Eligibility and enrollment

Generally, you are eligible if:

• You are a regular employee.
• You are a trainee as described in the Key Terms section.
• You are a retiree.
• You are a survivor/surviving spouse, which means an eligible family member of a deceased regular employee or retiree.
• You are a long-term Expatriate with U.S. Company-sponsored green card (also called permanent resident visas or PRVs) who retires/retired at the end of your current U.S. assignment on or after July 1, 2020 and remain in the U.S. with a valid PRV. If you choose not to enroll, there will be no opportunity to enroll at a later point in time during retirement.

You are not eligible if:

• You participate in any other employer dental plan to which ExxonMobil contributes.
• You fail to make any required contribution toward the cost of the Plan.
• You fail to comply with general administrative requirements including but not limited to enrollment requirements.
• You lost eligibility as described under the Loss of eligibility section.
• You are an Expatriate employee.

Eligible family members

You may also elect coverage for your eligible family members including:

• Your spouse. When you enroll your spouse for coverage, you may be required to provide proof that you are legally married. 
• A child who is described in any one of the following paragraphs (1) through (3):
1. has not reached the end of the month during which age 26 is attained, or
2. is totally and continuously disabled and incapable of self-sustaining employment by reason of mental or physical disability, provided the child:
• meets the Internal Revenue Service's definition of a dependent, and
• was covered as an eligible family member under this Plan immediately prior to age 26 when the child's eligibility would have otherwise ceased, and
• met the clinical definition of totally and continuously disabled before age 26 and continues to meet the clinical definition through subsequent periodic reassessment reviews, or
3. is recognized under a qualified medical child support order as having a right to coverage under this Plan.

A child aged 26 or over who was disabled but who no longer meets the requirements of paragraph two (2) above, ceases to be an eligible family member at the end of the month in which the applicable requirement is not met

Refer to Key terms  for definitions of eligible family members, child, suspended retiree, spouse, and Qualified Medical Child Support Order. 

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 is considered a suspended retiree and is not eligible for coverage until the earlier of the date the person:

• Reaches age 55, or
• Begins his or her retirement benefit under the ExxonMobil Pension Plan, at which time the person is again considered a retiree and may enroll.

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.

Special eligibility rules

A person who otherwise is not a spouse but who, as a dependent of a former Mobil employee who participated in or received benefits under a Mobil-sponsored plan or program prior to March 1, 2000, is considered an eligible dependent as long as that person's eligibility for coverage as a dependent under a Mobil-sponsored plan would have continued.

Coverage Tiers

You can choose coverage as a:

• Participant only
• Participant and spouse
• Participant and child(ren)
• Family

Each coverage tier described in this section has its own contribution rate. Employees contribute to the Dental Plan through monthly deductions from their pay on a pre-tax or after-tax basis. Retirees and survivors receiving monthly benefit checks from ExxonMobil pay by deductions from these checks on an after-tax basis. Other retirees or survivors and participants with continuation coverage pay by check or by monthly draft on their bank account.

There are also coverage tiers for surviving spouses and family members of deceased employees and retirees and employees on certain types of leaves of absence. 

For employees on an approved leave of absence (LOA), the following will apply:

• Military leaves:
• Mandatory / Required Military leave: coverage under the Plan continues during the entire duration of the leave at the employee contribution rate. You are not offered COBRA continuation coverage.
• Voluntary / Optional Military leave: coverage under the Plan will continue for up to 12 months at the employee contribution rate. At the end of the 12-month period, your coverage under the Plan will end and you will have the opportunity to elect COBRA. The LOA does not count towards the duration of time you are eligible for COBRA
• Health/Dependent Care leave: coverage under the Plan will continue for up to 6 months at the employee contribution rate. At the end of the 6-month period, your coverage under the Plan will end and you will have the opportunity to elect COBRA. The LOA does not count towards the duration of time you are eligible for COBRA.
• Personal leave: coverage under the Plan will continue for up to 12 months at the employee contribution rate. At the end of the 12-month period, your coverage under the plan will end and you will have the opportunity to elect COBRA. The LOA does not count towards the duration of time you are eligible for COBRA.

