Index

About Disability

Eligibility and Enrollment

Short-Term Disability Benefits

Long-Term Disability Benefits

Short and Long-Term Disability Benefits Disqualification

Pregnancy / Childbirth

Rehabilitation Program

Administrative and ERISA Information
- Basic Plan Information
- Benefit Claims
- Filing a Mandatory Appeal
- Statue of Limitations
- Filing a Voluntary Appeal and Statue of Limitations
- No Implied Promises
- If the Plan is Amended or Terminated
- Your Rights Under ERISA

Key Terms

Administrative and ERISA Information

Q. What other information do I need to know about the Plan?

A. This section contains technical information about the Plan and identifies its administrator. It also contains a summary of your rights with respect to the Plan and instructions about how you can submit an appeal if your claim for benefits is denied.

The formal name of the Plan is the ExxonMobil Disability Plan.

Plan Sponsor and Participating Affiliates

The Plan is sponsored by:

Exxon Mobil Corporation
5959 Las Colinas Boulevard
Irving, Texas 75039-2298

All of Exxon Mobil Corporation's divisions and most of the major U.S. affiliates participate in the ExxonMobil Disability Plan. A complete list of participating affiliates is available from the Administrator-Benefits upon written request. 

Certain employees covered by collective bargaining agreements as well as employees of Station Operators Inc., dba ExxonMobil CORS do not participate in the plan.

Basic Plan Information

Plan Administrator
The Plan Administrator for the ExxonMobil Disability Plan is the Administrator-Benefits. The Administrator-Benefits is the Manager-Global Benefits Design, Exxon Mobil Corporation. You may contact the Administrator-Benefits as follows:

Type of Plan
The ExxonMobil Disability Plan is a welfare plan providing disability benefits. The trustee of the assets of this fund is Bank of New York, 1 Wall Street, New York, New York 10286.

Plan Numbers
The Plan is identified with government agencies under these numbers: the Employer Identification Number 13-5409005, the Plan Number 559.

Plan Year
The Plan year is the calendar year.

Plan Funding
Benefits are funded through employer contributions.

Benefit Claims

All benefit claims must be filed within one year of the date of loss. A claim must be filed in writing to your human resources contact for short-term disability benefits or LINA long-term disability benefits. Your employer or LINA is responsible for determining and informing you of your entitlement to a benefit and any amount payable to you under the Plan.

For long-term disability benefits:

LINA
Gateway View Plaza
1600 West Carson Street
Suite #300
Pittsburgh, PA 15219

LINA will review your claim and respond to you within a reasonable period of time, normally within 45 days after receiving your claim. If your claim is denied completely or partially, you or your beneficiary will receive written notice of the decision. The notice will describe:

• The specific reasons for the denial,
• Any additional information or material that is needed to validate the claim and the reason that information is required, and
• The process for requesting an appeal.

If LINA needs additional time to decide on your claim because of special circumstances, you will be notified within the 45-day period. You will receive a response no later than 75 days after your claim was initially received.

Filing a Mandatory Appeal

If your claim is denied, you, your beneficiary or your designated representative may appeal the denial of long-term benefits to LINA, and appeal the denial of short-term disability benefits to the Administrator-Benefits. The written appeal should include the reasons why you believe the benefit should be paid and information that supports, or is relevant to, your claim (written comments, documents, records, etc). The written appeal may also include a request for reasonable access to, and copies of, all documents, records and other information relevant to your claim. Your written appeal should be made within 180 days after you receive any denial notice. The review will take into account all comments, documents, records and other information submitted relating to the claim, without regard to whether such information was submitted or considered in the initial benefit determination. You  will receive a response to the appeal within 45 days.

If additional time is needed to decide your claim because of special circumstances, you will be notified within the 45-day claim response period. Although, an extension may be requested the law stipulates that no additional time must be allowed.

If the appeal is denied, you will receive written notice of the decision. The notice will set forth:

• The specific reason(s) for the denial and the Plan provisions upon which the denial is based.
• A statement that you are entitled to receive, upon request and free of charge, reasonable access to, and copies of, all documents, records and other information relevant to the claim.
• A statement of the voluntary appeal procedure and your right to obtain information about such procedure or a description of the voluntary appeal procedure.
• A statement of your right to bring an action under section 502(a) of the Employee Retirement Income Security Act (ERISA).

