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受托人的意见
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在再保险

Complainant: Surviving Spouse
被申请人: 雇主
ROD Case No: 137, 1982年3月24日

Board of Trustees: Harrison Combs, Chairman; John J. 奥康奈尔,受托人;
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, 受托人审查了有关雇主根据雇主福利计划的条款向已故雇员的未亡配偶提供健康和死亡福利的争议的事实和情况，并在此就此事发表意见.

背景事实

The Employee worked for the 雇主 from October 1975 to December 12, 1975. On December 26, 1975, he was killed in an automobile accident.

Under the UMWA 1974 Benefit Plan (“1974 Benefit Plan”), the surviving spouse and minor dependents were eligible for a Death and Survivors Benefit of $7,500, payable in monthly installments over a five-year period, 1月1日起, 1976. The UMWA Health and Retirement Funds (“Funds”) paid this benefit from January 1, 1976, 到1980年2月. 的资金 also paid 健康 benefits during the same period.

截至6月1日, 1978, 雇主根据1978年全国烟煤工资协议第XX(c)(3)(i)条制定了雇主福利计划. 在为确定雇主提供福利的责任而进行的调查期间，1974年福利计划继续提供健康和死亡津贴.

1月16日, 1980, 皇冠搏彩中心网站通知雇主，雇主负责为已故雇员的未亡配偶和未成年受抚养子女提供福利, 根据第三条.D(1) of the 雇主’s Benefit Plan.

2月14日, 1980, 雇主通知各皇冠搏彩中心网站，由于雇员在1975年12月的第一个星期辞职，雇主将不向已故雇员的家属提供福利.

6月20日, 1980, the 雇主 advised the Funds that the surviving spouse had remarried on August 5, 1978.

争端

由6月1日起，雇主是否负责为未亡配偶及未成年受养人提供福利, 1978, 到1981年1月?

各方立场

未亡配偶代表的立场:她认为她和未成年受抚养人有资格获得福利.

雇主职位:雇员在去世前几周辞去了雇主的工作. 因此, the 雇主 is not responsible for providing any benefits to the dependents.

相关的规定

Article XX (c)(3)(i) of the National Bituminous Coal Wage Agreement of 1978 which provides:

(i) Except as provided in (ii) below, 6月1日生效, 1978, each signatory 雇主 shall establish an Employee benefit plan to provide, implemented through an insurance carrier(s), 本协议所涵盖的雇员以及领取养老金者的健康和其他非养老金福利, under the 1974 Pension Plan and Trust, whose last classified employment was with such 雇主. 在本协议有效期内，各雇主应按该等计划规定的水平保证根据该等计划提供的福利. 此类计划还应包括各签署雇主在12月5日之前继续支付死亡抚恤金, 1977, 根据1974年退休金计划而最后受雇于该雇主的已故雇员及退休人员, 以1974年福利计划和信托先前规定的相同方式和相同金额. 根据本款制定的计划将通过引用并入本协议，并成为本协议的一部分, 根据这些计划提供的健康和其他非养老金福利的条款和条件应在这些计划中规定.

第二条.E(3) of the 雇主’s Benefit Plan which provides:

第三条规定的健康津贴应提供给(1)任何未婚配偶和(ii)此种配偶的未婚未亡受抚养子女，如D款第(2)和(5)项所界定, of an Employee or Pensioner who died: …

(3) 当该雇员或养恤金领取者有权根据a段领取健康福利时, B, (二)本条第(三)款, 但(i)该等雇员或领取退休金者在《皇冠搏彩中心网站》生效日期前死亡，且其配偶没有资格领取未亡配偶的福利, 只有在配偶有资格根据第三条D款分期领取死亡抚恤金的期间内…….

第三条.D(1) of the 雇主’s Benefit Plan which provides:

(1)对于截至12月5日仍在领取抚恤金的案件，应继续支付死亡抚恤金, 1977, under the 1974 Benefit Plan, for deceased Employees and Pensioners, whose last classified employment was with the 雇主, in the same manner and in the same amounts, as previously provided for in the 1974 Benefit Plan.

第三条.E(1)(e) of the 雇主’s Benefit Plan which provides:

(e) If an Employee quits or is discharged, 健康, 视力保健, 人身、意外死亡和肢解保险自最后工作日期起终止.

健康的好处/Death Benefits
Q&A #169

Question: The widow of an active miner applies for benefits, 在她的矿工丈夫死亡之日和申请之日之间，她(a)再婚，(b)离婚(第二次婚姻已被解除)。. Is she eligible for death benefits? Is she eligible for 健康 benefits?

Answer: Such a person is eligible for death benefits since, at the time of the miner’s death, she was a surviving dependent. 作为未亡配偶，她没有资格享受医疗福利，因为这种福利在再婚后终止.

讨论

根据第三条.D.(1) of the 雇主’s Benefit Plan, 雇主须继续支付截至12月5日已根据1974年福利计划支付的死亡抚恤金, 1977, for deceased Employees whose last classified employment was with the 雇主. 付款s must be continued in the same manner and same amounts as under the 1974 Benefit Plan. The employee’s last classified employment was with the 雇主. And, as of December 5, 1977, death benefits were in pay status under the 1974 Benefit Plan. 因此, the 雇主 is responsible for providing death benefits in installment payments from June 1, 1978, the effective date of the 雇主’s Benefit Plan, 到1月1日, 1981, 根据1974年养恤金计划的规定，配偶和未成年受扶养人有资格领取死亡抚恤金的最后一个月.

根据第二条.E(3) of the 雇主’s Benefit Plan, 未亡配偶和未成年受扶养人有资格享受分期支付死亡抚恤金期间的医疗保险. 配偶再婚, 然而, terminates her 健康 coverage as well as that of the minor dependents. 在这种情况下, 因此, 未亡配偶和未成年受抚养人自6月1日起有资格获得雇主的医疗保险, 1978, the effective date of the 雇主’s Benefit Plan, 到8月4日, 1978, the date the surviving spouse remarried.

The 雇主 notes, 然而, that 根据第三条.E(1)(e) of the 雇主’s Benefit Plan, 如果员工辞职, all 健康 and other benefits coverage ceases as of the date last worked. 雇主索赔, 因此, that because the Employee terminated his employment with the 雇主 on December 12, 1975, two weeks prior to his death, 未亡配偶和未成年受抚养人无权享受雇主福利计划下的任何福利. 第三条.E(1)(e) must be read in conjunction with 第三条.D(1), 要求雇主继续支付1974年福利计划规定的死亡抚恤金. 根据该计划, 自愿终止雇佣关系的雇员在最后工作日后的30天内继续有资格获得福利保障. 因为雇员的未亡配偶和受扶养人在1974年福利计划下适当地领取死亡抚恤金, the 雇主’s claim that the Employee’s eligibility for benefits coverage ceased on December 12, 1975, 没有价值.

受托人的意见

受托人认为，雇主有责任从6月1日起为未亡配偶和未成年受扶养人提供健康福利, 1978, 到8月4日, 1978, and death benefits from June 1, 1978, 到1981年1月.