If you take a leave of absence (LOA), you will pay your health plan contributions on a after-tax basis through direct debit (automatically taken from bank account) or direct bill (to be paid by check or with credit card). That’s because you will not be receiving your regular paychecks while you’re on a leave. On the first day of the pay period available after you return to work, you will start paying your contributions through pre-tax deductions once more. If your health plan coverage was cancelled during your LOA because you did not pay the contributions, you can make new benefit elections after you return to work—whether you return in the same or the following calendar year.

Dual coverage

No one can be covered more than once in the Dental Plan. You and a family member cannot both enroll as employees (or retirees) and elect coverage for each other as eligible family members. If you and your spouse or adult child work for the company (or are retirees) you may both be eligible for coverage. Each of you can be covered as an individual employee (or retiree), or one of you can be covered as the employee (or retiree) and the other can be an eligible family member. Also, if you and your spouse have children, each child can only be covered by one of you.

When the orthodontia maximum has been met under an ExxonMobil Dental Plan, dependents cannot be added to another ExxonMobil employee's dental plan to obtain additional orthodontic benefits.  The $2,000 limit is per lifetime, per member. 

In addition, a marriage between two ExxonMobil employees does not allow enrollment or cancellation in any of the ExxonMobil health plans. In order to change your coverage you need to wait until you experience a change in status that allows coverage changes or Annual Enrollment.

How to enroll

Employees:

As a newly hired employee, you will receive enrollment materials from the ExxonMobil Benefits Service Center. If you wish to enroll, you have 30 days to do so after your start date for your coverage to begin on the first day of employment.

If no actions are taken within the time established, the next opportunity to enroll will be during annual enrollment, with coverage effective the first of the following year or upon a change in status with coverage being effective on the event date.

If you are eligible for the ExxonMobil Pre-Tax Spending Plan, you will be enrolled to pay your monthly contributions on a pre-tax basis unless you annually decline this feature. Your monthly pre-tax contributions and coverage tier must remain in effect for the entire plan year, unless you experience a change in status. (See Annual enrollment and Changing your coverage sections.)

You can enroll eligible family members only if you are enrolled in this Plan. You can enroll in the Plan using the Your Total Rewards portal.

You will be requested to provide documents at some future date to prove that the family members you enrolled were eligible (e.g. marriage certificate, birth certificate, etc.). If you fail to provide such requested documents within 60 days of the request, coverage for the family members will be canceled the first of the following month and you may be subject to discipline up to and including termination of employment for falsifying company records.

In the case of a change in status, enrollments must be completed within 30 days of the event. Your changes will take effect on the day of the event, except specific events as divorce or gaining/losing coverage under Children’s Health Insurance Program (CHIP) or Medicaid, for which participants have 60 days to make updates to coverage. However, your dependent children will stay on your health plans coverage through the end of the month they turn age 26, and your coverage will be through the end of the month in case your employment with the company ends (either through resignation, retirement, or termination).

Deductions will be updated in the pay period following or coincident with the event date.

See additional details in Changes in Status during Employment section.

Under the Children’s Health Insurance Program (CHIP) Reauthorization Act of 2009 you may change your Plan election for yourself and any eligible family members within 60 days of either (1) termination of Medicaid or CHIP coverage due to loss of eligibility, or (2) becoming eligible for a state premium assistance program under Medicaid or CHIP coverage. In either case, coverage is effective the first of the month following enrollment through Your Total Rewards portal.

Retirees:

Retirees have three opportunities to enroll in the Dental Plan:

1. At retirement, or
2. Upon loss of other employer coverage, or
3. When first eligible to be enrolled in Medicare as your primary plan.

There is no opportunity to enroll yourself in the Dental Plan at any other time, including during annual enrollment.

If you were enrolled in the Dental Plan as an employee, you and your eligible covered family members will continue to be enrolled in the Plan at retirement. However, as a retiree, you will pay your contributions on an after-tax basis via payroll deduction (if eligible), check, or bank draft.

Eligible family members may be added to your coverage at one of the three enrollment opportunities listed above or if you experience a change in status. Eligible family members cannot be added to your coverage at any other time, including during annual enrollment.

