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受托人的意见
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在再保险
原告: 养老金领取者
被申请人: 雇主
ROD案例编号: 84-443 – 1987年12月17日
Board of Trustees: Joseph P. 康纳斯,老., Chairman; Paul R. Dean,受托人; William B. Jordan,受托人; William Miller,受托人; Donald E. 皮尔斯,小.,受托人.
根据美国煤矿工人联合会(“UMWA”)1950年福利计划和信托的第九条, and under the authority of an exemption granted by the United States Department of Labor, 受托人审查了有关根据雇主福利计划条款向养恤金领取者提供健康福利的争议的事实和情况.
背景事实
投诉人最后一次在煤炭行业工作是在7月12日被投诉人工作, 1985. 8月22日, 1985, the Complainant was awarded a 1974年退休金计划 Age 55 retirement pension, 8月1日生效, 1985. The Complainant was advised by letter to contact his last signatory employer, 被申请人, regarding his eligibility for health benefits coverage as a 养老金领取者. The Respondent was provided a copy of that letter.
投诉人的代表表示，由于被投诉人是投诉人的最后签字雇主, 被投诉人负责向投诉人提供作为养恤金领取者的健康福利.
The Respondent has refused to provide health benefits coverage for the Complainant. 被投诉人声称投诉人受雇于被投诉人大约一个月，之后受雇于Durham的ello- teer, 北卡罗莱纳, a road construction company. In addition, 被申请人 states that it has ceased operations.
争端
被投诉人是否负责为投诉人提供作为养恤金领取者的健康福利.
Positions of the Parties
投诉人的立场:被投诉人负责为投诉人提供作为养老金领取者的健康福利.
Position of 被申请人: The Complainant was employed with 被申请人 for approximately one month and thereafter was employed elsewhere; therefore, 被申请人 is not responsible for providing the Complainant’s health benefits coverage. In addition, 被申请人 indicates that it has ceased operations.
相关的规定
1984年《皇冠搏彩中心网站》第20 (c)(3)(i)条有关部分规定:
(3)(i)各签署雇主应建立并维持员工福利计划，以提供, implemented through an insurance carrier(s), 本协议所涵盖的雇员以及领取养老金者的健康和其他非养老金福利, under the 1974 Pension Plan and Trust, whose last signatory classified employment was with such 雇主. 雇主根据该等计划向其合格参与人提供的福利应在本协议有效期内由该雇主按该等计划规定的水平予以保证.
Article I (1); (2) and (5) of the 雇主 Benefit Plan provide:
第一条-定义
The following terms shall have the meanings herein set forth:
(1) “雇主” means (雇主’s Name).
(2) “Wage Agreement” means the National Bituminous Coal Wage Agreement of 1984, as amended from time to time and any successor agreement.
(5) “养老金领取者” shall mean any person who is receiving a pension, other than (i) a deferred vested pension based on less than 20 years of credited service, 或(ii)全部或部分根据1974年养恤金计划第ii G条的规定记入的服务年数的养恤金, or any corresponding paragraph of any successor thereto, under the 1974 Pension Plan (or any successor thereto), whose last classified signatory employment was with the 雇主, subject to the provisions of 第二条乙 of this Plan.
第二条乙. (1) and (4) of the 雇主 Benefit Plan provide:
第二条-资格
The persons eligible to receive health benefits pursuant to Article III are as follows:
B. 养老金领取者
根据本办法第三条向养恤金领取人提供的健康津贴和人寿保险如下:
(1) Any 养老金领取者 who is not again employed in classified signatory employment subsequent to
(a) such 养老金领取者’s initial date of retirement under the 1974 Pension Plan, and
(b) 10月1日, 1984, shall be eligible for coverage as a 养老金领取者 under, and subject to all other provisions of this Plan. Notwithstanding (i) and (ii) of the definition of 养老金领取者 in Article I (5) of this Plan, 在12月5日符合1974年福利计划下领取养老金资格的任何此类养老金领取者, 1977, shall be eligible for such benefits, subject to all other provisions of this Plan.
(4) 在养恤金领取者以每月至少相当于500美元的工资率受雇的任何月份，不得提供健康福利.
讨论
1984年《皇冠搏彩中心》第XX(c)(3)(i)条要求签署雇主建立并维持雇主福利计划，为最后签署者分类就业于该雇主的养恤金领取者提供健康和其他非养恤金福利. 工资协议规定，在本协议有效期内，雇主根据该计划提供的福利应按该计划规定的水平得到保证.
第二条乙. (1)雇主福利计划规定，根据1974年养老金计划领取养老金的个人, 但以少于二十(20)年的累计服务年限为基础的递延既得退休金或根据第II(6)条记入的全部或部分累计服务年限为基础的退休金除外. of the 1974 Plan, is eligible for health benefits coverage under the 雇主 Benefit Plan. 第二条乙. 《皇冠搏彩中心》第(4)条规定，在养恤金领取者定期受雇且每月收入至少相当于$500的任何月内，不得提供健康福利. Inasmuch as the Complainant was awarded a UMWA 1974 Pension
Plan Age 55 retirement pension 8月1日生效, 1985, 申诉人符合第II条B (I)款的资格要求，有权获得其最后一个签字雇主提供的健康福利, subject to the earnings limitation set forth in 第二条乙. (4). 尽管被投诉人声称投诉人在被投诉人雇佣后受雇于另一家公司, such employment was with a road construction company, 达勒姆的尼罗·提尔, 北卡罗莱纳. 相应的, 投诉人在该雇佣过程中履行的任何职责不得视为签约雇主的机密工作. 因此, 被投诉人是投诉人为其执行机密工作的最后一个签字雇主.
被投诉人还声称，它不负责为申诉人提供医疗保险，因为申诉人只受雇于被投诉人一个月. This claim notwithstanding, Funds’ records indicate that the Complainant was employed by 被申请人 from September 11, 1984年至7月12日, 1985. 此外, under the terms of the 雇主 Benefit Plan, 雇主为其退休人员提供福利的义务并不取决于任何最低服务年限要求. Inasmuch as the Complainant meets the eligibility requirements of 第二条乙. (1)计划, he is entitled to health benefits coverage from his last signatory 雇主, 被申请人, subject to the earnings limitation set forth in 第二条乙. (4)规划.
被投诉人声称已停止经营，但这并不能解除其根据《皇冠搏彩中心》提供健康福利的义务. 只有在确定其最后签署雇主“不再营业”的情况下，领取退休金者才有资格享受1974年福利计划及信托的保障.“这种决定是由受托人根据既定程序作出的，与ROD程序分开.
受托人的意见
被投诉人负责为投诉人作为养恤金领取者提供医疗保险, 8月1日生效, 1985, consistent with the 雇主 Benefit Plan, including the earnings limitation set forth in 第二条乙. 计划的详情.