Michelle's Law Notice

Protects dependent students from losing group health coverage during a medically necessary leave of absence, or a change to part-time enrollment, due to serious illness or injury, generally for up to one year.

Heads up: The ACA requires group health plans to cover dependents to age 26 regardless of student status, so most plans no longer condition health coverage on being a full-time student, and Michelle's Law notice requirements don't apply to those plans. This page is relevant only if your plan covers dependents beyond age 26 based on student status, or if any other covered benefit is conditioned on student enrollment. If you're not sure, check your SPD or ask your TPA or carrier.
What A notice explaining continued coverage rights for dependents who must take a medically necessary leave from postsecondary school (or reduce to part-time) due to serious illness or injury.
Who Group health plans, insured or self-funded, that condition dependent coverage on student status. Since the ACA's age-26 rule, this applies mainly to plans that extend dependent coverage beyond age 26 based on full-time enrollment. Provide the notice to all participants whose dependents are subject to student-status verification.
When Each time you send a notice requesting proof of student status for dependent eligibility.
Risk Up to $100 per affected individual per day under IRC § 4980D for plan violations, including notice failures (statutory rate, not inflation-adjusted). In practice, the bigger risk is an improper coverage termination for a student on medical leave, which can generate ERISA complaints and DOL investigations.
Verify
Student-status request

Include the notice with every request for proof of student status (each term or plan year).

Enroll
Initial eligibility

Good practice to include at enrollment so dependents know their rights before a medical leave arises.

Trigger Due Date / Window Notes
Requesting proof of student status Include the notice with every request Required each cycle you ask for student-status certification (e.g., each term or plan year).
Initial eligibility / enrollment At or before enrollment (if plan uses student status) Good practice to include at enrollment so dependents know their rights before a medical leave arises.
Trigger: Requesting proof of student status
Window: Include the notice with every request
Notes: Required each cycle you ask for student-status certification.
Trigger: Initial eligibility / enrollment
Window: At or before enrollment (if plan uses student status)
Notes: So dependents know their rights before a medical leave arises.
  • Notice text: See the Model Notice section below, verbatim model language from 29 CFR § 2590.714 with fields for your plan name and administrator contact.
  • Eligibility terms: Your plan's SPD or certificate language on dependent coverage and any student-status requirements.
  • Medical leave process: How the dependent requests continued coverage and what documentation is needed (physician certification form or instructions).
  • Administrator contact: The name and phone number of the plan administrator or person handling these requests.
1
Confirm applicabilityCheck whether your plan conditions any covered benefit on full-time student status. If not, this notice is not required. If yes, proceed.
2
Prepare the noticeUse the model language in the Model Notice section below. Insert your plan name and plan administrator contact; that's the only customization needed.
3
Pair with student-status requestsAttach the notice every time you send a student-status verification request (by email, mail, or benefits portal).
4
Set up intakeDesignate a dedicated inbox or portal path for physician certifications and track the one-year continuation window from the date the leave begins.
5
Coordinate with carrier / TPAAlign documentation requirements, approval procedures, and how approval or denial decisions are communicated to the family.
  • Audience: Participants whose dependents are subject to student-status verification for plan eligibility; include the participant (employee) and, if applicable, a spouse who manages benefits.
  • Method: Paper or electronic. If delivering electronically, follow ERISA's e-disclosure safe harbor rules (employees must have consented or meet the electronic access criteria).
  • Clarity: Use plain language. Bold the one-year maximum continuation period and be specific about what documentation is required and where to submit it.
  • Notice copiesThe exact notice sent (date-stamped) and any version changes by plan year.
  • Distribution logFor each student-status verification cycle: who was notified, date sent, delivery method. For paper mailings, retain a Certificate of Mailing (USPS Form 3817) as proof of dispatch; certified mail is not required.
  • Physician certificationsTreating physician name, certification date, stated leave start date, and expected return date (if provided).
  • Continuation timelineFor each affected dependent showing the one-year window and when coverage ends.
  • Decision recordsApproval or denial records and any communications with the family or carrier/TPA.

Common traps

Forgetting to include the notice: Requesting student-status proof but forgetting to include the Michelle's Law Notice with the request; the law requires both to go out together.
Terminating coverage too soon: Requiring full-time enrollment during the approved medical leave period, or terminating coverage before the one-year window closes.
Not coordinating with the carrier or TPA: On what physician documentation is acceptable, leading to inconsistent approvals.

FAQs

Who is covered under Michelle's Law?
Dependent students enrolled in the group health plan whose eligibility is tied to full-time student status at a postsecondary school, and who take a medically necessary leave of absence (or reduce to part-time enrollment) due to a serious illness or injury.

How long can coverage continue?
Up to one year from the date the medically necessary leave begins, subject to any plan terms and premium requirements that would otherwise apply.

What documentation is required?
A written certification from the student's treating physician stating that the leave of absence is medically necessary, the date the leave begins, and the anticipated return-to-full-time-student date (if known).

What if our plan doesn't use student status anymore?
If your plan covers all dependents to age 26 regardless of student status, as most plans do under the ACA, Michelle's Law notice requirements do not apply. Confirm your plan terms and check with your TPA or carrier if you're unsure.

  • ACA age-26 interplay: Most health plans no longer condition eligibility on student status, so Michelle's Law requirements don't apply. The notice is still required for any plan that extends coverage beyond age 26 based on full-time enrollment, or that conditions any other covered benefit on student status.
  • Term-based verification cycles: If you verify student status each semester or term, you must include the Michelle's Law Notice with each verification request, not just the first one.
  • State mandates: Some states have additional protections for dependent students on medical leave. Coordinate with your carrier or TPA on any state-specific language that may need to be added.

The federal regulation includes verbatim model notice language. Use it as-is and customize only the three bracketed fields.

Model Michelle's Law Notice (from 29 CFR § 2590.714(b)(2)):

This notice is to inform you that under [NAME OF GROUP HEALTH PLAN], dependent students who lose their full-time student status because of a medically necessary leave of absence from a postsecondary educational institution may be eligible for continued coverage for up to 1 year under Michelle's Law, Public Law 110-381. To maintain coverage during a medically necessary leave of absence, the student's treating physician must provide written certification stating that the leave of absence is medically necessary and providing the date the leave begins and the anticipated date of return to full-time student status (if available). Contact [NAME AND TELEPHONE NUMBER OF APPROPRIATE PLAN ADMINISTRATOR OR OTHER PERSON] to request certification forms and additional information about this benefit.

What to customize: Replace [NAME OF GROUP HEALTH PLAN] with your plan's name. Replace the contact placeholder with your plan administrator's name and direct phone number. Do not shorten or paraphrase the rest; this is the regulatory model language.

When to send it: Attach this notice to every communication requesting proof of full-time student status for dependent eligibility.

29 CFR § 2590.714 (eCFR): source of the model language above.