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Uthell v. Mid-Illinois Concrete

December 11, 2006

LORETTA UTHELL, INDIVIDUALLY, AND, LORETTA UTHELL, AS ADMINISTRATOR OF THE ESTATE OF MELVIN H. UTHELL, DECEASED, PLAINTIFFS,
v.
MID-ILLINOIS CONCRETE, INC., AN ILLINOIS CORPORATION AND SOUTHERN ILLINOIS LABORERS' & EMPLOYERS' HEALTH AND WELFARE FUND, DEFENDANTS.



The opinion of the court was delivered by: Foreman, District Judge

MEMORANDUM AND ORDER

Before the Court are the parties' cross-motions for summary judgment, (Docs. 36,39,40), and responses (Docs. 43,44,45, and 48). These motions are discussed below.

I. Background

The following facts are undisputed. Plaintiffs' decedent, Melvin H. Uthell, was a ready-mix concrete truck driver for his employer, defendant Mid-Illinois Concrete, Inc. (MIC). On July 25, 2003, MIC recognized the Laborers International Union of North America as the exclusive bargaining representative of a unit of employees (Doc. 37, ¶3).

On August 1, 2003, MIC and the Laborers Union entered into a collective bargaining agreement (Doc. 37, ¶3). Under this agreement, Mid-Illinois Concrete agreed to participate in the Southern Illinois Laborers' and Employers' Health and Welfare Fund (The Fund) (Doc. 37, ¶3) as follows:

The Company [MIC] agrees to participate in Plan A of the Southern Illinois Laborers Health and Welfare Fund for its full time employees who have completed their probationary period. The Company will pay for seventy-four percent (74%) of single coverage for all employees who are eligible for such coverage and will pay for sixty-eight percent (68%) of the cost for family coverage, with the employee contributing the differential, which amount shall be deducted from the employee's weekly paycheck. The Company's contributions for health insurance will cease immediately upon an employee's termination of employment or, in the case of layoff or a leave of absence for any reason, the month following a month in which the employee has not performed any work. In the event of any increase in the current stated premiums for Plan A, the parties agree to reopen this agreement solely for the purpose of negotiating insurance. (Doc. 36, Exh. 1, p.8, Art. XII).

The Fund is a health and welfare fund that provides payments for medical claims and is required to be maintained and administered in accordance with the provisions of the Labor Management Relations Act of 1947 and the Employee Retirement Income Security Act of 1974, 29 U.S.C. § 1002(1), (ERISA). Mr. Uthell was a member of the bargaining unit covered by the collective bargaining agreement.

MIC became a signatory to a Participation Agreement with The Fund effective September 1, 2003 (Doc. 37, ¶6). Also on September 1, 2003, Mid Illinois Concrete began making monthly contributions to The Fund, thereby making its employees eligible for coverage effective October 1, 2003 (Doc. 37, ¶9). Prior to October 1, 2003, MIC employees were covered by Blue Cross and Blue Shield health insurance. The terms of eligibility, coverage and benefits available to Mr. Uthell under Blue Cross and Blue Shield differed significantly from those under The Fund's plan (Doc. 37, ¶¶7,8).

On or before August 1, 2003, Melvin H. Uthell, developed terminal cancer. He worked for MIC through August 5, 2003, after which his poor health rendered him unable to work and he took a leave of absence (Doc. 37, ¶11). On November 21, 2003, Mr. Uthell returned to work for an 8 1/2 hour shift to "help out during deer season." (Doc. 40, p.2).

Although Mr. Uthell stopped working on August 6, 2003, and returned one day in November, 2003, MIC continued to report to The Fund that Mr. Uthell was an active full time-employee until April 2004 (Doc. 37, ¶14). Also during this period, MIC continued to remit monthly active employee premiums to The Fund on Mr. Uthell's behalf (Doc. 37, ¶14).

MIC had a policy, (although it was not so obligated), that it would continue to pay its share of an employee's health care premium for sixteen (16) weeks after that employee ceased active employment (Doc. 39, p.8). On January 13, 2004, MIC sent Mr. Uthell a letter advising him that his sixteen-week period was about to expire and that he would be responsible for paying the entire premium himself (Doc. 39, p.8). This letter stated:

Dear Melvin[,]

You have already or will shortly exceed sixteen weeks of layoff or absence since October. According to the company benefits policy, the employee becomes responsible for all insurance costs for weeks in excess of sixteen during the fifty-two week period from October 1st through September 30th.

Your weekly cost of insurance, when the company no longer contributes will be $171.70 per week. Please make arrangements for payment by sending a check weekly or having a greater amount withheld when you are on low earnings.

Thank you for your attention to this matter.

Sincerely,

Marlys Thomas (Doc. 36, Exh. 5).

Mr. Uthell advised MIC that he wanted to continue his coverage, and thereafter, he began sending the entire premium to MIC (Doc. 39, p.8). MIC then forwarded his premium to The Fund monthly (Doc. 39, p.8).

Shortly thereafter, Mr. Uthell asked MIC how much his premium would be if he changed from "family" to "single" coverage (Doc. 39, p.8). On January 29, 2004, MIC sent Mr. Uthell a letter advising him of the cost for single coverage (Doc. 39, p.8). This January 29, 2004 letter stated:

Dear Melvin,

You have already or will shortly exceed sixteen weeks of layoff or absence since October. According to the company benefits policy, the employee becomes responsible for all insurance costs for weeks in excess of sixteen during the ...


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