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OPINION OF TRUSTEES
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In Re
Complainant: Employee
Respondent: Employer B
ROD Case No: 81-338 October 25, 1983
Board of Trustees: Harrison Combs, Chairman; John J. O’Connell, Trustee; Paul R. Dean, Trustee.
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 the facts and circumstances of this dispute concerning the period of health benefits coverage which the Employee is to be provided by the Employer under the terms of the Employer’s Benefit Plan and hereby render their opinion on the matter.
Background Facts
The Complainant performed classified work for Employer A from March 1980 to September 1981, when he was offered and accepted a classified job with the Respondent, Employer B.
Employer A reported 998 hours worked for the Complainant during the period January 1981 through September 1985 and the Respondent reported 1,674 hours worked from October 1, 1981 to the Complainant’s layoff in December 1982.
The Respondent provided benefits coverage for the Complainant and his dependents through June 1983.
Dispute
Is the Respondent responsible for the provision of benefits coverage for the Complainant beyond June 30, 1983.?
Position of the Parties
Position of the Complainant: The Respondent is responsible to provide the Complainant with benefits coverage based on his total hours worked, including the hours worked for Employer A, during the 24 consecutive calendar month period immediately prior to his date last worked.
Position of the Respondent: The Complainant was provided benefits coverage for the balance of the month from his date last worked plus 6 months based on his more than 500, but less than 2,000, hours worked during the period September 1981 to December 1982.
Pertinent Provisions
Article I. (1),(2) and (4) of the Employer’s Benefit Plan provides:
Article I – Definitions
The following terms shall have the meanings herein set forth:
(1) “Employer” means (coal company)
(2) “Wage Agreement” means the National Bituminous Coal Wage Agreement of 1981, 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’s Benefit Plan provides:
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), (e), and (f) of the Employer’s 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:
Numbers of Hours Worked for the
Employer in the 24 Consecutive
Calendar Month Period Immediately
Prior to the Employee’s Date Last Period of Coverage Continuation
Worked from the Date Last Worked
2,000 or more hours Balance of month plus 12 months
500 or more but less than
2,000 hours Balance of month plus 6 months
Less than 500 hours 30 days
(e) Quit or Discharge
If an Employee quits or is discharged, health, life and accidental death and dismemberment insurance coverage will terminate as of the date last worked.
(f) Other Employment
Notwithstanding the foregoing, in the event an Employee accepts employment during a period of continued coverage under paragraph (a), health, life and accidental death and dismemberment insurance coverage will terminate as of the date of such employment. If, however, such employment subsequently terminates prior to the dare the Employee’s coverage under paragraph (a) otherwise terminates, such Employee’s health, life and accidental death and dismemberment insurance coverage will be reinstated following the later of (i) termination of such employment or (ii) any continued health coverage resulting therefrom, and will continue to the date such coverage under paragraph (a) would have otherwise terminated. It is the obligation of the Employee to notify the Employer within 10 days by certified mail of both the acceptance and. termination of such employment; failure to provide such notice will result in permanent termination of coverage. Nothing in this paragraph shall extend coverage beyond the date determined pursuant to paragraph (a).
Discussion
Article III.D. (1)(e) provides that health, life and accidental death and dismemberment insurance coverage of an Employee who quits his employment terminates as of the date he last worked for the Employer. Therefore, Employer A was not responsible to provide benefits coverage after the date the Complainant quit his employment to accept work with the Respondent.
Article III.D.(1)(a) provides that a laid-off Employee’s continuation of coverage is determined by the number of hours he had worked for the Employer during the 24 consecutive calendar month period immediately prior to his date last worked, The Respondent provided the Complainant with continuation of coverage to the end of the month from his date last worked plus 6 months, based on his 1,674,hours worked for the Respondent.
Article III.D.(1)(f) does not apply to the Complainant since he did not accept employment with Respondent during a period of continued coverage.
Inasmuch as there is no provision in the Employer’s Benefit Plan that a laid-off Employee’s last Employer must provide continuation of coverage for the Employee based on hours worked for another Employer, the Respondent is not responsible for the provision of benefits coverage for the Complainant beyond June 30, 1983.
Opinion of Trustees
The Trustees are of the opinion that the Respondent is not responsible for the provision of benefits coverage for the Complainant beyond June 30, 1983.