‘Michelle’s Law’ Mandates Coverage

Group health plans and health insurers must provide coverage for up to one year to college students who would otherwise lose health coverage when they take a medically necessary leave of absence, under a law signed by President Bush last month.

Called Michelle’s Law, after a New Hampshire student who died from cancer in 2005, Public Law 110-381 requires health plans and insurers to alert student beneficiaries about their rights under the law. The law is effective for plan years that begin on or after Oct. 9, 2009.

The law will only apply if a group health plan provides coverage to a dependent child who is a student at a postsecondary institution. It covers full time and part time students. In general, federal law does not require that group health plans cover dependents.

The law goes into effect when a medically necessary leave of absence or other change in enrollment causes the child to lose student status under the terms of the plan. Plans that do not require student status for older children do not have to comply with the law.

Benefits the child receives during the required extension must be the same as if the child had continued coverage as a student not on leave.

If the plan sponsor changes the design (e.g., changes insurers or moves from insured to self-insured coverage) and the new plan provides coverage for dependent children, the child would continue coverage under the new plan until the one-year period runs out.

MANAGED CARE November 2008. ©MediMedia USA

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