OPINION OF TRUSTEES
Complainants: Laid-off Employee
ROD Case No: 84-410 – June 18, 1987
Board of Trustees: Joseph P. Connors, Sr., Chairman; Paul R. Dean, Trustee; William B. Jordan, Trustee; William Miller, Trustee; Donald E. Pierce, Jr., Trustee.
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 benefits coverage for a laid-off Employee under the terms of the Employer Benefit Plan.
The Complainant was working in a classified job for the Respondent when he was injured on April 11, 1985. As a result of his injury, he was unable to return to work and was awarded Workers Compensation. On June 6, 1986, the Complainant was provided a release from his attending physician to return to work. The Complainant’s representative has stated that the Complainant did not return to work following his release because the Respondent had no work available. The Respondent provided the Complainant with health benefits coverage until June 6, 1986, when coverage was terminated.
On August 23, 1986, the Respondent laid off the Complainant. The Complainant’s representative contends that the Respondent is responsible for providing the Complainant with continued health benefits for the balance of the month plus 12 months from the date of layoff, or through August 31, 1987.
Whether the Respondent is responsible for providing the Complainant with health benefits after June 6, 1986.
Positions of the Parties
Position of the Complainant: The Respondent is responsible for providing the complainant with continued health benefits coverage for the balance of the month plus 12 months from the date the Complainant was laid off, or through August 31, 1987.
Position of the Respondent: The Respondent has not responded to repeated correspondence by Funds staff requesting its position in this dispute.
Article I (I), (2) and (4) of the Employer Benefit Plan provide:
Article I – Definitions
The following terms shall have the meanings herein set forth:
(1) “Employer” means (name of coal company).
(2) “Wage Agreement” means the National Bituminous Coal Wage Agreement of 1984, as amended from time to time and any successor agreement.
(4) “Employee” shall mean a person working in a classified job for the Employer, eligible to receive benefits hereunder.
Article III D.(1)(a) and (d) of the Employer Benefit Plan provide:
Article III – Benefits
D. General Provisions
(1) Continuation of Coverage
If an Employee ceases work because of layoff, continuation of health, life and accidental death and dismemberment insurance coverage is as follows:
Number of Hours Worked for
the Employer in the 24
Consecutive Calendar Month
Period Immediately Prior to Period of Coverage
the Employee’s Date Continuation from the
Last Worked Date Last Worked
2,000 or more hours Balance of month plus
500 or more but less than Balance of month plus
2,000 hours 6 months
Less than 500 hours 30 days
(d) Maximum Continuation of Coverage
In no event shall any combination of the provisions of (a), (b), (c), (e) or (g) above result in continuation of coverage beyond the balance of the month plus 12 months from the date last worked.
Under Article III D.(1)(a) of the Employer Benefit Plan, the period of coverage continuation for a laid-off Employee is measured from the Employee s date last worked, not from the Employee’s date of layoff. Article III D.(1)(d) provides that such a period of coverage continuation shall not exceed the balance of the month plus 12 months from the date last worked. Inasmuch as the Complainant last worked on April 11, 1985, and was provided health benefits coverage until June 6, 1986, the Respondent has fulfilled its obligation to the Complainant as a laid-off Employee under Article III D.(1)(a) of the Plan.
Opinion of the Trustees
The Respondent is not responsible for providing the Complainant with continued health benefits coverage as a laid-off Employee beyond what has already been provided.