income Secu-
rity 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 in-
surance coverage, and for other purposes. 
JULY 30, 2008 
Reported from the Committee on Energy and Commerce 
with an amendment 
JULY 30, 2008 
Committees on Education and Labor, and Ways and 
Means discharged; committed to the Committee of the 
Whole House on the State of the Union and ordered 
to be printed 
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