Jody Lee, Compliance Manager, Johnson & Dugan
Both the federal government and the State of California have passed “Michelle’s Law”, allowing college students to continue coverage on a parent’s group health plan if they are required to take a medical leave of absence from school. The laws are similar, but each takes effect on a different date. California Legislation, SB1168, took effect on January 1, 2009 and the Federal law, HR2851, will take effect on the first day of the Play Year on or after October 9, 2009.
Both laws require that insurance carriers continue health coverage for a dependent student when they take a medically necessary leave of absence from school, when that leave otherwise would cause loss of eligibility under provisions of the plan. The continuation under both Federal and California law is for one year, and physician certification of medical necessity is required. An extension beyond one year will be allowed under the California law for a child’s persistent disabling condition when the child is dependent on the covered employee for support and maintenance. Additional certification will be required for the extension.
The insurer will be distributing the appropriate notices to dependents nearing the limiting age of the plan's eligibility provision. The notice will explain the requirements for extension under the new law.
Other notable differences in the California law:
• The law does not apply to self-funded plans covering California employees. Those plan will, however, be required to comply with the federal law when it takes effect.
• The California law states that student coverage cannot be terminated based on a break in the school calendar.
Please contact your Johnson & Dugan team if you have any questions.
