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OPINION OF TRUSTEES
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在再保险
Complainant: Surviving Spouse
被申请人: 雇主
ROD Case No: 51 – 1979年11月26日
Board of Trustees: Harrison Combs, Chairman; John J. O’Connell, Trustee;
Paul R. 迪恩,受托人.
根据美国联合煤矿工人1950年福利计划和信托皇冠搏彩中心网站第九条, 并根据美国劳工部授予的豁免授权, 受托人审查了有关雇主为已故雇员的遗属提供死亡和医疗福利的争议的事实和情况，并在此提出他们对此事的意见.
背景事实
The Employee was last employed on 12月5日, 1977年由当时签署了1974年NBCWA和现在签署了1978年NBCWA的被告雇主. The Employee had worked for the Respondent 雇主 from November 1, 1977年至12月5日, 1977 and had previously worked for another 雇主 signatory to the NBCWA of 1974. During the 24-month period prior to his last work date, 12月5日, 1977, 雇员在保密的签字工作岗位上工作了2000小时以上，并有资格根据1974年劳动和就业福利计划("先前计划")的规定获得1977年12月以后12个月的持续健康和死亡津贴. The 雇主 did not operate from 12月5日, 1977年至3月27日, 1978 because of the nationwide strike which preceded the signing of the NBCWA of 1978.
该雇员在1978年协定生效之日或此后因健康状况不佳而无法重返工作岗位. 被告雇主声称，雇员声称“他生病了，将不得不辞职一段时间”;他还表示，他已经“签署了社会保障残疾福利，并正在领取款项。.”(实际上, the Employee began receiving Social Security disability payments in October, 1978 with payments effective Sept., 1978).
The Employee died on November 13, 1978. 被申请人雇主没有根据1978年协议将雇员纳入保险范围，并且拒绝根据雇员的死亡向雇员的未亡配偶提供健康福利或人寿保险.
Question or Dispute
雇员的尚存配偶是否符合资格根据答辩雇主的福利计划享有健康及人寿保险福利, established pursuant to Article XX of the NBCWA of 1978?
Positions of the Parties
被申请人: The Respondent 雇主 maintains that the Employee had quit his job, relieving the 雇主 of responsibility for providing benefits.
投诉人:未亡配偶的代表认为雇主有义务, under the 1978 Wage Agreement, to provide coverage to the Employee as a disabled employee.
Pertinent Regulations
(1) Article II A(2) of the 雇主’s Benefit Plan, 其中规定，第III条规定的福利应提供给任何“被雇主解雇或残疾，并在3月27日具有持续资格的员工”, 1978 for coverage under the UMWA 1974 Benefit Plan (“prior Plan”) as a laid off or disabled employee; coverage for such laid off or disable Employees shall not continue beyond the date when they would no longer have been eligible for such coverage under the provisions of the prior Plan.”
(2) Article III B(1)(a) of the 雇主’s Benefit Plan, which provides that life insurance will be provided for Employees, as described in Article II, 一个节, in the amount of $12,000 if death was due to other than violent, external and accidental means.
(3) Article III E(1)(e) of the 雇主’s Benefit Plan, which provides that if an Employee quits or is discharged, health and life insurance coverage will terminate as of last date worked.
(4) Article II A of UMWA 1974 Benefit Plan (prior Plan), 其中规定应向任何失业人员提供健康福利，其失业时间由受托人确定(但在任何情况下都不超过一年)，紧接在该雇佣终止之日之后. (The Trustees administratively determined that laid off or disabled employees would remain eligible for coverage for one year if they had worked 2000 hours in classified signatory service with employers in the coal industry within the 24-month period preceding last work date; in the case of quit or discharge, eligibility would continue for 30 days).
(5) Article III B(4) of prior Plan, which provided that a death benefit ($7,500) would be paid upon the death of a Participant referred to in Article II A, who was survived by one or more dependents.
(6) Article II E(3) of 雇主’s Benefit Plan, 规定雇员在符合资格领取II A项下的健康福利期间死亡的未亡配偶及受供养子女, 如果未亡配偶没有资格领取未亡配偶津贴，这种津贴将持续60个月.
讨论
At the time of the Employee’s last work date, 12月5日, 1977, 他是1974年福利计划和信托的参与者，并在过去的24个月内在机密签署工作中工作超过2000小时. It is not established on what date the Employee became disabled, 但很明显，他的残疾是在罢工期间发生的，因为他在罢工前的最后一天工作，在协议签署时无法恢复工作. 因此，雇员有资格继续享有1974年福利计划(先前计划)规定的健康和死亡津贴，直至12月31日, 1978 as a laid off or disabled Employee.
雇主表示，雇员告知他生病了，将不得不辞职一段时间，并进一步表示，雇员正在领取社会保障残疾金. 在此基础上, 雇主认为他已经辞职，没有责任提供福利. 因此，在1978年协议生效时，雇主并未为雇员提供福利保障, 3月27日, 1978. 实际上, 然而, the Employee did not begin receiving Social Security Disability payments until October, 1978, the month before his death.
没有提交任何证据证明雇员辞职，并且由于他有资格在其最后工作日期之后继续享受一年的保险, 12月5日, 1977, under the prior Plan, 雇员有资格获得健康和死亡保险(根据雇员计划第II A(2)条)，直至其于11月13日死亡, 1978. Since death occurred after the effective date of the 1978 Agreement, 3月27日, 1978, 死亡抚恤金的数额由雇主计划第III B(1)(a)条确定，未亡配偶有资格根据雇主计划第II E(3)条享受健康福利.
Opinion of the Trustees
The 雇主 is responsible for payment of the $12,在雇主计划的限制下，向雇员的未亡配偶一次性支付6,000美元的人寿保险福利，并进一步负责向未亡配偶和任何合格的受抚养子女提供为期60个月的健康福利.