In the case of a change in status,  enrollments must be completed within 30 days of the event and coverage will be effective on the day of the event. Deductions will be updated in the pay period following or coincident with the event date.

You will be requested to provide documents at some future date to prove that the family members you enrolled were eligible (e.g. marriage certificate, birth certificate, etc.). If you fail to provide such requested documents within the required time period, coverage for the family members will be cancelled the first of the following month. If you enroll family members who are not eligible for the Plan, for instance, by covering children who do not meet the eligibility requirements, you may lose eligibility for yourself and your family under all ExxonMobil health plans.

You may cancel your coverage at any time; however, you may not re-enroll unless you experience a corresponding change in status or you wait until one of the enrollment opportunities listed above. Coverage will be terminated at the end of the month in which your elected change has been received.

Eligible family members may also be removed from your coverage at any time; however, they may not be reinstated unless you experience a corresponding change in status or you wait until one of the enrollment opportunities listed above.

Note: You are required to remove family members who are no longer eligible for coverage at the time of loss of eligibility. To remove an ineligible family member you are required to notify the ExxonMobil Benefits Service Center of the loss of eligibility or your ineligible family members within 30 days from the date of the event except for the events of divorce or loss of CHIP / Medicaid coverage of you, your spouse or dependent for which you have up to 60 days to report. You may enroll in COBRA benefits continuation coverage within 60 days from the later of the date coverage is lost or COBRA Election Notice statement date. If you fail to notify the ExxonMobil Benefits Service Center, you may also lose eligibility for yourself and your family under all ExxonMobil health plans. In addition, you will be required to reimburse the Plans for any claims paid after the loss of eligibility for any ineligible person(s).

Annual enrollment

Each year,  ExxonMobil offers an annual enrollment period.

Employees

 During this time, employees can make changes to coverage by adding or removing family members. Family members may be added or removed for any reason during annual enrollment. However, family members must be removed as soon as they are no longer eligible.Changes elected during annual enrollment take effect the first of the following year.

You should not wait until annual enrollment to remove a family member who loses eligibility; they should be removed at the time eligibility is lost. For consequences for covering an ineligible family member, see Loss of Eligibility.

If you do not want to make any changes, you don’t have to do anything during Annual Enrollment to continue with your current plan selection for the following year. However, if as an employee you want to participate in a Flexible Spending Account (FSA), you must enroll each year, even if you are currently enrolled in an FSA.

If as an employee you pay your monthly contributions on an after-tax basis and would like to continue making contributions on an after-tax basis for the following year, you must elect to do so during each Annual Enrollment and after each change in status. Otherwise, your contributions will be switched to a pre-tax basis beginning the first day of the following year.

Retirees

Retirees cannot enroll in or make changes to their Dental Plan coverage during annual enrollment. They may still elect to drop coverage for themselves or a family member.

Changing your coverage

Employees:

To make a change to your coverage after your initial enrollment you must wait until Annual Enrollment or until you experience one of the following Changes in status.

Note: Changes in coverage associated with a change in status are effective on the date of the event. However, your dependent children will stay on your health plans coverage through the end of the month they turn age 26, and your coverage will be through the end of the month in case your employment with the company ends (either through resignation, retirement or termination). If the change is made during Annual Enrollment, changes are effective the first day of the following year.

Retirees:

To make a change to your coverage after your retirement you must wait until you experience a Post-Retirement Change in Status that allows enrollment into the Plan.

Note: Changes in coverage associated with a change in status are effective on the date of the event. However, your dependent children will stay on your health plans coverage through the end of the month they turn age 26.

Changes in Status during employment

Retirees and survivors please see Post-Retirement Changes in Status.

If a change in status event described in this section occurs, the participant may be permitted or required to:

• Enroll in coverage;
• End coverage; or
• Change the dependents covered.

The participant’s new coverage election must be consistent with the qualified change in status event. If the actions permitted or required are not taken in the timeframes indicated, you may need to wait until the upcoming Annual Enrollment period or another change in status event.

