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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: 84-088——1986年4月29日

董事会:Joseph Connors, Sr., 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, 并根据美国劳工部授予的豁免授权, the Trustees have reviewed the facts and circumstances of this dispute concerning the level of 健康 benefits coverage for an 员工 under the terms of the 雇主 Benefit Plan. 他们在此就此事发表意见.

背景事实

1984年4月, 投诉人被调离专家组，担任被投诉人的卡车司机. 后来发现, 因为申诉人的驾驶执照已被吊销, 被告无法为他的卡车投保. 因此, 3月7日, 1985, the Respondent suspended the Complainant with intent to discharge and the Complainant filed a grievance.

仲裁人于3月26日作出裁决, 如果被告在4月22日之前无法获得保险, 1985, 放电将成为最终结果, 而是被告是否能够获得保险, 投诉人将被复职，且无欠薪.

4月24日, 1985, the arbitrator determined that coverage could be obtained at a reasonable cost and ruled that the Complainant should be reinstated as of April 22, 1985. 然而, 因为被告在1985年3月的第二个星期解雇了其雇员, 投诉人被恢复为处于下岗状态的在职雇员. 投诉人共工作1年,在3月7日之前的连续24个日历月期间，答辩人的工作时间为209小时, 1985.

4月30日, 1985, 投诉人接受了新雇主的工作, but states that he was not employed on a permanent basis and was not provided with 健康 benefits coverage by the new 雇主. 在11月5日与皇冠搏彩中心网站组织工作人员的电话交谈中, 1985, the Complainant stated that he did not notify the Respondent in writing of the acceptance and termination of the new employment.

A representative of the Respondent has stated that the Respondent provided 健康 benefits coverage for the Complainant through April 1985. 5月5日, 1985, the Respondent attempted to contact the Complainant and was informed by the Complainant’s wife that the Complainant had returned to work. 当时, the Respondent informed the Complainant’s wife that her husband’s coverage under the 雇主 Benefit Plan was terminated. The Respondent has denied responsibility for the provision of 健康 benefits coverage for the Complainant beyond May 5, 1985, 被投诉人得知投诉人接受新工作的日期.

争端

Is the Respondent responsible for the provision of extended 健康 benefits coverage for the Complainant and his eligible dependents based upon the number of hours worked for the Respondent during the 24 consecutive calendar month period prior to the Complainant’s last day worked?

各方立场

Position of the 原告: The Respondent is responsible for the provision of extended 健康 benefits coverage for the Complainant and his eligible dependents based upon the number of hours worked for the Respondent during the 24 consecutive calendar month period prior to the Complainant’s last day worked.

Position of the 被申请人: The Respondent is not responsible for the provision of 健康 benefits coverage beyond May 5, 1985, 获悉投诉人接受其他工作的日期.

相关的规定

雇主福利计划第I(1)、(2)、(3)、(4)条规定:

第一条-定义

下列术语具有本协议规定的含义:

(1) “雇主”指(煤炭公司名称).

(2) “工资协议”指1984年《皇冠搏彩中心网站》, 如不时修订及任何后续协议.

(3) “计划管理人”应为雇主, 雇主的子公司, 雇主的关联公司或雇主的雇员, 由雇主指定.

(4) “雇员”系指为雇主从事保密工作的人员, 有资格获得本协议项下的福利.

第三条D. (1)(a)和(f)雇主福利计划规定:

第三条-福利

D. 一般规定

(1) 续保

(a) 裁员

如果雇员因裁员而停止工作，
健康的延续, 人寿、意外死亡和肢解保险的保险范围如下:

工作时数
24 .雇主
连续日历月
承保期紧接之前的期间
雇员入职日期 继续
最后的工作 最近工作日期

2000小时以上 月余额加上12个月

500或更多，但少于 月加余额
2000小时 6个月

少于500小时 30天

(f)其他就业

尽管有上述规定, in the event an 员工 accepts employment during a period of continued coverage under paragraph (a), 健康, life and accidental death and dismemberment coverage will terminate as of the date of such employment. If, 然而, such employment subsequently terminates prior to the date the 员工’s coverage under paragraph (a) otherwise terminates, 雇员的健康, life and accidental death and dismemberment coverage will be reinstated following the later of (i) termination of such employment or (ii) any continued 健康 coverage resulting therefrom, 并将继续到(a)款规定的保险本应终止的日期. It is the obligation of the 员工 to notify the 雇主 within 10 days by certified mail of both the acceptance and termination of such employment; failure to provide such notice will result in permanent termination of coverage. Nothing in this paragraph shall extend coverage beyond the date determined pursuant to paragraph (a).

讨论

尽管申诉人已被停职，意图解除职务, the arbitrator’s final order to reinstate the Complainant nullifies any effect of the disciplinary action with respect to the Respondent’s obligation to provide benefits coverage. 因此, the issue in this case must be decided based on the Respondent’s obligation to provide benefits coverage to a laid-off 员工.

第三条D. (1) (a) of the 雇主 Benefit Plan provides continued 健康 benefits coverage for a laid-off 员工 based upon the number of hours worked for the 雇主 during the 24 consecutive calendar month period immediately prior to the 员工’s last day worked. 尽管有上述规定，第三条第D款. (1)(f) of the 雇主 Benefit Plan states that “in the event an 员工 accepts employment during a period of continued coverage…健康, life and accidental death and dismemberment coverage will terminate as of the date of such employment.“然而, if such employment should terminate before continued 健康 benefits coverage would have terminated under 第三条D. (1)(a)在保险期限延续期间，保险将恢复. 第三条D. (1) (f) further states that it is “the obligation of the 员工 to notify the 雇主 within 10 days by certified mail of both the acceptance, and termination of such employment; failure to provide such notice will result in permanent termination of coverage.”

Although the Complainant has stated that his later employment was not permanent and that he did not receive 健康 benefits coverage, the notification provisions of the Plan do not distinguish between the acceptance of “temporary” or “part-time” and full-time employment. 因此, 在没有适当通知的情况下, 申诉人的健康福利已于4月30日适当终止, 1985, 投诉人接受其他工作的日期. 相应的, the Respondent is not responsible for the provision of additional 健康 benefits coverage for the Complainant and his eligible dependents.

受托人的意见

The Respondent is not responsible for provision of the 健康 benefits coverage for the Complainant and his eligible dependents beyond April 30, 1985.