The law was enacted to ensure that dependent students who take a medically necessary leave of absence do not lose health insurance coverage.
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Extended Coverage
The law requires group health plans to extend the coverage of a dependent child who is on a medically necessary leave of absence if the child is enrolled in the plan on the basis of being a student at a post-secondary educational institution immediately before the first day of the leave of absence. Coverage must be extended until the sooner of: (1) one year from the start of a medically necessary leave of absence, or (2) the date coverage would otherwise terminate under the terms of the plan. A ‘medically necessary leave of absence’ means a leave of absence from a post-secondary educational institution or any other change in enrollment that—(1) commences while the child is suffering from a serious illness or injury; (2) is medically necessary; and (3) causes the child to lose student status for purposes of coverage under the terms of the plan. The extended coverage must provide the same benefits as if the child was not on a medically necessary leave of absence.
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Notice of Michelle’s Law
A group health plan (and health insurance issuer providing health insurance coverage in connection with the plan) must include with any notice regarding a requirement for certification of student status for coverage, notice of the terms for continued coverage during medically necessary leaves of absence under Michelle’s law. The description must be in language understandable to the typical plan participant.
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Effective Date
Michelle’s law is effective for plan years beginning on or after October 9, 2009. For calendar year plans this means January 1, 2010. For non-calendar year plans with plan years beginning November 1 or December 1, the law is effective in 2009. For example, the law is effective on November 1, 2009 for a plan with a plan year running from November 1- October 31.
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