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受托人的意见
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在再保险
投诉人:下岗职工
被申请人:雇主
ROD案例编号:98-038 - 2003年1月28日
受托人:. 弗兰克·邓纳姆，迈克尔·H. 霍兰德，马蒂·D. 哈德逊和
艾略特一. 西格尔.
的 Trustees have reviewed the facts and circumstances of this dispute concerning the provision
of health benefits coverage for laid-off 员工 under 雇主福利计划的条款.
背景事实
的 Complainants were employed in classified positions for the Respondent on January 31,
2002, when they were laid off, and the company ceased operations. 该组织的代表
Complainants states that the Respondent stopped paying medical claims around August 2001.
As a result, the Complainants have received collection notices. 该组织的代表
Complainants also states that the Respondent is required to provide payment of the covered
medical expenses incurred by the Complainants and their eligible dependents during their
employment and during their period of eligibility for continued coverage as laid-off 员工.
的 UMWA filed a lien against the Respondent for the Complainants unpaid medical bills. 的
Respondent states that money to pay the unpaid medical bills is currently in an escrow account
应该很快就会被释放. 该组织的代表 Complainants states that the money
for the Complainants’ medical bills has been released; however, it is insufficient to pay all the
未付医药费. In addition, the representative states that there is no money to provide
继续为下岗职工提供保险.
的 Respondent is signatory to the National Bituminous Coal Wage Agreement (“Wage
协议”).
争端
Is the Respondent required to provide coverage for the Complainants’ unpaid medical bills and
for the provision of health benefits coverage for the Complainants as laid-off 员工 under
雇主福利计划的条款?
受托人的意见
连杆箱编号. 98-038
第二页
双方立场
Position of the Complainant: 的 Respondent is responsible for payment of the covered medical
charges incurred by the Complainants during their employment and during their periods of
eligibility for continued coverage as laid-off 员工 under the terms of the Employer Benefit
计划.
Position of the Respondent: 的 Respondent states that the delinquent accounts will be settled.

相关的规定
Article XX Section (c)(3)(i) of the National Bituminous Coal Wage Agreement of 1998 provides
在相关部分:
(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 员工 covered by this Agreement as well as pensioners,
under the 1974 Pension 计划 and Trust whose last signatory classified employment was
with such Employer and who are not eligible to receive benefits from a plan maintained
根据《煤炭法. 雇主为其合格雇员提供的福利
Participants pursuant to such plan shall be guaranteed during the term of this Agreement
由该雇主按该计划规定的水平提供. . . .

Article I (1), (2) and (4) of 雇主福利计划 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 Agreement of 1998,
as amended from time to time and any successor agreement.
(4) “Employee” shall mean a person working in a classified job for the Employer,
有资格获得本协议项下的福利.
第二条A款. (4)雇主福利计划规定:
受托人的意见
连杆箱编号. 98-038
第3页
第二条-资格
的 person eligible to receive the health benefits pursuant to Article III are as 如下:
A. 积极的员工
(4) A new Employee will be eligible for health benefits from the first day worked
与雇主联络.
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 and accidental death and dismemberment insurance coverage is as
如下:
工作时数
为雇主提供的表格
连续日历月承保期间
继续之前的紧接期间
雇员最后工作日期最后工作日期
2000小时或以上
加12个月
每月余额500元或以上但少于500元
2000小时加6个月
30天内少于500小时
受托人的意见
连杆箱编号. 98-038
第4页
讨论
Article XX (c)(3)(i) of the 1998 Wage Agreement requires each signatory Employer to establish
and maintain an Employer Benefit 计划 to provide health and other non-pension benefits for its
员工. 的 Wage Agreement stipulates that benefits provided by the Employer pursuant to
such 计划 shall be guaranteed during the term of the Agreement by that Employer at levels set
在该图则中列明.
第二条A款. (4) of 雇主福利计划 provides health benefit coverage for active
员工 working in classified jobs for a signatory Employer. 第三条D. (1)(a)计划
provides continued benefits coverage for laid-off 员工 based upon the number of hours
worked for the Employer during the 24-month period immediately prior to the date last worked.
的 Complainants were actively employed in classified positions when they were laid off by the
2002年1月的答辩人. 的refore, the Respondent is required to provide health benefits
coverage to the Complainants during their employment and for the continuation of the
Complainants’ health benefits coverage beyond January 2002, pursuant to Article III. D. (1) (a)
雇主福利计划.
受托人的意见
的 Respondent is required to provide payment of the covered medical expenses incurred by the
Complainants and their eligible dependents during their employment and during their individual
periods of eligibility for continued coverage as laid-off 员工, consistent with the terms of
雇主福利计划.