Statute of Limitations

After you have received the response to the mandatory appeal, you may bring an action under section 502(a) of ERISA. Such action must be filed within one year of the date on which your mandatory appeal was decided.

Filing a Voluntary Appeal

If your appeal is denied, you may submit a voluntary appeal to the Administrator-Benefits. New information pertinent to the claim is required for the voluntary appeal to be considered. You must submit your voluntary appeal within 30 days of the denial of your mandatory appeal. The statute of limitations or other defense based on timeliness is suspended during the time that a voluntary appeal is pending.

You will be notified within 15 days after your request was received that such information was considered or is not pertinent. If it is determined that there is new relevant information, a decision will be made within 60 days after the Administrator-Benefits receives your request for a voluntary appeal. If it is determined that there is no new information pertinent to your claim, your voluntary appeal will not be considered.

No Implied Promises

Nothing in this SPD says or implies that participation in the ExxonMobil Disability Plan is a guarantee of continued employment.

If the Plan is Amended or Terminated

The company reserves the right at any time and for any reason to terminate, suspend, withdraw, amend or modify the Plan or any of its provisions. Any benefit to which you are entitled at the time of termination will be provided. If any material changes are made in the future, you will be notified.

Your Rights Under ERISA

As a participant in the Plan, you have certain rights and protections under the Employee Retirement Income Security Act of 1974 (ERISA). ERISA provides that as a plan participant, you shall be entitled to:

Receive Information About Your Plan And Benefits

• Examine, without charge, at the office of the Administrator-Benefits and at other specified locations, such as worksites and union halls, all documents governing the Plan, including collective bargaining agreements, and a copy of the latest annual report (Form 5500 Series) filed by the Plan with the U.S. Department of Labor and available at the Public Disclosure Room of the Employee Benefits Security Administration.
• Obtain, upon written request to the Administrator-Benefits, copies of documents governing the operation of the Plan, including collective bargaining agreements, and copies of the latest annual report (Form 5500 Series) and updated summary plan description. The Administrator-Benefits may require a reasonable charge for the copies.
• Receive a summary of plan's annual financial report. The Administrator-Benefits is required by law to furnish each participant with a copy of this summary annual report.

Prudent Actions By Medical Plan Fiduciaries
In addition to creating rights for plan participants, ERISA imposes duties upon the people who are responsible for the operation of the employee benefit plan. The people who operate the Plan have a duty to do so prudently and in the interest of you and other plan participants and beneficiaries. No one, including your employer, your union, or any other person, may fire you or otherwise discriminate against you in any way to prevent you from obtaining a plan benefit or exercising your rights under ERISA.

Enforce Your Rights

• If your claim for a benefit is denied or ignored, in whole or in part, you have a right to know why this was done, to obtain copies of documents relating to the decision without charge, and to appeal any denial, all within certain time schedules.
• Under ERISA, there are steps you can take to enforce the above rights. For instance, if you request a copy of plan documents or the latest summary annual report from the Plan and do not receive them within 30 days, you may file suit in a Federal court. In such a case, the court may require the Administrator-Benefits to provide the materials and pay you up to $110 a day until you receive the materials, unless the materials were not sent because of reasons beyond the control of the Administrator-Benefits.
• If you have a claim and an appeal for benefits, which are denied or ignored, in whole or in part, you may file suit in Federal court. If it should happen that plan fiduciaries misuse the Plan's money, or if you are discriminated against for asserting your rights, you may seek assistance from the U.S. Department of Labor, or you may file suit in a Federal court. The court will decide who should pay court costs and legal fees. If you are successful, the court may order the person you have sued to pay these costs and fees. If you lose, the court may order you to pay these costs and fees, for example, if it finds your claim is frivolous.

Assistance with Your Questions
If you have any questions about the Plan, you should contact Benefits Administration. If you have any questions about this statement or about your rights under ERISA, or if you need assistance in obtaining documents from the Administrator-Benefits, you should contact the nearest office of the Employee Benefits Security Administration, U.S. Department of Labor, listed in your telephone directory or the Division of Technical Assistance and Inquiries, Employee Benefits Security Administration, U.S. Department of Labor, 200 Constitution Avenue N.W., Washington, D.C. 20210. You may also obtain certain publications about your rights and responsibilities under ERISA by calling the publications hotline of the Employee Benefits Security Administration.