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COLLEGE STUDENTS ON MEDICAL LEAVE ARE NOW PROTECTED FROM COVERAGE TERMINATION

By September 1, 2009No Comments

College students covered under a parent’s health plan will be able to keep that coverage while taking a medically necessary leave of absence from school, under a new law.

Under H.R. 2851 — also known as Michelle’s law — group health plans or insurers may not terminate coverage of a dependent child who is eligible for coverage under a parent’s plan on the basis of being enrolled in a post-secondary educational institution, when that dependent takes a medically necessary leave of absence from school due to a serious illness or injury. Coverage must remain in place for one year after the medically necessary leave of absence begins, or the date coverage would otherwise have terminated under the plan, whichever occurs first. So, for example, if the plan by its terms will cover a college student enrolled on a full-time basis until the end of the year in which the student turns age 22, a student beginning a medically necessary leave of absence could not have coverage terminated until the earlier of that date, or one year after beginning the leave.

Plans and insurers may require a written certification by a treating physician verifying that the covered dependent is suffering from a serious illness or injury, and that the leave is medically necessary.

Also, if the health plan under which the dependent is covered changes, the dependent must be allowed to continue coverage under the new plan.

According to estimates from the Congressional Budget Office, less than 1% of students go on medical leave of absence annually, and about half of these are covered as dependents under employer-sponsored health insurance.

The new law is effective for plan years beginning on or after October 9, 2009.