May 31, 1983 (Opinion issued in letter form; name and address deleted)
Re: Opinion of Trustees Resolution of Dispute
Case No. 81-167
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 hospitalization for oral surgery under the Employer’s Benefit Plan.
Under Article III. A. (1)(g) of your Employer’s Benefit Plan, benefits are provided for hospitalization for dental procedures only if the hospitalization is necessary due to a preexisting medical condition and prior approval is received from the Plan Administrator. Because our medical staff has determined that your hospitalization was not necessary due to a preexisting medical condition and prior approval was not obtained from your Plan Administrator, your Employer is not responsible for payment of charges for your hospitalization for dental procedures.
Harrison Combs, Chairman John J. O’Connell, Trustee Paul R. Dean, Trustee