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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: 98-0051 - 2010年11月22日

受托人: 迈克尔W. 丹尼尔·L·巴克纳. 莫里斯·D·法西奥. 菲布希和迈克尔
H. 荷兰

The Trustees have reviewed the facts and circumstances of this dispute concerning the provision of benefits under the terms of the 雇主 Benefit Plan.

背景事实

The Complainant was notified by letter dated March 28, 2002, that he was eligible for a 1974年退休金计划 Disability pension, 10月1日生效, 1998. The Complainant was advised to contact the Respondent, 最后签署人雇主, regarding his eligibility for health benefits coverage as a 养老金领取者. The Respondent has refused to provide health benefits coverage for the Complainant.

争端

Is the Respondent required to provide health benefits coverage for the Complainant as a 养老金领取者?

双方立场

Position of the 原告: The Respondent is required to provide health benefits coverage for the Complainant as a 养老金领取者.

Position of the 被申请人: Respondent has not submitted a response to this ROD.

相关的规定

Article XX Section (c)(3)(i) of the National Bituminous Coal Wage Agreement of 2007 provides in pertinent part:

(3)(i) Each signatory 雇主 shall establish and maintain an Employee
提供的福利计划, 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 under the 1974 Pension Plan and Trust whose last signatory classified employment was with such 雇主 and who are not eligible to receive benefits from a plan maintained pursuant to the Coal Act. The benefits provided by the 雇主 to its eligible Participants pursuant to such plan 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 1998 雇主 Benefit Plan provide:

第一条-定义

(1) “雇主”指(填上雇主名称).

(2) “Wage Agreement” means the National Bituminous Coal Wage Agreement of 1978, as amended from time to time and any successor agreement.

(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; (ii) a pension based in whole or in part on years of service credited under the terms of Article II G of the 1974 Pension Plan, or any corresponding paragraph of any successor thereto, under the 1974 Pension Plan (or any successor thereto), whose last classified signatory employment was with the 雇主, subject to the provisions of 第二条乙 of this Plan; or (iii) a special permanent layoff pension under the terms of Article II.E(4) of the1974 Pension Plan, during any period prior to the person’s attainment of age 55.

第二条乙. 1998年雇主福利计划第(1)条规定:

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 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) 12月31日, 1997, 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 I(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

第二条乙. of the 雇主 Benefit Plan established pursuant to the 1998 Wage Agreement states that health benefits coverage shall be provided for 养老金领取者, 在某些情况下, who are receiving pension benefits under the 1974 Pension Plan. Article I (5) of the 雇主 Benefit Plan defines such 养老金领取者 as any person whose last classified signatory employment was with the 雇主, and who is receiving a pension under the 1974年退休金计划 with certain exceptions not relevant here. The Complainant is receiving a Disability Pension from the 1974 Pension Plan. 因此, he satisfies the definition of “养老金领取者” as set forth in Article I (5) of the Plan and is eligible for health benefits coverage under 第二条乙. of the 雇主 Benefit Plan established by 最后签署人雇主, the Respondent.

The Respondent has asserted that the Complainant is not entitled to a disability pension from the 1974 Pension Plan. The Respondent’s challenge of a pension eligibility decision under the 1974 Pension Plan may not be addressed by the Trustees in the ROD process. The Respondent’s challenge has been addressed in a separate procedure authorized by Article XX. 工资协议第(g)(3)条.

受托人的意见

The Respondent is required to provide health benefits coverage for the Complainant as a 养老金领取者, 10月1日生效, 1998, consistent with the terms of the 雇主 Benefit Plan. Any 雇主 challenge of a pension eligibility decision must be raised in a separate procedure authorized by Article XX. 工资协议第(g)(3)条, and may not be addressed by the Trustees in the ROD process.