Barred Employee
An employee who is covered by a collective bargaining agreement except to the extent participation is provided under such agreement.

Benefit Service
Generally, all the time from the first day of employment until you leave the company's employment. Excluded are:

• Unauthorized absences;
• Leaves of absence of over 30 days (except military leaves or leave under the Federal Family and Medical Leave Act);
• Certain absences from which you do not return;
• Periods when you work as a non-regular employee, as a special agreement person, in a service station, car wash, or car-care center operations; or
• When you are covered by a contract that requires the company to contribute to a different benefit program, unless a special authorization credits the service.

Benefit Pre-Determination
The review of proposed treatment or services before the expense is incurred to determine if, and to what extent, charges will be covered by the Plan.

Care Manager
Magellan Bahavioral Health or its successor as designated by Exxon Mobil Corporation.

Case Management
Review provided by medical professionals who consult with the patient and/or care providers to determine effective, cost-efficient ways to treat illnesses and utilize plan benefits.

Change in Status
Life or work event that allows you to make changes to your elections during the plan year and outside of Annual Enrollment.

Child
A person under age 26 who is:

• A natural or legally adopted child of a regular employee or retiree;
• A grandchild, niece, nephew, cousin, or other child related by blood or marriage over whom a regular employee, retiree, or the spouse of a regular employee or retiree (separately or together) is the sole court appointed legal guardian or sole managing conservator;
• A child for whom the regular employee or retiree has assumed a legal obligation for support immediately prior to the child's adoption by the regular employee or retiree; or
• A stepchild of a regular employee or retiree.

Child does not include a foster child. 

Claims Administrator / Processor
Aetna Life Insurance Company, or affiliates, for claims other than outpatient prescription drugs, and Medco for retail and mail order of outpatient prescription drugs.

Co-Payments
Your share of medical (including out-patient prescription drugs) and mental health and chemical dependency expenses. For some services, such as hospital stays, the co-payment will be a percentage of the cost of the service once the deductible has been satisfied. For other services, such as routine office visits to a POS II provider, the co-payment will be a fixed amount. For outpatient prescription drugs there is a percentage co-payment.

Covered Medical Expense

• For treatment of injury or sickness — a medically necessary expense incurred by a covered person that is not excluded from coverage;
• For treatment of mental health or chemical dependency — a medically necessary expense that is certified in advance of actual treatment or an out-of-network inpatient treatment, that is provided according to the terms of the Plan, and that is not otherwise excluded from coverage.

Covered Person
Any person identified on the books of the employer as a regular employee, retiree, extended part-time employee, eligible family member, or survivor who:

• Complies with the established enrollment requirements and makes any required contributions;
• In the case of a retiree, family member, or survivor, is not eligible for Medicare; and
• Is not eligible for any other medical plan to which ExxonMobil contributes on their behalf.

Custodial Care
Care that helps meet personal needs and daily living activities. Such care, even if ordered by a doctor and performed by a licensed medical professional such as a nurse, is not covered by the Plan.

Deductible
The amount of covered expenses you must pay each calendar year before the Plan begins sharing the cost. Fixed amount co-payments do not apply toward this amount. Outpatient prescription drug co-payments are not subject to nor do they count toward the annual deductible. Services and supplies not provided for a fixed co-payment are subject to an annual deductible, which must be met before the Plan begins to pay.

Eligible Employees
Most U.S. dollar-paid employees of Exxon Mobil Corporation and participating affiliates are eligible. Full-time employees not hired on a temporary basis (also called "regular employees") are eligible. Extended part-time employees, as classified on the employer's books and records, are also eligible.

The following are not eligible to participate in the Plan: employees of Station Operators, Inc. (SOI), leased employees as defined in the Internal Revenue Code, barred employees, or special agreement persons as defined in the plan document. Generally, special-agreement persons are persons paid by the company on a commission basis, persons working for an unaffiliated company that provides services to the company, and persons working for the company pursuant to a contract that excludes coverage of benefits.

Eligible Family Members
Eligible family members are generally your:

Explanation of Benefits (EOB)
The summary you receive after your claim is processed. Codes referred to on the EOB are explained on the document.

Extended-Care Facility
An institution that meets the following criteria:

• Provides 24-hour skilled nursing care and related services for the rehabilitation of injured or sick persons.
• Has policies developed with the advice of and subject to the review of professional personnel to cover nursing care and related services.
• Has a physician, a registered professional nurse or a medical staff responsible for the execution of such policies.
• Requires that every patient be under the care of a physician and makes a physician available to furnish medical care in an emergency.
• Maintains clinical records on each patient and has appropriate methods for dispensing drugs and biologicals.
• Provides for periodic review by a group of physicians to examine the need for admissions, adequacy of care, duration of stay and the medical necessity of continuing confinement of patients.
• Is licensed pursuant to law or is approved by an appropriate authority as qualifying for licensing.
• Does not include a place that is primarily for custodial care.

