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受托人的意见
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在再保险
投诉: 养老金领取者
被申请人: 雇主
ROD案例编号: 98-007 - 2001年7月10日
受托人: A. 弗兰克·邓纳姆，迈克尔·H. 霍兰德，马蒂·D. 哈德逊和
艾略特一. 西格尔.
受托人审查了有关根据雇主福利计划条款提供福利的争议的事实和情况.
背景事实
The Complainants’ last signatory 雇主 was the Respondent. 申诉人目前根据1974年养恤金计划领取特别永久裁员养恤金. 根据1998年的《皇冠搏彩中心》(《官方网站》)，引入了特别永久下岗养恤金，向被永久解雇的雇员提供养恤金福利, has at least twenty years of signatory service on his date last worked, 年龄小于55岁. In order to establish that he has been permanently laid off, the Employee must either have been laid off because the 雇主 has closed the mine, 或已被解雇至少180天且未被拒绝召回其被解雇的矿山. When a miner receiving a special permanent layoff pension attains age 55, he becomes eligible for health benefits coverage from his last signatory 雇主. The Complainants are under age 55 和, 因此, 是否还没有资格作为特殊永久下岗养恤金领取者享受健康福利.
申诉人声称，他们符合第二条丙款规定的作为残疾雇员领取健康福利的资格要求. (1) of the 1998 雇主 Benefit Plan. 根据第二条C款. (1)某些残疾雇员在年满55岁之前有资格享受健康福利.
The Respondent has denied coverage for the Complainants under 第二条丙. (一)说明投诉人接受其特殊的永久性下岗抚恤金时, the Complainants “forfeited all associated employee rights.” The Respondent argues that, 基于这个没收, the Complainants can not claim that they are Employees who are disabled. 除了, 答辩人进一步指出，“雇员和领取退休金者的地位是相互矛盾和相互排斥的.“终于, 投诉人声称，如果投诉人希望获得与雇员有关的利益, 投诉人“必须放弃领取特别永久裁员退休金的资格”。.”
争端
被投诉人是否必须根据第二条C款为投诉人提供残疾雇员的健康福利. (1)在领取1974年养老金计划下的特殊永久性下岗养老金期间?
双方立场
申诉人的立场:申诉人符合获得第二条丙款规定的健康福利的资格要求. (1); 因此, 被投诉人必须为投诉人提供残疾雇员的保险.
被投诉人的立场:投诉人不符合第II条C项下残疾雇员的保险资格. (1)因为他们“通过接受特殊永久裁员养老金而丧失了所有相关的员工权利”.” Thus, the Complainants cannot simultaneously be 养老金领取者 和 Employees. In order to receive coverage as disabled Employees, 投诉人“必须放弃领取特别永久裁员退休金的资格”。.”
相关的规定
Article XX (10)(c) of the 1998 National Bituminous Coal Wage Agreement provides:
Article XX – HEALTH AND RETIREMENT BENEFITS
(10)保健:
在本协议期限内，雇主福利计划下提供的医疗保健福利根据本协议条款在雇主福利计划中提供的福利水平上得到保证.
(c) 养老金领取者 receiving a Special Permanent 裁员 Pension will be provided health benefits from their 雇主s in accordance with the layoff benefits otherwise provided under this Wage Agreement; subsequently, 55岁时, such pensioners shall receive health benefits from their 雇主s.
Article XX (7)(e) of the 1998 National Bituminous Coal Wage Agreement provides:
(e) Special Permanent 裁员 Pension – If on or after January 1, 1998, a working miner ceases performing classified work 和 meet the following criteria:
(i) he had 20 years of signatory service on his date last worked 和 was less than age 55; 和
(ii)(A)在其雇主永久关闭矿山的情况下，他被永久解雇, or
(B) he has been permanently laid off;
然后，矿工将有资格获得根据上述第(3)条计算的养老金, calculated as if he were then age 55. In the case of a layoff described in (ii)(A) above, 养老金将在被解雇和提出养老金申请后的第一个月的第一天生效. In the case of a layoff described in (ii)(B) above, 养老金将在被解雇后180天的第一个月的第一天生效，并提出养老金申请. 如果矿工处于裁员状态至少180天，则根据(ii)(B)被视为“永久裁员”, 和 has not refused a recall to the mine from which he was laid off. A miner who receives this special permanent layoff pension benefit, or any other pension benefit under this Article, 丧失所有资历, 面板, 以及召回权.
Article I (2), (4) 和 (5) of the 1998 雇主 Benefit Plan provides:
第一条定义
The following terms shall have the meanings herein set forth:
(2) “Wage Agreement” means the National Bituminous Coal Wage Agreement of 1998, as amended from time to time 和 any successor agreement.
(4) “Employee” shall mean a person working in a classified job for the 雇主, eligible to receive benefits hereunder.
(5) “Pensioner” shall mean any person who is receiving a pension, 除了(i)根据少于20年的记帐服务领取的递延既得退休金, (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 Article II B of this Plan; or (iii) a special permanent layoff pension under the terms of Article II. E(4) of the 1974 Plan, during any period prior to the person’s attainment of age 55. “养老金领取者”不指根据1986年《皇冠搏彩中心》第9711条享有福利的任何个人, as amended by the Coal Industry Retiree Health Benefit Act of 1992.
第二条丙. (1) of the 1998 雇主 Benefit Plan provides:
第2条资格
C. 残疾员工
此外，正在领取养恤金并因此有权根据本条B节领取健康福利的残疾养恤金领取人, health benefits under Article III shall also be provided to any Employee who:
(1)(a) has completed 20 years of credited service, 包括根据1974年养恤金计划第IV C(6)条或其任何后继条款的任何相应条款规定的签署人服务年数, 和
(b) has not attained age 55, 和
(c) 1974年12月6日以后在雇主的分类雇佣中致残，并且
(d) 符合领取《皇冠搏彩中心》第二章或其后续章节规定的社会保障残疾保险福利的资格;
第三条D. (1)(a) of the 1998 雇主 Benefit Plan provides:
第三条福利待遇
D. 一般规定
1. 续保
(a) 裁员
If any Employee ceases work because of layoff, 健康的延续, life 和 accidental death 和 dismemberment insurance coverage is as follows:
工作时数
为雇主在24
连续日历月
紧接之前的期间 保险期限
致雇员 继续
最近工作日期 最近工作日期
2000小时以上 Balance of month plus 12 months
500 or more but less 2,000 hours Balance of month plus 6 months
少于500小时 30天
受托人的意见
The Trustees deadlocked on this matter. Trustees Holl和 和 Hudson found for the Complainants. Trustees Dunham 和 西格尔 found for the Respondent. Under the ROD procedures adopted pursuant to the 1998 NBCWA, the matter was referred to a neutral interest arbitrator, 托马斯Tomczyk, 解决. 指示仲裁员从受托人提出的两份意见草案中选择一份. The arbitrator’s choice is printed below as the opinion of the Trustees.
Decision of the Arbitrator
雇主不需要根据雇主福利计划为申诉人作为残疾雇员继续提供医疗保险. 投诉人在年满55岁时将有资格获得雇主提供的保险.