The following qualified change in status events allow, or require, changes to a participant’s medical elections:

Event		You are required/permitted to		When
Qualified status change
Divorce Employee and spouse enrolled in ExxonMobil Dental Plan		You are required to remove coverage for your former spouse and stepchild(ren) but you may not remove coverage for yourself or other covered eligible family members. You may not make a change to your coverage if you and your spouse become legally separated because there is no impact on eligibility.		You must make these changes within 60 days of your divorce and you are not required to show documentation to drop dependents. If you do not to notify the ExxonMobil Benefits Service Center within 60 days, this will result in your former spouse and stepchild(ren) not being entitled to elect COBRA. If you fail to remove your spouse and any stepchild(ren) within 60 days of the event: You will continue to have pay the same pre-tax contribution for coverage even though you have removed your former spouse and stepchild(ren) Such contribution will remain the same until you have experienced another change in status or the first of the plan year following the next Annual Enrollment period You will be required to reimburse the Plans for any claims paid after the loss of eligibility for any ineligible person
Divorce Employee loses coverage under spouse's medical plan.		If you lose coverage under your spouse's health plan because of divorce, you can sign up for dental coverage for yourself and your eligible family members.		You must make these changes within 60 days following the date you lose coverage under your spouse's plan.
Death of a spouse or other eligible family member		Death of a spouse: You are required to remove coverage for your former spouse but you may not remove coverage for yourself or other covered eligible family members. If you lose coverage under your spouse's health plan due to spouse death, you can enroll or add/drop dependents to dental coverage; no changes are allowed for death of a child dependent other than removal of child. If you and your family members are enrolled in the ExxonMobil Dental Plan, any stepchildren will cease to be eligible upon your spouse's death unless you are their court appointed guardian or sole managing conservator. Death of dependent child: You are required to remove coverage for deceased child but no other changes are allowed.		You must provide notice of your spouse’s death within 30 days of the date of death. No other election changes will be permitted for those currently enrolled in the Plan. If you were covered on your spouse’s plan you must make an election within 30 days of the date of death.
Other loss of family member's eligibility (e.g. sole managing conservatorship of grandchild ends)		Coverage continues through their last day of eligibility for any event the participant reports. In some cases, continuation coverage under COBRA may be available. (SeeContinuation coveragefor more details about COBRA.)		You must notify the ExxonMobil Benefits Service Center as soon as a family member is no longer eligible. If you fail to notify the ExxonMobil Benefits Service Center within 60 days, the family member will not be entitled to elect COBRA. You remain responsible for ensuring that the dependent childis removed from coverage.If you fail to ensure that an ineligiblefamily member is removed in a timely manner, there may be consequences for falsifying company records.
Qualified change in employment status
You lose eligibility because of a change in your employment status, e.g. regular to non-regular or strike/lockout		Your dental plan participation will automatically be termed.		Last day of the month of the event
You gain eligibility because of a change in your employment status, e.g. non-regular to regular; trainee to regular		Enroll yourself and add any eligible family members. Since enrollment would not be upon original hire date, contributions would be on a post-tax basis if applied retroactively		You must make these changes within 30 days of the event
You begin or return from a leave of absence		You may be able to make changes to some health plan benefits . Contact ExxonMobil Benefits Service Center at 833-776-9966 with any questions.		You must make these changes within 30 days following the date of the event.
You return from expatriate assignment outside of the U.S.		If enrolled in Dental coverage during assignment, you and your eligible family members will be automatically enrolled in ExxonMobil Dental Plan. You may drop this coverage for yourself and your eligible family members if you wish to do so. If you are not currently enrolled in Dental coverage during assignment, you may enroll yourself and your eligible family members.		You must make these changes within 30 days following the date of the event.
