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OPINION OF TRUSTEES
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In Re
Complainants: Laid-off and Disabled Employees
Respondent: Employer
ROD Case No: 84-515 – January 19, 1988
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 health benefits coverage under the terms of the Employer Benefit Plan.
Background Facts
Eleven of the Complainants were employed in classified jobs for the Respondent until they were
laid off on February 16, 1987, or on September 14, 1987, when the Respondent ceased
operations. Three of the Complainants ceased work in classified jobs for the Respondent because
of disability. The representative for the Complainants states that the Respondent has not paid the
insurance premiums for the Complainants’ health benefits coverage since January 1987. He
contends that the Complainants are entitled to health benefits coverage as active, laid-off, and
disabled Employees beyond January 31, 1987 during their individual periods of eligibility.
The Respondent states that it has paid the insurance premiums for the Complainants’ health
benefits coverage through March 31, 1987. The Respondent also states that it intends to pay the
Complainants’ outstanding medical bills as soon as it is financially able to do so.
Dispute
Whether the Respondent is responsible for providing health benefits coverage for the
Complainants as active, laid-off, and disabled Employees.
Positions of the Parties
Position of the Complainants: The Respondent is responsible for providing health benefits
coverage for the Complainants as active, laid-off, and disabled Employees.
Position of the Respondent: The Respondent has been financially unable to provide health
benefits coverage for the Complainants; however, the Respondent intends to pay the
Complainants’ outstanding medical bills as soon as it is financially able to do so.
Opinion of Trustees
Resolution of Dispute
Case No. 84-515
Page 2
Pertinent Provisions
Article XX Section (c)(3)(i) of the National Bituminous Coal Wage Agreement of 1984 provides
in pertinent part:
(c) 1974 Plans and Trusts
(3)(i) Each signatory Employer shall establish and maintain an Employee benefit
plan to provide, implemented through an insurance carrier(s), 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 Employer. The benefits provided by the
Employer to its eligible Participants pursuant to such plans shall be guaranteed
during the term of this Agreement by that Employer at levels set forth in such
plans.
Article I (1), (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 (Employer’s Name).
(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 II A. (4) of the Employer Benefit Plan provides:
Article II – Eligibility
The persons eligible to receive the health benefits pursuant to Article III are as follows:
A. Active Employees
(4) A new Employee will be eligible for health benefits from the first day
worked with the Employer.
Article III D. (1) (a) and (b) of the Employer Benefit Plan provides:
Opinion of Trustees
Resolution of Dispute
Case No. 84-515
Page 3
Article III – Benefits
D. General Provisions
(1) Continuation of Coverage
(a) Layoff
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
12 months
500 or more but less than Balance of month plus
2,000 hours 6 months
Less than 500 hours 30 days
(b) Disability
Except as otherwise provided in Article II, section C, if an
Employee ceases work because of disability, the Employee will be eligible
to continue health, life and accidental death and dismemberment coverage
while disabled for the greater of (i) the period of eligibility for Sickness
and Accident benefits, or (ii) the period as set forth in the schedule in (a)
above.
Discussion
Article XX (c)(3)(i) of the National Bituminous Coal Wage Agreement of 1984 requires a
signatory Employer to establish and maintain an Employer Benefit Plan to provide health and
other non-pension benefits for its Employees. The Wage Agreement stipulates that benefits
provided by the Employer pursuant to such Plan shall be guaranteed during the term of the
Agreement by that Employer at levels set forth in such Plan. The Respondent’s claim that it is
financially unable to provide health benefits coverage does not relieve it of its obligation to
provide such coverage under the terms of the Wage Agreement. Article II A. of the Employer
Benefit Plan provides health benefits coverage for an active Employee working in a classified
Opinion of Trustees
Resolution of Dispute
Case No. 84-515
Page 4
job for a signatory Employer. Article II C. (3) provides health benefits coverage for a disabled
Employee who is receiving or would be eligible to receive Sickness and Accident Benefits
pursuant to the Wage Agreement. In addition, Article III D. (1)(a) provides continued benefits
coverage for a laid-off Employee for a defined period based upon the number of hours worked
for the Employer during the 24-month period immediately prior to the date last worked. Article
III D. (1)(b) provides continued benefits coverage for an Employee who ceases work because of
disability for the greater of (i) the period of eligibility for Sickness and Accident benefits, or (ii)
the period based on the number of hours worked as set forth in Article Ill D. (l)(a).
For those Complainants who were actively employed in classified positions until they were laid
off by the Respondent, the Respondent is responsible for providing health benefits coverage
through their dates last worked and through their individual periods of coverage continuation as
required under Article III. D. (1)(a). For the Complainants who ceased work because of
disability, the Respondent is responsible for providing continued health benefits coverage
through the period required under Article III. D. (1)(b).
Opinion of the Trustees
The Respondent is responsible for providing health benefits coverage for the Complainants
during their individual periods of eligibility as determined under the terms of the Employer
Benefit Plan.