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受托人的意见
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在再保险
原告: 养老金领取者
被申请人: 雇主
ROD案例编号: 84-371——1987年10月15日
董事会: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 health benefits coverage under the terms of the 雇主 Benefit Plan.
背景事实
The Complainant’s last signatory classified employment in the coal industry was with 被申请人 from March 12, 1981年至12月31日, 1984. The Complainant was awarded an Age 55 retirement pension under the 1974 Pension Plan, 8月1日生效, 1986. The Complainant was advised to contact his last signatory employer, 被申请人, 关于他是否有资格享受医疗保险. 被告获得了该信函的副本. The Complainant states that 被申请人 has refused to provide his health benefits coverage.
The Respondent is signatory to the National Bituminous Coal Wage Agreement (“Wage Agreement”) of 1984. Funds’ records indicate that 被申请人 ceased operations sometime in February 1987.
争端
Whether 被申请人 is responsible for providing health benefits coverage for the Complainant.
双方立场
Position of the 原告: The Respondent is responsible for providing dental benefits coverage for the Complainant.
Position of 被申请人: The Respondent has not responded to repeated correspondence from Funds staff regarding its position in this dispute.
相关的规定
Article XX (c)(3)(i) of the 1984 Wage Agreement provides in pertinent part:
第二十条——健康和退休福利
第(c)节1974计划和信托
(3)(i) Each signatory 雇主 shall establish and maintain an Employee benefit plan to provide, 通过保险公司实施), health and other non-pension benefits for its Employees covered by this Agreement as well as pensioners, 1974年养恤金计划和信托皇冠搏彩中心网站, whose last signatory classified employment was with such 雇主. The benefits provided by the 雇主 to its eligible Participants pursuant to such plans shall be guaranteed during the term of this Agreement by that 雇主 at levels set forth in such plans.
Article I (1), (2) and (5) 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”指(雇主名称).
(2) “Wage Agreement’ means the National Bituminous Coal Wage Agreement of 1984, 如不时修订及任何后续协议.
(5) “养老金领取者” shall mean any person who is receiving a pension, other than (i) a deferred vested pension based on less than 20 years of credited service, or (ii) a pension based in whole or in part on years of service credited under the terms of Article II G 1974年养恤金计划, 或其任何继承者的任何相应段落, 根据1974年退休金计划(或其任何后续计划), whose last classified signatory employment was with the 雇主, 以本计划第二条B款的规定为准.
第二条乙. (1)雇主福利计划规定:
第二条-资格
The persons eligible to receive the health benefits pursuant to Article III are as follows:
B. 养老金领取者
Health benefits and life insurance under Article III hereof shall be provided to 养老金领取者 as follows:
(1) Any 养老金领取者 who is not again employed in classified signatory employment subsequent to
(a) such 养老金领取者’s initial date of retirement under the 1974 Pension Plan, and
(b) 10月1日, 1984, 都有资格作为养老金领取者享受以下的保险, 并受本计划所有其他条款的约束. Notwithstanding (i) and (ii) of the definition of 养老金领取者 in Article 1(5) of this Plan, any such 养老金领取者 who was eligible for benefits under the 1974 Benefit Plan as a 养老金领取者 on December 5, 1977, 都有资格享受这些福利, 受本计划所有其他条文规限.
讨论
Article XX Section (c)(3)(i) of the 1984 Wage Agreement requires each signatory 雇主 to establish and maintain an 雇主 Benefit Plan to provide health and other non-pension benefits for 养老金领取者 whose last signatory classified employment was with such 雇主. The Wage Agreement stipulates that benefits provided by the 雇主 pursuant to such Plan shall be guaranteed during the term of the Agreement by that 雇主 at levels set forth in such Plan.
第二条乙. of the 雇主 Benefit Plan provides health benefits coverage for a 养老金领取者 who is receiving a 1974 Pension Plan pension, other than a deferred vested pension based on less than 20 years of credited service or a pension based in whole or in part on years of service credited under the terms of Article II G. 1974年养恤金计划. Inasmuch as the Complainant’s last signatory classified employment was with 被申请人 and he is receiving a 1974 Pension Plan Age 55 retirement pension, 被申请人 is responsible for providing health benefits coverage for the Complainant as a 养老金领取者, 8月1日生效, 1986.
A 养老金领取者 may be entitled to coverage under the 1974 Benefit Plan and Trust only if it is determined that the 养老金领取者’s last 雇主 is “no longer in business.” Such determination is made by the Trustees under established procedures separate from the ROD procedures.
受托人的意见
The Respondent is responsible for providing health benefits coverage for the Complainant and his eligible dependents 8月1日生效, 1986.