Termination of employment and rehire within 30 days or retroactive reinstatement ordered by court		If rehire is within 30 days or retroactive reinstatement ordered by court, you will be automatically enrolled in the same vision plan option you had prior to termination. If returning with a different plan year than termination, you can make any election changes. If rehire is after 30 days, enroll in all plans as new hire.		No action from the participant needed, automatic enrollment in same plan option. You must make election changes within 30 days following the date of the reinstatement. You must enroll within 30 days following the date of the reinstatement
Termination of employment by spouse or other family member or other change in their employment status triggering loss of eligibility under the other plan		Enroll yourself and other family members who may have lost eligibility under the spouse's or family member's plan in vision coverage.		You must make these changes within 30 days following the date of the event.
Other qualified changes
Another parent is ordered to provide coverage to your covered child through a QMCSO		Revoke or decrease the affected child’s election if coverage actually provided. The effective date will be the date of qualification or end of month if termination date is not listed.		Within 30 days following the date of the event
You are ordered to provide coverage to your eligible child through a QMCSO		Your coverage will be updated as directed by the order, including enrolling you and / or any eligible family members. The effective date will be the date of qualification You may also be able to make changes to your life and Health Care FSA coverage. Please call ExxonMobil Benefits Service Center at 833-776-9966 with any question.		You must make these changes within 30 days of the event.
Eligible dependent gains eligibility under another employer's plan		If the eligible dependent has or will obtain coverage under the other employer plan, remove them from coverage. You may also cancel coverage for yourself, if health care coverage is obtained through your spouse’s employer plan.		You must make these changes within 30 days of the event.
A significant change in coverage or cost* of your, your spouse’s plan. *applies also to a significant increase in health care cost sharing.		Changes to your spouse´s plan: you may enroll in medical, dental and/or vision coverage for yourself and any eligible family members. Change in coverage to your plan: mid-year changes to your plan coverages are not expected unless you have a change in status. Please call ExxonMobil Benefits Service Center at 833-776-9966 with any questions		Within 30 days following the date of the event.
HIPAA special enrollment provisions
Marriage		Enroll yourself and any eligible dependents. Drop coverage for yourself and your dependents (if being covered by your new spouse). Note that you cannot drop coverage for just your dependents, if you wish to drop coverage it would be for the whole family.		Within 30 days following the date of the event.
Gain a family member through birth, adoption or placement for adoption		Enroll yourself and any eligible dependents Drop coverage for yourself and your dependents. (Note that you cannot drop coverage for just your dependents, if you wish to drop coverage it would be for the whole family. Add any eligible dependents to your coverage.		You must add the new family member within 30 days even if you already have family coverage. Coverage is effective on the date of birth, adoption, or placement for adoption.
You or a family member loses eligibility under another employer's group health plan		Enroll yourself and other family members who might have lost eligibility, add affected dependents.		You must make these changes within 30 days of the event.
A family member’s employer contributions cease.		Add affected dependents to your coverage.		You must make these changes within 30 days of the event.
The participant or the participant’s dependent becomes eligible for premium assistance under Medicaid or the Children’s Health Insurance Program (CHIP).		If the participant is becoming eligible, they may drop coverage. If a dependent is becoming eligible, they may remove coverage for affected dependents only.		Within 60 days of either: termination of Medicaid or CHIP coverage due to loss of eligibility, or becoming eligible for a state premium assistance program under Medicaid or CHIP coverage.

