Who is a "full-time student" for purposes of COBRA eligibility?

A beneficiary under a health plan who qualified for coverage under the “full time student” allowance of the plan, was no longer a full time student when she took a quarter off during which time she was not enrolled in classes. The beneficiary was an employee's daughter who was attending college and enrolled in the plan as a dependent. However, at the beginning of her second year at college, the daughter decided to delay her return to college, and canceled her registration. At this time, the insurer canceled the daughter’s coverage. Shortly thereafter, the daughter was involved in a car accident which left her totally disabled. The employee elected COBRA coverage for his daughter after the accident. When that coverage ended, the daughter received no further coverage from the original insurer.

The guardian for the daughter sued the original insurer, claiming that the daughter was entitled to lifetime medical coverage, under the theory of insurance coverage vesting, for her accident-related medical expenses because she was covered under the plan as a qualified dependent on the date of her accident. The insurer argued that it had no obligation to provide any further coverage because the daughter was not covered as a qualified dependent on the date of the accident because she was not a full-time student.

The court noted that the phrase “full time student” was not defined in the plan, but found that the plain meaning of “enrolled” was “to register” and that the plain meaning of “full time student” is “attending classes on a substantial basis.” Because the daughter was not attending any classes at the time of her accident, as a matter of law she did not meet the definition of “full time student enrolled in a school.” A mere intent to return to school is not sufficient to qualify a dependent as a full-time student. Therefore, the daughter did not satisfy the requirement for qualified dependent coverage under the plan. (Prudential Insurance Company of America, Inc. v. The Superior Court of Santa Cruz County, CalCtApp.)