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受托人的意见
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在再保险

投诉: 被解雇的员工
被申请人: 雇主
ROD案例编号: 84-410——1987年6月18日

Board of Trustees: Joseph P. 康纳斯,老., Chairman; Paul R. Dean,受托人; William B. Jordan,受托人; 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 benefits coverage for a laid-off Employee under the terms of the 雇主 Benefit Plan.

背景事实

The Complainant was working in a classified job for the Respondent when he was injured on April 11, 1985. As a result of his injury, he was unable to return to work and was awarded Workers Compensation. 6月6日, 1986, the Complainant was provided a release from his attending physician to return to work. The Complainant’s representative has stated that the Complainant did not return to work following his release because the Respondent had no work available. The Respondent provided the Complainant with health benefits coverage until June 6, 1986, when coverage was terminated.

On August 23, 1986, the Respondent laid off the Complainant. The Complainant’s representative contends that the Respondent is responsible for providing the Complainant with continued health benefits for the balance of the month plus 12个月 from the date of layoff, 或到8月31日, 1987.

争端

Whether the Respondent is responsible for providing the Complainant with health benefits after June 6, 1986.

双方立场

Position of the Complainant: The Respondent is responsible for providing the complainant with continued health benefits coverage for the balance of the month plus 12个月 from the date the Complainant was laid off, 或到8月31日, 1987.

Position of the 被申请人: The Respondent has not responded to repeated correspondence by Funds staff requesting its position in this dispute.

相关的规定

Article I (I), (2) and (4) of the 雇主 Benefit Plan provide:

第一条-定义

The following terms shall have the meanings herein set forth:

(1) “雇主” means (name of coal company).

(2) “Wage Agreement” means the National Bituminous Coal Wage Agreement of 1984, as amended from time to time and any successor agreement.

(4) “Employee” shall mean a person working in a classified job for the 雇主, eligible to receive benefits hereunder.

第三条D.(1)(a) and (d) of the 雇主 Benefit Plan provide:

第三条-福利

D. 一般规定

(1) 续保

(a) 裁员

If an Employee ceases work because of layoff, 健康的延续, life and accidental death and dismemberment insurance coverage is as follows:

工作时数
24 .雇主
连续日历月
Period Immediately Prior to 保险期限
雇员入职日期 继续
最后的工作 最近工作日期

2000小时以上 月加余额
12个月
500或更多，但少于 月加余额
2000小时 6个月
少于500小时 30天

(d) Maximum 续保

In no event shall any combination of the provisions of (a), (b), (c), (e) or (g) above result in continuation of coverage beyond the balance of the month plus 12个月 from the date last worked.

讨论

根据第三条D款.(1)(a) of the 雇主 Benefit Plan, the period of coverage continuation for a laid-off Employee is measured from the Employee s date last worked, not from the Employee’s date of layoff. 第三条D.(1)(d) provides that such a period of coverage continuation shall not exceed the balance of the month plus 12个月 from the date last worked. Inasmuch as the Complainant last worked on April 11, 1985, and was provided health benefits coverage until June 6, 1986, the Respondent has fulfilled its obligation to the Complainant as a laid-off Employee under 第三条D.(1)(a)计划.

受托人的意见

The Respondent is not responsible for providing the Complainant with continued health benefits coverage as a laid-off Employee beyond what has already been provided.