Extended Part-time Employee
An employee who is classified as a non-regular employee but who has been designated as an Extended Part-Time employee under his or her employer's employment policies relating to flexible work arrangements.

ExxonMobil Medical Plan
The Plan sponsored by Exxon Mobil Corporation which provides medical benefits for eligible employees, retirees, survivors and their family members, and includes the POS II option (described in this SPD) and HMO options.

Hospital
An institution which:

• Is licensed as a hospital (if licensing is required);
• Is operated pursuant to law for the care and treatment of sick and injured persons;
• Provides 24-hour nursing care and has facilities both for diagnosis and surgery, except in the case of a hospital primarily concerned with the treatment of chronic diseases; and
• Is not a hotel, rest home, nursing home, convalescent home, place for custodial care, or home for the aged.

For purposes of this definition, "hospital" shall also mean, with respect to treatment of substance abuse, a treatment facility, residential facility, or a clinic licensed or approved for such treatment by the appropriate authority for the jurisdiction in which the facility or clinic is located.

Medical Necessity or Medically Necessary

• Legal;
• Ordered by a physician for medical treatment;
• Reasonably required for the treatment or management of the condition for which it is ordered; and
• Commonly and customarily prescribed by the United States medical community as treatment or management of the condition for which it is ordered.

Magellan Behavioral Health may use its guidelines in an initial determination of whether a mental health service or supply is medically necessary.

The Administrator-Benefits has the exclusive and final authority to determine if a service or supply is medically necessary.

Medical Pre-Certification
Certification obtained prior to a hospital inpatient stay (including mental health and chemical dependency) to give notice of inpatient admission and the proposed care. If pre-certification notice is not given for inpatient care, the first $500 of expenses will not be covered. Pre-certification is also required for skilled nursing care, home health care, hospice care and some durable medical equipment.

Medical POS II (Point of Service)
A network of established physicians, hospitals and other medical care providers whose credentials have been screened according to Aetna's standards and who have agreed to provide their services at negotiated rates. The Medical Plan POS II is a network specifically selected by the Plan — it is part of Aetna's Choice^® POS II. This network is referred to in this SPD as the Medical POS II.

Mental Health Condition
Neurosis, psychoneurosis, psychopathy, psychosis, or mental or emotional disease or behavioral disorder or disturbance with a diagnosis code from the American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders (4th ed. 1994) (DSM-IV), or its successor publication, and which is appropriately treated by the Mental Health Network. Such a condition will be considered a mental health condition, regardless of any organic or physical cause or contributing factor.

Mental Health Preferred Provider Organization (MHPPO)
A nationwide network of providers and facilities whose credentials have been screened by Magellan Behavioral Health and who provide treatment for mental health and chemical dependency conditions at negotiated rates.

Mental Health Provider
A person, including a psychiatrist, psychologist, psychiatric nurse or social worker, therapist, or other clinician with at least a master's degree, who provides inpatient or outpatient treatment for a mental health condition, who is licensed in the state of practice and who is acting within the scope of that license (if applicable). If the person is not subject to a licensing requirement, the person must provide treatment consistent with that which would be provided by the type of providers listed above.

Network
Providers and facilities that participate in the medical POS II network or mental health PPO network available under the POS II option.

Non-Network
Providers and facilities located in the medical POS II or mental health PPO network areas, but which do not participate in a network available under this Plan.

Nurse
A registered graduate nurse (RN), a licensed vocational nurse (LVN), or a licensed practical nurse (LPN).

Out-of-Network Area
Geographic areas that do not fall within the medical POS II or mental health PPO network.

Out-of-Pocket Limit
The amount of covered medical expenses you pay in one year before the Plan begins paying 100%. The POS II "A" and "B" options have different out-of-pocket limits. After the out-of-pocket limit is reached, the Plan pays 100% of most covered expenses for the remainder of that year. Certain expenses that you pay do not apply to the out-of-pocket limit. The annual deductible and your percentage co-payments for eligible expenses apply to the out-of-pocket limit. The following charges do not apply to the out-of-pocket limit:

• Charges above reasonable and customary limits. 
• Charges not covered by the Plan. 
• Charge of $500 for non-compliance with medical pre-admission review process. 
• Charge of $500 for failure to pre-certify inpatient non-network and out-of-network mental health or chemical dependency services. 
• Co-payments for outpatient prescription drugs. 
• Charges for a private hospital room above the cost of the hospital's most common rate for a semiprivate room.

Outpatient Prescription Drug
A prescription drug or medicine obtained through either a retail pharmacy or through a mail service prescription program (including insulin and associated diabetic supplies if acquired through a prescription). A prescription drug or medicine, including injections, obtained or administered in a physician's office or in a hospital are not considered outpatient prescription drugs.

Physician
"Physician" means a person acting within the scope of his or her license and holding the degree of Doctor of Medicine (M.D.), Doctor of Osteopathy (D.O.), Doctor of Dental Surgery (D.D.S.), Doctor of Podiatry (D.P.M.), Doctor of Optometry (O.D.), or Doctor of Chiropractic (D.C.), or who is duly licensed as an Orthoptist, a Physician Assistant or Nurse Practicioner. "Primary Care Physician" means a Physician engaged in general practice, family practice, internal medicine, pediatrics or obstetrics/gynecology who provides basic health services to covered persons.

