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Administrative and ERISA Information
- Basic Plan Information
- No Implied Promises
- Future of the Plan
- Your Rights Under ERISA
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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 Pre-Tax Spending Plan.
Plan Sponsor and Participating Affiliates
The ExxonMobil Pre-Tax Spending
Plan is sponsored by:
Exxon Mobil Corporation
5959 Las Colinas Boulevard
Irving, TX 75039-2298
All of Exxon Mobil Corporation's divisions and most of
the major U.S. affiliates participate in the ExxonMobil Pre-Tax Spending
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 Pre-Tax
Spending 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:
Administrator-Benefits
ExxonMobil Pre-Tax Spending Plan
P.O. Box 2283
Houston, TX 77252-2283
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For service of legal process:
Administrator-Benefits
ExxonMobil Pre-Tax Plan
4550 Dacoma
Houston, TX 77092
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Type of Plan
The Health Care Flexible Spending Account component of the ExxonMobil
Pre-Tax Spending Plan, a cafeteria plan under IRC Section 125, is a
welfare plan under ERISA.
Claims Administrator
The claims administrator provides information about claims payment. The
claims administrator is Aetna for HCFSA and DCFSA.
Claims Fiduciary and Appeals
The claims fiduciary is the person to whom all appeals are filed. The
claims fiduciary is Aetna for HCFSA. The Administrator-Benefits is the
claims fiduciary for the DCFSA and eligibility. You may contact the
claims fiduciary as follows:
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HCFSA Appeals:
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Voluntary HCFSA, DCFSA and Eligibility Appeals:
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Aetna
P. O. Box 14463
Lexington, KY 40512-4463 |
Administrator-Benefits
ExxonMobil Pre-Tax Spending Plan
P.O. Box 2283 Houston
Texas 77252-2283 |
Plan Numbers
The ExxonMobil Pre-Tax Spending Plan is identified with government agencies under
two numbers: the Employer Identification Number, 13-5409005, and the Plan Number (PN), 601.
Plan Year
The plan year is January 1 through December 31.
No Implied Promises
Nothing in this SPD says or implies that participation in the ExxonMobil
Pre-Tax Spending Plan is a guarantee of continued employment with the company.
Future of the Plan
ExxonMobil has the right
to change, suspend, withdraw, amend, modify or terminate the Plan or any of its provisions
at any time and for any reason. A change also may be made to required contributions and future
eligibility for coverage, and may apply to those who retired in the past, as well as those who
retire in the future. If any material changes are made in the future, you will be notified.
For health plans, certain rules apply regarding what happens when a plan is changed, terminated
or merged.
Expenses incurred before the effective date of a plan change or termination
will not be affected. Expenses incurred after a plan is terminated will not be covered. If a
plan cannot pay all of the incurred claims and plan expenses as of the date the Plan is changed
or terminated, ExxonMobil will make sufficient contributions to the Plan to make up the difference.
Your Rights Under ERISA
As a participant in the ExxonMobil Pre-Tax Spending 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 Pre-Tax Spending Plan, including collective bargaining agreements, and a copy of the
latest annual report (Form 5500 Series) filed by the Pre-Tax Spending 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 Pre-Tax Spending Plan, including collective bargaining agreements, and copies of the latest annual report (Form 5500 Series) and updated summary plan description. The administrator may require a reasonable charge for the copies.
- Receive a summary of the Pre-Tax Spending 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 Pre-Tax Spending Plan Fiduciaries
In addition to creating rights for Pre-Tax Spending Plan participants, ERISA imposes duties upon the people who are responsible for the operation of the employee benefit plan. The people who operate your Pre-Tax Spending Plan, called "fiduciaries" of the Pre-Tax Spending Plan, have a duty to do so prudently and in the interest of you and other Pre-Tax Spending 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 Pre-Tax Spending Plan documents or the latest summary annual
report from the Pre-Tax Spending 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.
- 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 a state or Federal court. In addition, if you disagree with the Pre-Tax Spending Plan's decision or lack thereof concerning the qualified status of a domestic relations order, you may file suit in Federal court. If it should happen that Pre-Tax Spending 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 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 your Pre-Tax Spending Plan, you should contact Aetna
Member Services via the telephone number on your ID card, or call 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.
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