[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2851 Introduced in House (IH)]
110th CONGRESS
1st Session
H. R. 2851
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.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
June 25, 2007
Mr. Hodes (for himself, Mr. Castle, Ms. Shea-Porter, Mr. Nadler, Mrs.
McCarthy of New York, Mr. Davis of Illinois, Ms. Sutton, Mrs. Boyda of
Kansas, Mr. McGovern, Mr. Stark, Ms. Castor, Ms. Clarke, Mr. Cohen, Mr.
Johnson of Georgia, Mrs. Lowey, Mr. Edwards, Mr. Emanuel, Ms. Solis,
Ms. Zoe Lofgren of California, Mr. Lantos, Mr. Sherman, Mr. Wu, Mr.
Lincoln Davis of Tennessee, Mr. Kagen, Mr. Larson of Connecticut, Mr.
Berry, Mr. McDermott, Mrs. Tauscher, Ms. Harman, Mr. Gutierrez, Mr.
Scott of Virginia, Ms. Schakowsky, Mr. Mitchell, Mr. Sarbanes, Ms.
Kaptur, Mr. Gilchrest, Mr. Barrow, Mr. McNulty, Mr. Welch of Vermont,
Ms. Schwartz, Mr. Braley of Iowa, Mr. Ellison, Mr. Regula, and Mr.
Bishop of New York) introduced the following bill; which was referred
to the Committee on Energy and Commerce, and in addition to the
Committees on Education and Labor and Ways and Means, for a period to
be subsequently determined by the Speaker, in each case for
consideration of such provisions as fall within the jurisdiction of the
committee concerned
_______________________________________________________________________
A BILL
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 the ``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), 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 severe
illness or injury;
``(2) is medically necessary; and
``(3) causes such child to lose full-time student status
under the terms of the plan.
``(b) Requirement To Continue Coverage.--
``(1) In general.--In the case of a dependent child
described in paragraph (2), a group health plan (or health
insurance coverage offered in connection with such a plan)
shall not terminate coverage of such child 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 a beneficiary under the plan
who--
``(A) is a dependent child, under the terms of the
plan, of a participant or beneficiary of the plan;
``(B) was enrolled in the plan or coverage as of
the first day of the medically necessary leave of
absence involved; and
``(C) was enrolled as a full-time student at a
postsecondary educational institution (as described 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
issuer 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 entitled to the same benefits as
if (during the medically necessary 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 dependent child described in subsection (b) but before
the date described 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 requirements of paragraphs (1) and
(2) of subsection (a) have been met.''.
(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, 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 severe
illness or injury;
``(2) is medically necessary; and
``(3) causes such child to lose full-time student status
under the terms of the plan.
``(b) Requirement To Continue Coverage.--
``(1) In general.--In the case of a dependent child
described in paragraph (2), a group health plan (or health
insurance coverage offered in connection with such a plan)
shall not terminate coverage of such child 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) Child described.--A dependent child described in this
paragraph is a beneficiary under the plan who--
``(A) is a dependent child, under the terms of the
plan, of a participant or beneficiary of the plan;
``(B) was enrolled in the plan or coverage as of
the first day of the medically necessary leave of
absence involved; and
``(C) was enrolled as a full-time student at a
postsecondary educational institution (as described 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
issuer 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 entitled to the same benefits as
if (during the medically necessary 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 dependent child described in subsection (b) but before
the date described 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 requirements of paragraphs (1) and
(2) of subsection (a) have been met.''.
(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, 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 severe
illness or injury;
``(2) is medically necessary; and
``(3) causes such child to lose full-time student status
under the terms of the plan.
``(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 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) Child described.--A dependent child described in this
paragraph is a beneficiary under the plan who--
``(A) is a dependent child, under the terms of the
plan, of a participant or beneficiary of the plan;
``(B) was enrolled in the plan or coverage as of
the first day of the medically necessary leave of
absence involved; and
``(C) was enrolled as a full-time student at a
postsecondary educational institution (as described 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 entitled to the same benefits as
if (during the medically necessary 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 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 requirements of paragraphs (1) and
(2) of subsection (a) have been met.''.
(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 of the
enactment of this Act and to medically necessary leaves of absence
beginning during such plan years.
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