Pre-determination
A written pre-determination request will result in a detailed response as to whether a treatment or service is covered under the Medical Plan and whether the proposed cost is within reasonable and customary limits, thus ensuring all parties are aware of the financial consequences, providing all circumstances described in the request remain unchanged. Please note that a pre-determination, either verbal or written, is not a guarantee of payment, as claims are paid based on the actual services rendered and in accordance with Plan provisions.

Primary Participant
The term primary participant refers to the participant whose identification number is used. The primary participant is the employee, retiree, survivor or an individual who elected COBRA coverage. Covered family members use the primary participant's identification number to access all medical benefits.

Qualified Medical Child Support Order
A Qualified Medical Child Support Order (QMCSO) is a court decree under which a court order mandates health coverage for a child. A QMCSO must include, at a minimum:

• Name and address of the employee covered by the health plan.
• The name and address of each child for whom coverage is mandated.
• A reasonable description for the coverage to be provided.
• The time period of coverage.
• The name of each health plan to which the order applies.

You may obtain, without charge, a copy of the Plan's procedures governing QMCSO determinations by written request to the Administrator-Benefits.

Regular Employee
Full-time employees at ExxonMobil Corporation or participating affiliates who are not hired on a temporary basis. Regular employees include employees designated by their employer as part-time regular.

Retiree
Generally, a person at least 55 years old who retires with 15 or more years of benefit plan service. Retiree status may also be attained by someone who is retired by the company and entitled to long-term disability benefits under the ExxonMobil Disability Plan after 15 or more years of benefit plan service, regardless of age.

Room and Board
Room, board, general-duty nursing and any other services regularly furnished by the hospital as a condition of being hospitalized. It does not include professional services of physicians or private-duty nursing.

Surgical Procedure
This term refers to the following:

• A cutting operation.
• Suturing a wound.
• Treating a fracture.
• Reduction of a dislocation.
• Radiotherapy (excluding radioactive isotope therapy) if used in lieu of a cutting operation for removal of a tumor.
• Electrocauterization.
• Diagnostic and therapeutic endoscopic procedures.
• Injection treatment of certain conditions.
• Laser treatments.

Note: Minor procedures such as biopsies or removal of moles or warts, even if performed in a doctor's office, are considered surgery.

Spouse; Marriage
All references to a spouse, to a married person, or to a marriage shall refer to spouses or marriages within the meaning of the federal laws of the United States.

Survivor/ Surviving Spouse
A surviving unmarried spouse or child of a deceased ExxonMobil regular employee or retiree.

Suspended Retiree
A person who becomes a retiree due to incapacity within the meaning of the ExxonMobil Disability Plan and who begins long-term disability benefits under that plan, but whose benefits stop because the person is no longer incapacitated. A person remains a suspended retiree until the earlier of the date the person:

• Reaches age 55; or
• Begins his or her benefit or receives a lump-sum settlement under the ExxonMobil Pension Plan, at which time the person is again considered a retiree.

The family members of a deceased suspended retiree will be eligible for coverage under this Plan only after the occurrence of the earlier of the following:

• The date the suspended retiree would have attained age 55; or
• The date a survivor begins receiving a benefit due to the suspended retiree's accrued benefit from the ExxonMobil Pension Plan.

Treatment of Last Resort
With respect to a covered person's specific medical condition, any hospital confinement, examination, surgical, medical or other treatment, service or supply that is not determined to be medically necessary for the treatment of such condition by virtue of being experimental or investigative, but that is authorized by the Administrator-Benefits under the following conditions:

1. the covered person's condition is life-threatening; and
2. the treatment is recommended by a treatment panel, which consists of a panel of physicians chosen by the Administrator-Benefits for purposes of reviewing potential treatments of last resort, and which makes such recommendations after considering:
   1. the scientific basis, if any, for the treatment;
   2. the prior use of appropriate treatment alternatives; and
   3. the potential efficacy of the treatment, the patient's physical condition, and the status of any government review of the treatment's use to address such condition.

   For purposes of Treatment of Last Resort, a person's condition is considered to be life-threatening if there is a reasonable likelihood that it will result in the person's death within a matter of months or it is likely premature death will occur without early treatment.

Urgent Care
Conditions or services that are non-preventative or non-routine and needed in order to prevent the serious deterioration of a person's health following an unforeseen illness, injury or condition. Urgent care includes conditions that could not be adequately managed without immediate care or treatment but do not require the level of care provided in an emergency room. Treatment of such a condition outside of an emergency room is paid according to the network status of the provider or facility. For example, out-of-network urgent care furnished by an out-of-network provider or facility is reimbursed at the out-of-network benefit level.

Year
Calendar year, January 1 through December 31.