"Michelle's Law" Adds to Growing List of Health Care Developments in 2009
December 15, 2008
A number of developments in federal benefits laws and regulations will require the attention of employer sponsored health care plan administrators in the coming year. Three developments, the Supreme Court of the United States' decision in Metropolitan Life Insurance Co v. Glenn, the Mental Health Parity and Addiction Equity Act, and the Genetic Information Nondiscrimination Act were summarized in previous Franczek Radelet eBulletins, which can be accessed by clicking on the document links. In addition, "Michelle's Law" is another important development in the area of health care. This legislation, explained in detail below, will play a significant role in expanding existing coverage for dependent college students.
Signed into law by President Bush in October 2008, Michelle's Law (H.R. 2851; Pub. L. No. 110-381) protects dependent college students who take medically necessary leaves of absence from losing health insurance coverage. The Law requires group health plans to continue coverage for dependent college students on medical leave for one year after the first day of the medically necessary leave of absence, or until the date on which such coverage would otherwise terminate under the terms of the plan. The Law applies to plan years that begin on or after October 7, 2009, and serves to amend ERISA, the Public Health Service Act, and the Internal Revenue Code. Therefore, calendar-year plans must comply with the Law by January 1, 2010.
Michelle's Law is named after a college student who, after being diagnosed with colon cancer, continued to carry a full course load in order to maintain insurance coverage under her parents' healthcare plan. Applying to "group health plans," the Law will affect every group health plan, even self-funded health plans. Plans that do not require student status for older dependent children are not subject to the requirements of Michelle's Law. The Law will also require plans to define what conditions are "medically necessary," and are thus entitled to the Act's protections. The Law provides little guidance as to what constitutes a "medically necessity." However, the Law allows health plans to require written certification by a physician to verify that the college student's illness or injury is serious enough to call for a medical leave of absence from college.