Pretax

About Pre-Tax Spending
- Information Sources
- Introduction
- Plan at a Glance

Eligibility and Enrollment

Pre-Tax Contributions for Medical, Dental and Vision Plan Coverage

Health Care Flexible Spending Account

Dependent Care Flexible Spending Account

Claiming Reimbursement

Tax Implications

Continuation Coverage

Administrative and ERISA Information

 

ExxonMobil Pre-Tax Spending Plan SPD
Updated Through 2011

orange square About The Pre-Tax Spending Plan

This summary plan description (SPD) is a summary of the ExxonMobil Pre-Tax Spending Plan (the Plan). It does not contain all plan details. In determining specific benefits, the full provisions of the formal plan documents, as they exist now or as they may exist in the future, always govern. Copies of these documents are available for your review.

Applicability to represented employees is governed by collective bargaining agreements and any local bargaining requirements.

orange square Information Sources

When you need information, you may contact:

Claims Administrator — Provides claim payment information and claim forms.

Phone Numbers:

Address:

Aetna Member Services
800-255-2386
210-366-2416 (if international, call collect)
Monday - Friday 8:00 a.m. to 6:00 p.m.,
(U.S. Central Time), except certain holidays
Automated Voice Response - 24 hours a day, 7 days a week
Aetna
P. O. Box 14586
Lexington, KY 40512-4586

To visit Aetna's Web site: www.aetna.com

Benefits Administration — Provides opportunity for specialized assistance from Customer Service Representatives.

Employees can enroll/change benefits on the ExxonMobil Me HR Intranet site through Employee Direct Access (EDA) when a change in status occurs. Enrollment forms are also available through ExxonMobil Benefits Administration for those without access to EDA.

 

Phone Numbers:

Address:

ExxonMobil Benefits Administration/Health Plan Services
713-680-5858 (Houston)
713-680-7070 (international, call collect)
800-262-2363 (toll free outside Houston)
262-314-2752 (fax)
Monday - Friday 8:00 a.m. to 3:00 p.m.
(U.S.Central Time), except certain holidays
ExxonMobil Benefits Administration
ExxonMobil BA BSC USBA
4300 Dacoma or "BH1"
Houston, Texas 77092

ExxonMobil Sponsored Sites — Access to plan-related information for employees and their family members.

  • ExxonMobil Me, the Human Resources Intranet Site — Can be accessed at work by current employees.
  • ExxonMobil Family, the Human Resources Internet Site — Can be accessed from home at www.exxonmobilfamily.com by everyone.

orange square Introduction

The ExxonMobil Pre-Tax Spending Plan (the Plan) allows you to take advantage of significant tax savings in three ways:

  • When you elect coverage under a medical, dental and/or vision plan to which a participating ExxonMobil employer contributes, your required contributions (what you may think of as your premiums) will be on a pre-tax basis, unless you opt out of this feature every year.
  • The Health Care Flexible Spending Account allows you to set aside pre-tax money for the reimbursement of out-of-pocket medical, dental or vision expenses for both you and your family members.
  • The Dependent Care Flexible Spending Account allows you to set aside pre-tax money for the reimbursement of day care charges provided for your children under age 13 or for a disabled child or adult who lives with you and depends on you financially. This account does not cover medical or dental expenses.

You may participate in one, two or all three parts of the Plan:

  • You are enrolled to pay your contributions for medical, dental and vision plan coverage on a pre-tax basis. If you do not wish to pay your contributions on a pre-tax basis, you must opt out of this feature each year during Annual Enrollment. If you do not opt out each year, your contributions will be made on a pre-tax basis beginning the following plan year.
  • Each year, you must elect an annual amount to contribute in order to participate in the Health Care Flexible Spending Account and/or the Dependent Care Flexible Spending Account.

Your participation in the Plan does not reduce any ExxonMobil benefits related to pay (for example, Life Insurance and Savings Plan contributions).


To help you find specific plan information quickly and easily, these helpful tools are included:

  • Plan at a Glance, a quick user's guide highlighting plan basics.
  • Charts and tables throughout this SPD providing information, examples, highlights of plan provisions, etc.
  • References to places you can get more information.

A careful reading of this SPD will help you understand how the Plan works so you can make the best use of the plan provisions.

orange square Plan at a Glance

Enrolling
If you are eligible, you may participate in one, two or all three parts of the Plan. See page 4.

Pre-Tax Contributions You are enrolled to pay your contributions for medical, dental and vision plan coverage on a pre-tax basis. See page 13.

The Health Care Flexible Spending Account
You may set aside pre-tax dollars for unreimbursed, out-of-pocket medical, dental or vision expenses incurred by you and your family members during the plan year. See page 14.

The Dependent Care Flexible Spending Account
The Dependent Care Flexible Spending Account can help you pay for a family member's care expenses with pre-tax dollars if you provide day care for a qualified dependent so you, and your spouse if you are married, can work outside the home. Eligible expenses include charges for day care provided for your children under age 13 or for a disabled child or adult who lives with you and depends on you financially. See page 21.

Getting Reimbursed
You may be reimbursed automatically from the Health Care Flexible Spending Account for claims processed as a participant in the ExxonMobil Medical Plan POS II "A" or "B" option, the ExxonMobil Dental Plan and eligible claims processed by OptumHealth Vision for the ExxonMobil Vision Plan. Otherwise, you must file a claim form and attach documentation of your expenses to be reimbursed from either the Health Care or Dependent Care Flexible Spending accounts. See page 24.

Tax Implications
The Plan provides significant tax savings. Examples show how you save taxes by participating in the Plan. See page 28.

Consolidated Omnibus Budget Reconciliation Act 1985 (COBRA)
You and your family members who lose eligibility may continue pre-tax coverage for a limited time under certain circumstances. See page 31.

Administrative and ERISA Information
The Plan is subject to rules of the federal government, including the Employee Retirement Income Security Act of 1974, as amended (ERISA), not state insurance laws. See page 34.