110th CONGRESS
1st Session
S. 400
To amend the Employee Retirement Income Security Act of 1974 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 SENATE OF THE UNITED STATES
January 25, 2007
Mr. SUNUNU (for himself, Mr. GREGG, and Mrs. CLINTON) introduced the following
bill; which was read twice and referred to the Committee on Health, Education,
Labor, and Pensions
A BILL
To amend the Employee Retirement Income Security Act of 1974 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- Subpart A of part 7 of title I of the Employee
Retirement Income Security Act of 1974 (29 U.S.C. 1181 et seq.) is amended
by adding at the end the following:
`SEC. 704. 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 a leave of absence from a postsecondary
educational institution (including an institution of higher education as
defined in section 102 of the Higher Education Act of 1965) that--
`(1) is due to a severe illness or injury, as certified by the attending
physician of the dependent child involved; and
`(2) causes the dependent child involved to lose full-time student status.
`(b) Requirement To Continue Coverage-
`(1) IN GENERAL- In the case of a dependent child described under 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 child who--
`(A) is a dependent of a participant or beneficiary of the plan or coverage;
`(B) is 18 years of age or older;
`(C) was enrolled in the plan or coverage as of the first day of the
medically necessary leave of absence involved; and
`(D) 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 the dependent child submits to the plan or issuer and the
postsecondary educational institution involved, documentation and certification
by the child's attending physician stating that the leave of absence involved
is a medically necessary leave of absence.
`(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 Additional Coverage- A dependent child described under subsection
(b) shall be entitled to an extension under this section of only those benefits
to which the child was entitled under the terms of the plan or coverage
as of the first day of the medically necessary leave of absence involved.
`(e) Coverage Under Successor Plan- If an employer or health insurance issuer
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 dependent children, such new group health plan shall
be subject to this section in the same manner as the group health plan coverage
in effect on the first day of the medically necessary leave of absence of
such dependent child.
`(f) Presumption- For purposes of administrative or judicial proceedings,
there shall be a rebuttable presumption that the documentation and certification
under subsection (b)(3) entitles the dependent child involved to coverage
as described under this section.'.
(b) Amendments to the Internal Revenue Code- Subchapter B of chapter 100
of the Internal Revenue Code of 1986 (26 U.S.C. 9811 et seq.) is amended--
(1) in the table of sections, 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.';
(2) by inserting after section 9813 the following:
`SEC. 9813. COVERAGE OF DEPENDENT STUDENTS ON MEDICALLY NECESSARY LEAVE
OF ABSENCE.
`(a) Medically Necessary Leave of Absence- The term `medically necessary
leave of absence' means a leave of absence from a postsecondary educational
institution (including an institution of higher education as defined in
section 102 of the Higher Education Act of 1965) that--
`(1) is due to a severe illness or injury, as certified by the attending
physician of the dependent child involved; and
`(2) causes the dependent child involved to lose full-time student status.
`(b) Requirement To Continue Coverage-
`(1) IN GENERAL- In the case of a dependent child described under 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 child who--
`(A) is a dependent of a participant or beneficiary of the plan or coverage;
`(B) is 18 years of age or older;
`(C) was enrolled in the plan or coverage as of the first day of the
medically necessary leave of absence involved; and
`(D) 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 the dependent child submits to the plan or issuer and the
postsecondary educational institution involved, documentation and certification
by the child's attending physician stating that the leave of absence involved
is a medically necessary leave of absence.
`(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 Additional Coverage- A dependent child described under subsection
(b) shall be entitled to an extension under this section of only those benefits
to which the child was entitled under the terms of the plan or coverage
as of the first day of the medically necessary leave of absence involved.
`(e) Coverage Under Successor Plan- If an employer or health insurance issuer
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 dependent children, such new group health plan shall
be subject to this section in the same manner as the group health plan coverage
in effect on the first day of the medically necessary leave of absence of
such dependent child.
`(f) Presumption- For purposes of administrative or judicial proceedings,
there shall be a rebuttable presumption that the documentation and certification
under subsection (b)(3) entitles the dependent child involved to coverage
as described under this section.'.
END
