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受托人的意见
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在再保险
原告: 被解雇的员工
被申请人: 雇主
ROD案例编号: 84-076——1986年1月14日
董事会:Joseph P. 康纳斯,老., Chairman; Paul R. 院长，受托人. Jordan,受托人; William Miller,受托人; Donald E. 皮尔斯,小.,受托人.
Pursuant to Article IX of the United Mine Workers of America (“UMWA”) 1950 Benefit Plan and Trust, and under the authority of an exemption granted by the United States Department of Labor, the Trustees have reviewed the facts and circumstances of this dispute concerning the level of health benefits coverage for laid-off Employees under the terms of the 雇主 Benefit Plan.
背景事实
The Complainants’ representative has stated that on or around June 10, 1985, the Complainants were laid off from classified employment with the Respondent and that the Respondent has failed to provide extended health benefits coverage for the Complainants from that date. The Complainants’ representative has submitted medical invoices for services which were incurred prior to June 10, 1985 and has asked that the Respondent be responsible for the payment of these invoices.
的资金 determined that the Respondent was no longer in business, effective June 10, 1985. 10月16日, 1985, the Complainants were advised by letter that the Funds will provide their health benefits coverage pursuant to Article II E. of the UMWA 1974 Benefit Trust, effective June 11, 1985. Eligibility for such coverage will extend only through the period of eligibility established under Article III D. (1) (a) of the 雇主 Benefit Plan and is subject to the terms and conditions set forth in the UMWA 1974 Benefit Plan and Trust.
The Respondent has failed to answer repeated correspondence from the Funds requesting its position in this dispute. Therefore, the Trustees must render a decision based upon the available information on file.
争端
Is the Respondent responsible for the payment of medical charges for services incurred by the Complainants prior to June 11, 1985.
各方立场
Position of the 原告: The Respondent is responsible for the payment of medical charges for services incurred by the Complainants prior to June 11, 1985.
Position of the 被申请人: The Respondent has failed to inform the Funds of its position in this dispute.
相关的规定
Article XX (c) (3) (i) of the National Bituminous Coal Wage Agreement of 1984 provides:
第二十条——健康和退休福利
第(C)条1974计划和信托
(3) (i) Each signatory 雇主 shall establish and maintain an Employee benefit plan to provide, 通过保险公司实施, health and other non-pension benefits for its Employees covered by this Agreement as well as pensioners, 1974年养恤金计划和信托皇冠搏彩中心网站, whose last signatory classified employment was with such 雇主. The benefits provided by the 雇主 to its eligible Participants pursuant to such plans shall be guaranteed during the term of this Agreement by that 雇主 at levels set forth in such plans.
Article I (1), (2) and (4) of the 雇主 Benefit Plan provide:
第一条-定义
The following terms shall have the meanings herein set forth:
(1) “雇主”指(煤炭公司).
(2) “Wage Agreement” means the National Bituminous Coal Wage Agreement of 1984, as amended from time to time and any successor agreement.
(4) “Employee” shall mean a person working in a classified job for the 雇主, 有资格获得本协议项下的福利.
第二条A款. 雇主福利计划的第(1)和(4)项 provide:
第二条-资格
The persons eligible to receive the health benefits pursuant to Article III are as follows:
A. 积极的员工
Benefits under Article III shall be provided to any Employee who:
(1)is actively at work* for the 雇主 on the effective date of the Wage Agreement; or
(4)A new Employee will be eligible for health benefits from the first day worked with the 雇主.
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*”Actively at work” includes an Employee of the 雇主 who was actively at work on September 30, 1984, and who returns to active work with the 雇主 two weeks after the effective date of the Wage Agreement.
讨论
The Complainants’ representative has submitted medical invoices for services which were incurred prior to the date of layoff. Inasmuch as the Complainants satisfied the definition of active Employee as set forth in Article I (4) and 第二条A款. 雇主福利计划的第(1)和(4)项, the Respondent is responsible for the provision of health benefits coverage pursuant to Article XX (C) (3) (i) of the National Bituminous Coal Wage Agreement of 1984 during the Complainants’ employment with the Respondent.
相应的, the Trustees are of the opinion that the Respondent is responsible for the payment of all medical charges incurred by the Complainants prior to the date of layoff. Such benefits are to be provided at the levels specified in the 雇主 Benefit Plan.
受托人的意见
The Respondent is responsible for the provision of health benefits coverage at the level set forth in the 雇主 Benefit Plan for the Complainants through their period of active employment.