受托人的意见
争议的解决
情况下没有. 84-655
第1页
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受托人的意见
______________________________________________________________________________
在再保险
原告:员工
被申请人:雇主
ROD案例编号:84-655 - 1988年7月21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 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
provision of health benefits coverage under the terms of the Employer Benefit Plan.
背景事实
的 Complainant has been employed in a classified position with the 被调查者 since April
1986. In June 1986, the 被调查者 corporation was purchased by the current owner. 的
被调查者 is signatory to the National Bituminous Coal Wage Agreement (“Wage Agreement”)
of 1984.
的 被调查者, under its previous owner, had provided health benefits coverage for the
Complainant through the Bituminous Industry Trust/Business Insurance Trust (BIT”) and
California Life Insurance until April 30, 1987, when the BIT was terminated. 由于无力偿债，
the BIT and California Life Insurance have ceased paying health benefits claims for services
在1987年4月30日之前绘制. 的 Complainant has submitted a copy of an unpaid hospital
bill for medical services rendered in May 1986. 申诉人希望电视知道是谁
负责未付的医院账单.
争端
Whether the 被调查者 is responsible for payment of the outstanding medical charges incurred
由申诉人于1986年5月提交.
双方立场
Position of the Complainant: 的 Complainant asks who is responsible for payment of the
unpaid hospital bill which was incurred in May 1986 during his employment with the
被调查者.
受托人的意见
争议的解决
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Position of the 被调查者: 的 被调查者 has not responded to repeated correspondence from
Funds’ staff requesting its position in this dispute.
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) Each signatory Employer shall establish and maintain an
Employee benefit plan to provide, implemented through an insurance carrier(s),
health and other non-pension benefits for its Employees covered by this
Agreement as well as pensioners, under the 1974 Pension Plan and Trust, whose
last signatory classified employment was with such Employer. 的好处
provided by the Employer to its eligible Participants pursuant to such plans shall
be guaranteed during the term of this Agreement by that Employer at levels set
在这样的计划中.
Article I (1), (2) and (4) of the Employer Benefit Plan provide:
第一条-定义
的 following terms shall have the meanings herein set forth:
(1)“雇主”指(雇主名称).
(2) “Wage Agreement” means the National Bituminous Coal Wage
Agreement of 1984, as amended from time to time and any successor
协议.
(4) “Employee” shall mean a person working in a classified job for the
Employer, eligible to receive benefits hereunder.
第二条A款. (4) of the Employer Benefit Plan provides:
第二条-资格
的 persons eligible to receive the health benefits pursuant to 第二条I are as follows:
A. 积极的员工
受托人的意见
争议的解决
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(4) A new Employee will be eligible for health benefits from the first day
与雇主合作.
讨论
Article XX Section (c)(3)(i) of the 1984 Wage Agreement requires an Employer to provide an
Employer Benefit Plan… “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 shall be guaranteed during the term of this Agreement by that
雇主在这些计划中规定的水平.” Although the 被调查者 corporation was purchased
by a new owner in June 1986, a change in ownership does not affect the corporate existence nor
the corporation’s debts, obligations or liabilities. 的refore, the 被调查者 corporation remains
liable for the health benefits coverage required by the Wage Agreement.
第二条. A of the Employer Benefit Plan provides health benefits coverage for an active
Employee working in a classified job for a signatory Employer. 被告当场
case implemented its Employer Benefit Plan until April 30, 1987 through an employer trust fund
保险公司. 的 employer trust fund and the carrier subsequently became insolvent.
Implementation of a plan through a carrier, in and of itself, does not relieve the 被调查者
corporation of its primary obligation to provide benefits pursuant to the Wage Agreement.
Inasmuch as the Complainant was eligible for health benefits coverage from the 被调查者 as
an active Employee at the time his outstanding medical charges were incurred, the 被调查者 is
responsible for payment of those charges under the terms of the Employer Benefit Plan.
受托人的意见
的 被调查者 is responsible for payment of the covered medical charges incurred by the
Complainant and his eligible dependents during his employment with the 被调查者 under the
terms of the Wage Agreement and the Employer Benefit Plan.