Post-Retirement Changes in Status

Employees please see Changes in Status during employment.

Event		You are required/permitted to		When
Qualified status change
Divorce Retiree and spouse enrolled in ExxonMobil Dental Plan		You are required to remove coverage for your former spouse and stepchild(ren) but you may not remove coverage for yourself or other covered eligible family members. You may not make a change to your coverage if you and your spouse become legally separated because there is no impact on eligibility.		You must make these changes within 60 days of your divorce and you are not required to show documentation to drop dependents. If you do not to notify the ExxonMobil Benefits Service Center within 60 days, this will result in your former spouse and stepchild(ren) not being entitled to elect COBRA. If you fail to remove your spouse and any stepchild(ren) within 60 days of the event: You will continue to have pay the same pre-tax contribution for coverage even though you have removed your former spouse and stepchild(ren) Such contribution will remain the same until you have experienced another change in status or the first of the plan year following the next Annual Enrollment period You will be required to reimburse the Plans for any claims paid after the loss of eligibility for any ineligible person
Divorce Retiree loses coverage under spouse's medical plan.		If you lose coverage under your spouse's health plan because of divorce, you can sign up for vision coverage for yourself and your eligible family members.		You must make these changes within 60 days following the date you lose coverage under your spouse's plan.
Death of a spouse or other eligible family member		Death of a spouse: You are required to remove coverage for your former spouse but you may not remove coverage for yourself or other covered eligible family members. If you lose coverage under your spouse's health plan, you can sign up for vision coverage for yourself and your eligible family members. If you and your family members are enrolled in the ExxonMobil Dental Plan, any stepchildren will cease to be eligible upon your spouse's death unless you are their court appointed guardian or sole managing conservator. Death of dependent child: You are required to remove coverage for deceased child but no other changes are allowed		You must provide notice of your spouse’s death within 30 days of the date of death. No other election changes will be permitted for those currently enrolled in the Plan. If you were covered on your spouse’s plan you must make an election within 30 days of the date of death.
Other loss of family member's eligibility (e.g. sole managing conservatorship of grandchild ends)		Coverage continues through the end of the month in which they cease to be eligible. In some cases, continuation coverage under COBRA may be available. (SeeContinuation coveragefor more details about COBRA.)		You must notify the ExxonMobil Benefits Service Center as soon as a family member is no longer eligible. If you fail to notify the ExxonMobil Benefits Service Center within 60 days, the family member will not be entitled to elect COBRA. You remain responsible for ensuring that the dependent childis removed from coverage.If you fail to ensure that an ineligiblefamily member is removed in a timely manner, there may be consequences for falsifying company records.
Other qualified changes
Another parent is ordered to provide coverage to your covered child through a QMSCO		Revoke or decrease the affected child’s election if coverage actually provided. The effective date will be the date of qualification or end of month if termination date is not listed.		Within 30 days following the date of the event
You are ordered to provide coverage to your eligible child through a QMCSO		Your coverage will be updated as directed by the order, including enrolling you and / or any eligible family members. The effective date will be the date of qualification. You may also be able to make changes to your life and Health Care FSA coverage. Please call ExxonMobil Benefits Service Center at 833-776-9966 with any question.		You must make these changes within 30 days of the event.
Eligible dependent gains eligibility under another employer's plan		If the eligible dependent has or will obtain coverage under the other employer plan, remove them from coverage. You may also cancel coverage for yourself, if health care coverage is obtained through your spouse’s employer plan.		You must make these changes within 30 days of the event.
A significant change in coverage or cost* of your, your spouse’s plan. *applies also to a significant increase in health care cost sharing.		Changes to your spouse´s plan: you may enroll in medical, dental and/or vision coverage for yourself and any eligible family members. Change in coverage to your plan: mid-year changes to your plan coverages are not expected unless you have a change in status. Please call ExxonMobil Benefits Service Center at 833-776-9966 with any questions		Within 30 days following the date of the event.
HIPAA special enrollment provisions
Marriage		Enroll yourself and any eligible dependents. Drop coverage for yourself and your dependents (if being covered by your new spouse). Note that you cannot drop coverage for just your dependents, if you wish to drop coverage it would be for the whole family.		Within 30 days following the date of the event.
Gain a family member through birth, adoption or placement for adoption		Enroll yourself and any eligible dependents Drop coverage for yourself and your dependents. (Note that you cannot drop coverage for just your dependents, if you wish to drop coverage it would be for the whole family. Add any eligible dependents to your coverage.		You must add the new family member within 30 days even if you already have family coverage. Coverage is effective on the date of birth, adoption, or placement for adoption.
You or a family member loses eligibility under another employer's group health plan		Enroll yourself and other family members who might have lost eligibility, add affected dependents.		You must make these changes within 30 days of the event.
A family member’s employer contributions cease.		Add affected dependents to your coverage.		You must make these changes within 30 days of the event.
The participant or the participant’s dependent becomes eligible for premium assistance under Medicaid or the Children’s Health Insurance Program (CHIP).		If the participant is becoming eligible, they may drop coverage. If a dependent is becoming eligible, they may remove coverage for affected dependents only.		Within 60 days of either: termination of Medicaid or CHIP coverage due to loss of eligibility, or becoming eligible for a state premium assistance program under Medicaid or CHIP coverage.

Other changes that may affect your coverage

Change in coverage costs or significant curtailment

If the cost for coverage charged to you significantly increases or decreases during a plan year, you may be able to make a corresponding prospective change in your election, including the cancellation of your election. This provision also applies to a significant increase in the dental deductible or coinsurance.

