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受托人的意见
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在再保险

原告: 员工
被申请人: 雇主
ROD案例编号: 11-0001

受托人: 迈克尔·H. 荷兰，丹尼尔·L. Fassio和Marty D. 哈德逊

The Trustees have reviewed the facts and circumstances of this dispute concerning the provision of benefits under the terms of the 雇主 Benefit Plan.

背景事实

Complainant is employed by, and receiving health benefits coverage from, Respondent. 8月22日, 2011, Complainant’s alleged common-law wife called Respondent to inquire about her eligibility for health benefits from Respondent. 在那次通话中, 指称的同居妻子声称她是申诉人的未婚夫, 她和申诉人在一起已经八年了，但还没有嫁给他, 她被伤害过一次，她害怕再来一次. 因此，答辩人拒绝向她提供医疗福利. 申诉人为其所谓的同居妻子和, 来支持他的普通法婚姻要求, has submitted: (1) a divorce decree establishing that he divorced his ex-wife on January 17, 2006; (2) a notarized statement by the alleged common-law wife that she has never been married to anyone; (3) a letter from a bank confirming that Complainant and his alleged common-law wife have maintained a joint bank account since 2007; and (4) two notarized statements from individuals claiming that Complainant and his alleged common-law wife have presented themselves as husband and wife to such individuals since at least 2009.

争端

Is Respondent required to provide health benefits coverage to Complainant’s alleged common-law wife?

双方立场

Position of the 原告: Respondent is required to provide health benefits coverage to
Complainant’s alleged common-law wife pursuant to the terms of the 雇主 Benefit Plan.

Position of the 被申请人: Claimant’s alleged common-law wife identified herself as a fiancée, 而不是普通法上的配偶, 8月22日, 2011, 电话和是, 因此, 没有资格享受雇主福利计划的健康福利.

相关的规定

雇主福利计划第II(D)(1)条规定:
第2条资格
D. 合格的家属

Health benefits under Article III shall be provided to the following members of the family of any 员工, 养老金领取者, 或根据A节领取健康福利的残疾雇员, B, 或本条第2款(C)项:

(1) A spouse who is living with or being supported by an eligible 员工 or 养老金领取者;

Q&H-1(81)相关部分规定:
如果任何一方的背景中没有在世的配偶, a valid common-law marriage exists if the relationship has been one of substantial and continuous duration and the parties have been living together openly as married persons and are recognized as such in the community.

假设一个有效的习惯法婚姻已经成立, the dependent spouse will be eligible for health benefits and the children will also be eligible if they are dependent on the participant.

讨论

Article II(D)(1) of the 雇主 Benefit Plan provides health benefits to a spouse who is living with or being supported by an eligible employee. The Trustees have previously decided that a common-law spouse may be eligible for health benefits from the 雇主 Benefit Plan (see RODs 156, 81-685, 84-256和88-245). 要建立普通法婚姻，Q&A H-81 requires that: (1) there is no living spouse in the background; (2) the relationship is of substantial and continuous duration; and (3) the parties have been living together openly as married persons and are recognized as such in the community. The Trustees decided that a relationship must continue for a period of not less than nine months to be of substantial and continuous duration (see ROD 84-256).

Complainant’s divorce decree and his alleged common-law wife’s notarized statement that she has never been married to anyone are sufficient to establish that there is no living spouse in the background. The individuals’ notarized statements that Complainant and his alleged common-law wife have presented themselves to such individuals as husband and wife since at least 2009 are sufficient to establish that the relationship is of substantial and continuous duration. The individuals’ notarized statements and the letter confirming the couple’s joint bank account are sufficient to establish that the parties have been living together openly as married persons and are recognized as such in the community. 因此, 投诉人提交的证据, 本身, 足以建立普通法上的婚姻关系吗, but the alleged common-law wife’s statements to Respondent that she is Complainant’s fiancée and that she has not married him suggest that she cannot be Complainant’s common-law spouse.

然而, 在先前的rod中, representations to the employer were not conclusive in determining 普通法婚姻的存在. 在ROD 81-685, the employee submitted documents to his employer on which he stated that his alleged common-law wife was “not related,“女性朋友”
或者是“亲密的朋友”,“但, 尽管有这些陈述, the Trustees concluded that the weight of the evidence submitted was sufficient to establish a common-law marriage. 在ROD CA-080, the employer argued that the surviving spouse had remarried after she revealed that she was living in a common-law relationship during a phone call, but the Trustees determined that no common-law marriage existed because Respondent had not submitted sufficient documentation to establish a common-law marriage.

就像上面讨论的rod一样, the alleged common-law wife’s statements to Respondent do not conclusively determine, 不妨碍原告成立, 普通法婚姻的存在. Inasmuch as the weight of the evidence submitted is sufficient to establish that there is no living spouse in the background, the relationship is of substantial and continuous duration and the parties have been living openly as married persons and are recognized as such in the community, 申诉人已经建立了有效的普通法婚姻.

受托人的意见

根据雇主福利计划第II(D)(1)条, Respondent is required to provide health benefits to Complainant’s common-law spouse.