July 27, 1982
(Opinion issued in letter form; name and address deleted)
Re: Opinion of Trustees
Resolution of Dispute
Case No. 81-80
Pursuant to Article IX of the United Mine Workers of America 1950 Benefit Plan and Trust, and under the authority of an exemption granted by the United States Department of labor, the Trustees have reviewed your Request for Advisory Opinion concerning coverage of your dependent’s oral surgery under your Employer’s Benefit Plan.
Under Article III. A. (1) (g) of the Employer’s Benefit Plan, as amended June 7, 1981, benefits are provided for hospitalization for dental procedures only if the hospitalization is necessary due to a pre-existing medical condition and prior approval is received from the Plan Administrator. Because prior approval was not obtained from your Plan Administrator, your Employer is not responsible for payment of charges for your dependent’s hospitalization for oral surgery.
Sincerely,
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Harrison Combs, Chairman
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John J. O’Connell, Trustee
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Paul R. Dean, Trustee