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OPINION OF TRUSTEES ______________________________________________________________________________
投诉人:被投诉人:ROD案件编号:
员工
雇主
1983年7月25日，81-27
在再保险
Board of Trustees: Harrison Combs, Chairman; John J. O’Connell, Trustee; Paul R. 迪恩,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 and other non-pension benefits coverage for an 员工 by the 雇主 under the terms of the 雇主’s Benefit Plan and hereby render their opinion on the matter.
背景事实
该雇员于1978年3月至9月30日为雇主A工作, 1981; also, 1982年3月起, 至五月十四日, 1982, 当他被解雇的时候. 在此期间, 雇主 A was mining coal for 雇主 B under an Agreement which provides that 雇主 B would be responsible for payments to the United Mine Workers of America Health and Retirement Funds for coal royalties. In addition, 雇主 B provided benefits coverage to 雇主 A’s 员工s and Pensioners.
雇主B报了1,591 classified hours worked by the 员工 during the 24-month period immediately prior 至五月十四日, 1982, 他上次约会的对象. 不过, 雇主 B cancelled the 员工’s health and other non-pension benefit coverage effective June 30, 1981, 因为雇主A不再为它生产煤了. 雇主A索赔 that its contract with 雇主 B stipulated that 雇主 B was to provide health and other non-pension benefit coverage for the 员工s of 雇主 A. The contract, a copy of which is in file, does not address benefit coverage.
雇主 A submitted a “No Longer in Business Letter” to the Funds on January 14, 1982. The information contained in the letter indicated that 雇主 A had gone out of business on March 27, 1981. 然而, information received subsequently indicates that 雇主 A began operating again during September 1981 and is still in business.
The 员工 has outstanding health services bills which were incurred during the periods July 1, 1981年至9月9日, 1981, 3月4日, 1982年至5月14日, 1982.
争端
受托人解决争议意见. 81-27
第二页
Which 雇主 was responsible for providing coverage to the 员工 and his dependents from June 7, 1981, 到9月8日, 1981, 3月4日, 1982年至11月30日, 1982?
各方立场
Position of 员工: He wants to know which 雇主 was responsible for providing him with health and other non-pension benefit coverage after June 7, 1981.
Position of 雇主 A: It has a contract with 雇主 B which stipulated that 雇主 B would provide benefit coverage for 雇主 A’s 员工s.
Position of 雇主 B: It was only required to provide benefit coverage for 雇主 A’s 员工s during the periods when they were working on 雇主 B’s property.
相关的规定
第二条. A. (1) 1981年雇主福利计划规定:
第二条-资格
The persons eligible to receive the health benefits pursuant to 第三条 are as follows:
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 work1 for the 雇主 on the effective date of the Wage Agreement, or….
第二条.A. (2) 1981年雇主福利计划规定. 积极的员工
第III条规定的福利应提供给下列任何员工:
(2) is on layoff or disabled from the 雇主 and had continuing eligibility as of the effective date of the Wage Agreement, 投保1978年的雇主福利
1 Actively at work includes an 员工 of the 雇主 who was actively at work on March 26, 1981, and who returns to active work with the 雇主 two weeks after the effective date of the Wage Agreement.
受托人解决争议意见. 81-27
第3页
作为下岗或残疾雇员的计划(“先前计划”). Coverage for such laid-off or disabled 员工s shall not continue beyond the date when they would no longer have been eligible for such coverage under the provision of the prior Plan.
第三条. D. (1)(a) 1981年雇主福利计划规定. 一般规定
1. (a)裁员
如果雇员因裁员而停止工作, 健康的延续, 视力保健, life and accidental death and dismemberment insurance coverage is as follows:
Number of Hours Worked for the 雇主 in the 24 Consecutive Calendar Month Period Immediately Prior to the 员工’s Date
最后的工作
2000小时以上
500小时或以上，但少于2000小时
少于500小时
自最后工作日期起的续保期限
月余额加上12个月
月余额加上6个月30天
讨论
根据第二条. A. (1)雇主的福利计划, a signatory 雇主 is required to provide benefits coverage to its active 员工s.
根据第三条.D. 雇主福利计划的第1 (a)条, a laid-off employee who worked more than 500 hours for the 雇主 during the 24-calendar month period prior to the date he last worked is eligible for continuation of coverage for the balance of the month plus 6 months from the date last worked.
该雇员自1978年3月起受雇于雇主A, 到9月9日, 1981, 3月4日, 1982年至5月14日, 1982, 当他被解雇的时候. He was eligible for benefits coverage from 雇主 A as an active 员工 during these periods.
受托人解决争议意见. 81-27
第4页
The 员工 worked more than 500 hours during the 24-calendar month period immediately prior 至五月十四日, 1982. 因此, he was eligible for continuation of coverage from 雇主 A from May 15, 1982年至11月30日, 1982.
雇主A索赔, 然而, that he is not responsible for providing coverage to the 员工 because the contract between 雇主s A and B required 雇主 B to provide such coverage. The contract which 雇主 A has submitted for review does not support this claim, 且雇主A未提交任何其他证据支持其陈述. 无论如何, 即使假设, 在雇主A为雇主B开采煤炭期间, 雇主 A had delegated its obligations under the 雇主’s Benefit Plan to 雇主 B, 这不会减轻雇主A的这些义务. 因此, 雇主 A is responsible for providing coverage for the 员工 and his eligible dependents from July 1, 1981, 雇主B终止其保险的日期, 到9月8日, 1981, 3月4日起, 1982年至11月30日, 1982.
受托人的意见
The Trustees are of the opinion that 雇主 A is responsible for the provision of health and other non-pension benefits coverage for the 员工 and his dependents during the period July 1, 1981年至9月8日, 1981, 3月4日, 1982年至11月30日, 1982.