受托人的意见
争议的解决
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______________________________________________________________________________
受托人的意见
______________________________________________________________________________
在再保险
投诉人:下岗职工和退休人员
被申请人:雇主
ROD案例编号:84-431 - 1987年7月17日
董事会:Joseph P. 康纳斯,老., Chairman; Paul R. Dean,受托人; William B. 约旦,
Trustee; 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 计划
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
provision of health benefits coverage 根据雇主福利计划的条款.
背景事实
的 Complainants are laid-off Employees of the Respondent and 养老金领取者 whose last
classified signatory employment in the coal industry was for the Respondent. 下岗
Complainants worked for the Respondent until December 1986, when the Respondent ceased
操作. 的 Respondent is signatory to the National Bituminous Coal Wage Agreement
(“工资协议”).
的 Respondent provided health benefits,coverage for the Complainants through the Bituminous
Industry Trust/Business Insurance Trust (“BIT”) and California 人寿保险 until April 30,
1987年，BIT终止. 由于资不抵债，BIT和加州人寿保险公司
have ceased paying health benefits claims for services rendered prior to April 30, 1987. 的
representative for the Complainants has stated that the Respondent has not provided health
投诉人在1987年4月30日后的福利.
的 representative for the Complainants asks whether the Respondent is responsible for payment
of the Complainant’s medical bills that are unpaid due to the insolvency of BIT and California
人寿保险. 的 representative for the Complainants also asks whether the Respondent is
responsible for providing the Complainants’ health benefits coverage after April 30, 1987.
争端
Whether the Respondent is responsible for the provision of health benefits for the Complainants
根据雇主福利计划的条款.
受托人的意见
争议的解决
情况下没有. 84-431
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双方立场
Position of the Complainants: 的 Respondent is responsible for payment of the covered medical
charges incurred by the Complainants prior to April 30, 1987, and for the provision of health
benefits coverage for the Complainants beyond that date during their individual periods of
根据雇主福利计划条款确定的资格.
Position of the Respondent: 的 Respondent has not responded to repeated correspondence from
就其在这一争端中的立场.
相关的规定
Article XX Section (c)(3)(i) of the National Bituminous Coal Wage Agreement of 1984 provides
在相关部分:
(c) 1974年计划和信托
(3)(i)每一签字雇主应建立并保持一份
员工福利计划提供，通过一个实施
保险公司为其提供健康和其他非养老金福利
本协议所涵盖的雇员以及养老金领取者
1974年养老金计划和信托皇冠搏彩中心网站，最后一个签署人保密
受雇于这样的雇主. 提供的好处
雇主根据该等计划向其合格的参与者提供
在本协议有效期内，由
雇主在这些计划中规定的水平.
Article 1 (1), (2), (4) and (5) 雇主福利计划的成员 provide:
第一条-定义
下列术语具有本协议规定的含义:
(1)“雇主”指(雇主名称).
(2)“工资协议”指全国烟煤工资
不时修订的1984年协议及任何后续协议
协议.
(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.
(5) “Pensioner” shall mean any person who is receiving a pension, other than
(i)基于少于20年的已归属退休金
service, or (ii) a pension based in whole or in part on years of service
受托人的意见
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credited under the terms of Article II G of the 1974 Pension 计划, or any
corresponding paragraph of any successor thereto, under the 1974 Pension
最后一个机密签署人的计划(或其任何后继计划)
employment was with the Employer, subject to the provisions of Article II
本计划B项.
第二条A款. 雇主福利计划第(1)及(4)条规定:
第二条-资格
的 persons eligible to receive health benefits pursuant to Article III are as 如下:
A. 积极的员工
第III条规定的福利应提供给下列任何员工:
(1) is actively at work* for the Employer on the effective date of the
Wage Agreement; on
(4) A new Employee will be eligible for health benefits from the first
我为雇主工作了一天.
第二条乙. (1)雇主福利计划规定:
B. 养老金领取者
Health benefits and life insurance under Article III hereof shall be provided to
领取退休金人士如下:
(1)任何不再受雇于保密签字人的养老金领取者
之后的就业
(a)根据《皇冠搏彩中心网站》，领取退休金者的最初退休日期
退休金计划;及
(b) 1984年10月1日，应有资格获得保险
根据并受本协议所有其他条款约束的退休人员
计划. 尽管有(i)及(ii)的定义
本计划第I(5)条之退休金领取者，任何该等退休金领取者
谁符合1974年福利计划的资格
在1977年12月5日成为养老金领取者，将有资格领取
该等福利受本计划所有其他条款的约束.
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________
*
Actively at work includes an Employee of the Employer who was actively at work on
September 30, 1984, and who returns to active work with the Employer two weeks after the
工资协议生效日期.
第三条D. 雇主福利计划第(1)(a)条规定:
第三条-福利
D. 一般规定
(1)续保
(一)裁员
If an Employee ceases work because of layoff, continuation of health, life
意外死亡和肢解保险的范围是
如下:
工作时数
24 .雇主
连续日历月
承保期紧接之前的期间
雇员的日期从
最后工作日期最后工作时间
每月结余2000小时或以上
12个月
500或以上但少于月结余额
2000小时6个月
30天内少于500小时
讨论
Article XX Section (c)(3)(i) of the 1984 Wage Agreement requires an Employer to provide an
Employer Benefit 计划… “implemented through an insurance carrier(s), [for] health and other
non-pension benefits…” It further requires that “benefits provided by the Employer to its eligible
Participants pursuant to such plans 在本协议有效期内，由
雇主在这些计划中规定的水平.尽管本案的被告
implemented its Employer Benefit 计划 until April 30, 1987 through an employer trust fund and
insurance carrier which subsequently became insolvent, such event does not relieve the
Respondent of its primary obligation to provide benefits pursuant to the Wage Agreement.
Inasmuch as the Complainants were eligible for health benefits coverage from the Respondent at
the time their outstanding medical charges were incurred, the Respondent is responsible for
受托人的意见
争议的解决
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根据雇主福利计划的条款支付这些费用. 此外,因为
as the Complainants were eligible for health benefits coverage beyond April 30, 1987 as laid-off
Employees and 养老金领取者, the Respondent is responsible for the provision of their health
benefits coverage throughout their individual periods of eligibility as determined under the terms
雇主福利计划的成员.
受托人的意见
的 Respondent is responsible for payment of the covered medical charges incurred by the
Complainants prior to April 30, 1987, and for the provision of health benefits coverage for the
Complainants throughout their individual periods of eligibility as determined under the terms of
雇主福利计划.