1981年1月27日

(Opinion issued in letter form; name and address deleted)

杆没有. 158

This is in reference to your recent request for an advisory opinion from the Trustees of the UMWA Health and Retirement Funds concerning your eligibility for continuation of health benefit coverage under the Employer’s Benefit Plan (“Employer’s Plan”).

在你的请求中, you state that you are 25 years old, and that you are disabled as a result of injuries you sustained on your Employer’s property on 1月 9, 1979. You are receiving “compensation” for your injuries. Your Employer provided health and non-pension benefits from 1月 9, 1979, the date you last worked, 直到4月, 1980. It is your position that your Employer is responsible for your health benefits as long as you are disabled. From the information you submitted, 然而, it does not appear that you are currently eligible to receive continued health benefits under your Employer’s Plan.

Article III(E)(1)(b) of the Employer’s Plan provides that an Employee who ceases work because of disability is eligible, 最多, for continued benefit coverage to the end of the month in which he lest worked plus 12 months thereafter. Your Employer provided benefits to the end of the month in which you last worked, 1月, 1979, and for 14 months thereafter, 直到4月, 1980. Under Article III(E)(1)(b), your Employer has no further responsibility to provide you with continued health benefits.

Under Article II(C)(1) of the Employer’s Plan, an Employee is eligible for health benefits if he meets the following requirements: a) has completed 20 years of credited service, including the required number of years of signatory service; b) has not attained age 55; and, c) became disabled after December 6, 1974, while in classified employment with the Employer and is eligible for Social Security disability benefits. Because you are only 25 years old, end have not completed 20 years of service, you are clearly not eligible for continued benefit coverage under Article II(C)(1) of the Employer’s Plan.

最后, 根据第II(B)条 of the Employer’s Plan, an Employer must provide health and non-pension benefits to any pensioner receiving pension benefits under the 1974年退休金计划 (” 1974 Pension Plan”). You are not currently receiving a pension and, 因此, are not eligible for continued benefits under Article II(B). If, 然而, you have applied for and have been awarded Social Security Disability Insurance benefits based on your mine accident, you may be eligible for a 1974 Pension Plan disability pension. 在这种情况下, your employer would be responsible for continuation of health coverage, 根据第II(B)条, from the effective date of that pension. Should you need additional information regarding application for a disability pension, you should contact the UMWA Health & Retirement Funds Field Office in your area.
For the reasons above you are not currently eligible to receive continued health benefits. Accordingly, your Employer is not responsible for continuation of health coverage beyond April, 1980. Should you receive a UMWA 1974 disability pension, 然而 you would regain your eligibility for health benefits, under your Employer’s Plan.

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哈里森·库姆斯，主席

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约翰J. 奥康奈尔,受托人

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Paul R. 迪恩,受托人