[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2851 Engrossed in House (EH)]
110th CONGRESS
2d Session
H. R. 2851
_______________________________________________________________________
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
``(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.''.
(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 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. 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 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 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.
Passed the House of Representatives July 30, 2008.
Attest:
Clerk.
110th CONGRESS
2d Session
H. R. 2851
_______________________________________________________________________
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.