Effective for plan years beginning on or after October 9, 2009, Michelle's Law requires group health plans to continue healthcare coverage for dependent students who would otherwise lose their coverage because of a medically necessary leave of absence from a postsecondary educational institution.
Michelle's Law (Public Law 110-381) prohibits a group health from terminating coverage of a dependent child under the plan due to a medically necessary leave of absence from a postsecondary educational institution 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.
The law defines “medically necessary leave of absence” as:
- A leave of absence of dependent child from a postsecondary educational institution or any other change in enrollment of such child at such an institution, that—
- Commences while such child is suffering from a serious illness or injury;
- Is medically necessary; and
- Causes such child to lose student status for purposes of coverage under the terms of the plan or coverage.
For the law to apply, a group health plan must receive written certification by a treating physician of the dependent child that states that the child is suffering from a serious illness or injury and that the leave of absence (or other change of enrollment) is medically necessary.
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