File Download: 84-722

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OPINION OF TRUSTEES
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In Re
Complainants: Laid-off Employees
Respondent: Employer
ROD Case No: 84-722 – November 14, 1990
Board of Trustees: Joseph P. Connors, Sr., Chairman; Paul R. Dean, Trustee; William Miller,
Trustee; Donald E. Pierce, Jr., Trustee; Thomas H. Saggau, Trustee.
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 for laid-off Employees under the terms of the Employer
Benefit Plan.
Background Facts
The Complainants worked for the Respondent in classified positions until February 27, 1987,
when they were laid off.
One of the Complainants has stated that the Respondent terminated health benefits coverage for
its Employees in October 1986. The representative for the Complainants contends that the
Respondent is responsible for payment of the covered medical charges incurred by the
Complainants and their eligible dependents during their employment and during their periods of
eligibility for continued coverage as laid-off Employees.
The Respondent was signatory to the National Bituminous Coal Wage Agreement (“Wage
Agreement”) of 1984.
Dispute
Whether the Respondent is responsible for payment of the Complainants’ unpaid medical bills
and for the provision of health benefits coverage for the Complainants as laid-off Employees
under the terms of the Employer Benefit Plan?
Positions of the Parties
Position of the Complainants: The 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 Employees under the terms of the Employer Benefit
Plan.
Opinion of Trustees
Resolution of Dispute
Case No. 84-722
Page 2
Position of the Respondent: The Respondent has not responded to repeated correspondence from
Funds’ staff requesting its position in this dispute.
Pertinent Provisions
Article XX Section (c)(3)(i) of the National Bituminous Coal Wage Agreement of 1984 provides
in pertinent part:
(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. The benefits 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 forth in such plans.
Article I (I), (2) and (4) of the Employer Benefit Plan provide:
Article I – Definitions
The following terms shall have the meanings herein set forth:
(1) “Employer” means (Employer’s Name).
(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
Employer, eligible to receive benefits hereunder.
Article II A. (4) of the Employer Benefit Plan provides:
Article II- Eligibility
The persons eligible to receive the health benefits pursuant to Article III are as follows:
A. Active Employees
(4) A new Employee will be eligible for health benefits from the first day
worked with the Employer.
Opinion of Trustees
Resolution of Dispute
Case No. 84-722
Page 3
Article III D. (I)(a) of the Employer Benefit Plan provides:
Article III – Benefits
D. General Provisions
(1) Continuation of Coverage
(a) Layoff
If an Employee ceases work because of layoff, continuation of
health, life and accidental death and dismemberment insurance coverage is
as follows:
Number of Hours worked for
the Employer in the 24
Consecutive Calendar Month
Period Immediately Prior to Period of Coverage
the Employee’s Date Continuation from the
Last Worked Date Last Worked
2,000 or more hours Balance of month plus
12 months
500 or more but less than Balance of month plus
2,000 hours 6 months
Less than 500 hours 30 days
Discussion
Article XX Section (c)(3)(i) of the 1984 Wage Agreement requires each signatory Employer to
establish and maintain an Employer Benefit Plan to provide health and other non-pension
benefits for its Employees. The Wage Agreement stipulates that benefits provided by the
Employer pursuant to such Plan shall be guaranteed during the term of the Agreement by that
Employer at levels set forth in such Plan.
Article II A. (4) of the Employer Benefit Plan provides health benefits coverage for active
Employees working in classified jobs for a signatory Employer. Article III D. (I)(a) of the Plan
provides continued benefits coverage for laid-off Employees based upon the number of hours
worked for the Employer during the 24-month period immediately prior to the date last worked.
Inasmuch as the Complainants were actively employed in classified positions by the Respondent
until February 27, 1987, when they were laid off, the Respondent is responsible for providing
health benefits coverage to the Complainants and their eligible dependents during their
employment and for the continuation of the Complainants’ health benefits coverage beyond
February 27, 1987, pursuant to Article III D. (I)(a) of the Employer Benefit Plan. Accordingly,
Opinion of Trustees
Resolution of Dispute
Case No. 84-722
Page 4
the Respondent is responsible for 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 coverage as laid-off Employees, as determined under the terms of the
Employer Benefit Plan.
Opinion of the Trustees
The Respondent is responsible for 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 Employees, consistent with the terms of
the Employer Benefit Plan.