June 27, 1979
(Opinion issued in letter form; name and address deleted)
RE: Opinion of Trustees
Resolution of Disputes Case No. 8
Pursuant to Article IX of the UMWA 1950 Benefit Plan and Trust, and under the authority of an exemption granted by the U.S. Department of Labor, the Trustees have received the question of the beginning date of health benefit eligibility for a hospitalized dependent child of a new employee under the Employer’s benefit plan. Their opinion is issued in Question and Answer form as follows:
Subject: HEALTH BENEFITS; Dependents, Effective date of Eligibility Reference: NBCWA 1978, Art. XX C(3)
Question: A mine worker first employed in a classified job for a signatory employer on July 1, 1978 had a dependent child who had been hospitalized since June 15, 1978 and was still hospitalized and receiving care as of July 1, 1978.
Does the Employer’s benefit plan cover the dependent child for health benefits as of July 1, 1978, the date of the mine worker’s initial eligibility? Or does the dependent child’s eligibility begin after that episode of illness is ended?
Answer: The dependent child’s eligibility for health benefit coverage begins as of the initial date of the participant’s eligibility, July 1, 1978. This is the practice followed by the Funds in the past and there is no provision in the current benefit plans indicating a change.