If the cost of coverage under your spouse’s dental plan significantly increases or there is a significant curtailment of coverage that permits revocation of coverage during a plan year and you cancel that coverage, you will be able to sign up for dental coverage for yourself and any eligible family members. 

If you die

If you die while enrolled, your covered eligible family members can continue coverage. Their eligibility continues with the company contributions for a specified amount of time:

• If you have 15 or more years of benefit service at the time of your death, eligibility continues until your spouse remarries or dies.
• If you have less than 15 years of benefit service, eligibility continues for twice your length of Benefit Service or until the spouse remarries or dies, whichever occurs first.

Children of deceased employees or retirees may continue participation as long as they are an eligible family member and are not eligible to be enrolled in Medicare as their primary medical plan. If your surviving spouse remarries, eligibility for your stepchildren also ends. Special rules may apply to family members of individuals who become retirees due to disability. (See Continuation coverage for suspended retirees).

If you become a suspended retiree

If you are a retiree and you would otherwise lose coverage because you have become a suspended retiree under the ExxonMobil Disability Plan, you may continue coverage for yourself and your family members who were eligible for plan participation before you became a suspended retiree for either 12 or 18 months.

Coverage continues for 12 months from the date coverage would otherwise end if you received transition benefits under the ExxonMobil Disability Plan. However, if you did not receive transition benefits under the ExxonMobil Disability Plan, coverage continues for 18 months from the date coverage would otherwise end. The cost of this continued coverage is 102% of the combined participant and company contributions.

When coverage ends

Coverage for you and/or your family members ends on the earliest of the following dates:

• The last day of the month in which:
• You terminate employment (except as a retiree or due to disability),
• A family member ceases to be eligible (for example, a child reaches age 26), or
• A retiree becomes a suspended retiree (see suspended retiree under Eligible Family Members).
• You do not make your required contribution,

OR

• The effective date:
• You die,
• The Plan ends,
• Your employer discontinues participation in the Plan,
• You enrolled an ineligible family member and in the opinion of the Administrator-Benefits, the enrollment was a result of fraud or a misrepresentation of a material fact.
• You are no longer eligible for benefits under this Plan (e.g. employment classification changes from regular employee to non-regular employee or from non-represented to represented where you are no longer eligible for this Plan; from regular to expatriate employee),
• A Qualified Medical Child Support Order is no longer in effect for a covered family member
• You elect not to participate.

You are responsible for ending coverage with the ExxonMobil Benefits Service Center when your enrolled spouse or family member is no longer eligible for coverage. If you do not complete your change within 30 days for most changes in status (and 60 days in the case of divorce or if you, your spouse or your covered dependent gains or loses eligibility for Medicaid or Children’s Health Insurance Program (CHIP) coverage), any contributions you make for ineligible family members will not be refunded.

For employees and eligible family members, if your participation in any group health plan (e.g. Medical, Dental, Vision), to which ExxonMobil contributed, was suspended for non-payment of required contributions, in order to enroll in this Plan you must repay all required contributions retroactively to the date of suspension.

If you are a retiree, eligible family member of retiree or a survivor and have missed payments, contact the ExxonMobil Benefits Service Center (EMBSC) immediately for guidance in order to regularize your situation.

Cancellation and reinstatement process for retirees, eligible family member of a retiree or a survivor participating in Dental, Vision, and/or any of the ExxonMobil Retiree Medical Plan (EMRMP) options (together or separately, the Retiree Health Plans)- will be as follows.

Cancellation of Retiree Health Plans due to non-payment of premiums:

Cancellations due to non-payment of plan premiums will be prospective, with a 3 month grace period starting 1^st month of unpaid contributions, so participants may pay owed contributions within that grace period to avoid cancellation. For example, if retiree has not made payments for their January, February, and March premiums during that 3 month timeframe, coverage will be cancelled effective April 1.

Reinstatement of Retiree Health Plans:

Once your coverage has been terminated, you can request to be reinstated upon showing good cause.  The applicable Retiree Health Plan- (or its designee) will review requests for reinstatements on a case-by-case basis. If an individual has been involuntarily disenrolled for failure to pay plan premiums, they may request reinstatement no later than 60 calendar days following the effective date of disenrollment.

