File Download: 84-357

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OPINION OF TRUSTEES
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In Re

Complainants: Laid-off Employees
Respondent: Employer
ROD Case No: 84-357 – March 17, 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 laid-off Employees under the terms of the Employer Benefit Plan.

Background Facts

The Complainants last worked in classified positions for the Respondent on December 20, 1985. On December 20, 1985, the Respondent idled the mines where the Complainants worked. The Complainants were laid off on February 14, 1986.

The representative for the Complainants contends that the Complainants are entitled to continued health benefits coverage, effective February 14, 1986, based on their hours worked for the Respondent in the 24-month period prior to the layoff date.

The Respondent has stated that continuation of coverage for the Complainants is measured from the date last worked. Therefore, the Respondent contends that the Complainants are entitled to continued health benefits coverage from December 20, 1985, based on the number of hours each individual worked for the Respondent in the 24-month period prior to that date.

Dispute

Is the Respondent responsible for the continuation of health benefits coverage for the Complainants from the date last worked or the date of layoff?

Position of the Parties

Position of the Complainants: The Respondent is responsible for the continuation of health benefits coverage for the Complainants from the date of layoff,

Position of the Respondent: The Complainants are entitled to continuation of the health benefits coverage from the date last worked based on their hours worked for the Respondent in the 24-month period prior to the date last worked.

Pertinent Provisions

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 (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 II A. (1) and (4) of the Employer Benefit Plan provide:

Article II – Eligibility

The persons eligible to receive the health benefits pursuant to Article III are as follows:

A. Active Employees

Benefits under Article III shall be provided to any Employee who:

(1) is actively at work* for the Employer on the effective date of the Wage Agreement; or

(4) A new Employee will be eligible for health benefits from the first day worked with the Employer.

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*Actively at work includes an Employee of the Employer who was actively at work on September 30, 1984, and who returns to active work with the Employer two weeks after the effective date of the Wage Agreement.

Article III D. (I) (a) of the Employer Benefit Plan provides:

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

Discussion

Under Article III D. (I)(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. Inasmuch as the Complainants last worked for the Respondent on December 20, 1985, the Respondent is responsible for the continuation of health benefits coverage for their individual periods of eligibility from December 20, 1985, based on their hours worked for the Respondent in the 24 calendar-month period prior to December 20, 1985.

Opinion of the Trustees

The Respondent is responsible for providing continued health benefits coverage to the Complainants for their individual periods of eligibility from December 20, 1985, as determined under the terms of the Employer Benefit Plan.