Reinstatement for good cause will occur only when:

1. Reinstatement is requested no later than 60 calendar days following the effective date of disenrollment (in the example, 60 days from April 1)
2. The individual has been determined to meet the criteria specified below (i.e., receives a favorable determination); and
3. Within three (3) months of disenrollment for nonpayment of plan premiums, the individual pays in full the plan premiums owed at the time they were disenrolled (in the example, within 3 months from April 1).

If you fail to pay premiums within the grace period, your coverage is terminated, and you fail to show good cause, you and your eligible dependents will not have an opportunity to re-enroll at a future date in the applicable ExxonMobil Health Plan. You are still responsible for paying all owed premiums incurred during the grace period in which you were still part of the applicable ExxonMobil Health Plan.

Requests for reinstatement must be accompanied by a credible statement (verbal or written) explaining the unforeseen and uncontrollable circumstances causing the failure to make timely payment. An individual may make only one reinstatement request for good cause in the 60-day period. Generally, these circumstances constitute good cause:

• A serious illness, institutionalization, and/or hospitalization of the member or their authorized representative (i.e. the individual responsible for the member’s financial affairs), that lasted for a significant portion of the grace period for plan premium payment;
• Prolonged illness that is not chronic in nature, a serious (unexpected) complication to a chronic condition or rapid deterioration of the health of the member, a spouse, another person living in the same household, person providing caregiver services to the member, or the member’s authorized representative (i.e., the individual responsible for the member’s financial affairs) that occurs during the grace period for the plan premium payment;
• Recent death of a spouse, immediate family member, person living in the same household or person providing caregiver services to the member, or the member’s authorized representative (i.e., the individual responsible for the member’s financial affairs); or
• Home was severely damaged by a fire, natural disaster, or other unexpected event, such that the member or the member’s authorized representative was prevented from making arrangement for payment during the grace period for plan premium;
• An extreme weather-related, public safety, or other unforeseen event declared as a Federal or state level of emergency prevented premium payment at any point during the plan premium grace period. For example, the member’s bank or U.S. Post Office closes for a significant portion of the grace period; or
  
  

There may be situations in addition to those listed above that result in favorable good cause determinations. If an individual presents a circumstance which is not captured in the listed examples, it must meet the regulatory standards of being outside of the member’s control or unexpected such that the member could not have reasonably foreseen its occurrence, and this circumstance must be the cause for the non-payment of plan premiums. The Plan expects non-listed circumstances will be rare.

Examples of circumstances that do not constitute good cause include:

• Allegation that bills or warning notices were not received due to unreported change of address, out of town for vacation, visiting out of town family, etc.;
• Authorized representative did not pay timely on member’s behalf;
• Lack of understanding of the ramifications of not paying plan premiums;
• Could not afford to pay premiums during the grace period; or
• Need for prescription medicines or other plan services.

The ExxonMobil Business Service Center is the appointed designee reviewing reinstatement requests and making good cause determinations.

Loss of eligibility

Fraud against the Plan

Everyone in your family may lose eligibility for plan coverage, and you may be subject to disciplinary action up to and including termination of employment if you commit fraud against the Plan, for instance, by filing claims for benefits to which you are not entitled. Coverage may also be terminated if you refuse to repay amounts erroneously paid by the Plan on your behalf or which you recover from a third party. Your participation may be terminated if you fail to comply with the terms of the Plan and its administrative requirements. You may also lose eligibility if you enroll persons who are not eligible, for instance, by covering children who do not meet the eligibility requirements. This includes failing to provide timely notification of when a covered family member loses eligibility, e.g. spouse loses eligibility due to divorce.

Extended benefits at termination

You are entitled to extended coverage for as much as a year if you are terminated due to disability with fewer than 15 years of service. This coverage is provided at no cost to you. This is considered a portion of the COBRA continuation period. In order to assure coverage beyond this extension period, you must elect COBRA upon termination of employment.

Several conditions must be met:

• The disability must exist when your employment terminates.
• The extension lasts only as long as the disability continues, but no longer than 12 months.

This extension applies only to the employee who is terminated because of a disability. Continuation coverage for eligible family members may be available through COBRA.