Eligibility and enrollment

Most U.S. dollar payroll employees of Exxon Mobil Corporation and participating affiliates are eligible for this Plan.

Eligibility

Full-time employees not hired on a temporary basis (designated as regular employees) are eligible their first day of employment.

Effective July 1, 2021, a regular employee whose home country is the U.S. and who is working on an expatriate assignment outside the U.S. who is eligible to participate in the ExxonMobil International Medical and Dental Plan is also eligible to participate in the Pre-Tax Spending Plan.

A regular employee whose host country is the U.S. and who is temporarily working in the U.S. is not eligible to participate in the plan.

An employee who is classified as a non-regular employee, but who has been characterized as a trainee and has graduated from high school, complies with any enrollment requirements and makes required contributions, is eligible to participate in the Plan by paying contributions on a pre-tax basis.  Trainees may not participate in the HCFSA and DCFSA.

Leased employees as defined in the Internal Revenue Code, temporary, or part-time employees (classified as non-regular employees), barred employees or special-agreement persons are not eligible to participate in the Plan. A barred employee is an employee who is covered by a collective bargaining agreement, except to the extent participation is provided under such agreement.

A special-agreement person is, generally, a person paid on a commission or commission salary basis other than a person paid while employed by the Marketing department of ExxonMobil; an employee providing service to a non-affiliated organization that pays the person's salary or wages; or an employee working pursuant to an agreement that specifically excludes the person from coverage for benefits.

Retirees are not eligible to participate in the Plan because they do not receive taxable wages.

Initial and annual enrollment

• Employee Contributions. Participants in the Medical, Dental and Vision Plans are automatically enrolled to pay their monthly contributions on a pre-tax basis through the Plan. You may decline this tax-savings feature, but you must decline it every year during annual enrollment period and each time you make a change to your elected benefits - e.g. if you change the level of coverage in the Dental Plan in order to continue paying all your contributions on an after-tax basis, you must elect to opt out again.
• To participate in the Health Care Flexible Spending Account (HCFSA), you must enroll each year during the annual enrollment period.
• Enrollment each year is not required to participate in the rollover for the Health Care Flexible Spending Account (HCFSA). The carryover applies to any unused funds in your Health Care FSA at the end of the plan year, as long as you are an employee as of January 1 of the following plan year.
• To participate in the Dependent Care Flexible Spending Account (DCFSA), you must enroll each year during the annual enrollment period.
• Within 60 days of your date of hire, you may enroll in the HCFSA or DCFSA parts of the Plan to cover expenses. As a newly hired employee, if you enroll within 30 days of your start date, coverage begins the first day of employment. If you enroll between 31 and 60 days from your date of hire, coverage will be effective the first day of the month following completion of the enrollment in ExxonMobil Benefits portal. You must enroll again each year to participate in one or both of the flexible spending accounts. You also may decline paying your monthly medical, dental, and vision contributions on a pre-tax basis at that time.

Your election to participate in any of the accounts is irrevocable as of the close of the annual enrollment period and you may not change your election for the following year except for the events described in the following sections or for a mistake. 

Changes to Medical, Dental and Vision plans (health plans) pre-tax contributions

The following is a quick reference table that describes events which may allow changes, if the changes are submitted no later than sixty (60) days after the event, as well as the actions you may take. If you have any questions, please call the ExxonMobil Benefits Service Center prior to the expiration of sixty (60) days.

If this event occurs...	You may...
Marriage	Enroll yourself and spouse and any new eligible family members or change your Health Plans Options.
Divorce – Employee and spouse enrolled in ExxonMobil health plans	Change your level of coverage. You are required to remove coverage for your former spouse and any stepchild(ren) but you may not remove coverage for yourself or other covered eligible family members.
Divorce – Employee loses coverage under Spouse’s vision plan	Enroll yourself and other eligible family members who might have lost eligibility for Spouse’s plan.
Gain a family member through birth, adoption or placement for adoption or guardianship.	Enroll yourself and any eligible family members and change Health Plans Options.
Death of a spouse or other eligible family member.	Change your level of coverage. You may not cancel coverage for yourself or other covered eligible family members.
You or a family member loses eligibility under another employer's group health plan or other employer contributions cease which creates a HIPAA special enrollment right.	Enroll yourself and other family members that might have lost eligibility. This only pertains to the Health Plans Options. Change your level of coverage and change Health Plans Options.
Other loss of family member's eligibility (e.g., sole managing conservatorship of grandchild ends).	Change your level of coverage. You may not cancel coverage for yourself or other eligible family members.
You lose eligibility because of a change in your employment status, e.g., regular to non-regular, strike / lockout.	Your plan participation will automatically be termed at the end of the month.
You gain eligibility because of a change in your employment status, e.g. non-regular to regular.	Enroll yourself and add any eligible family members.
Termination of Employment by spouse or other family member or other change in their employment status (e.g., change from full-time to part-time) triggering loss of eligibility under spouse's or family member's plan in which you or they were enrolled.	Enroll yourself and other family members that may have lost eligibility under the spouse's or family member's plan and change your Health Plans Options.
Your former spouse is ordered to provide coverage to your children through a QMSCO.	End the family member's coverage, change level of coverage and terminate their participation in health plans.
Commencement of Employment by spouse or other family member or other change in their employment status (e.g., change from part-time to full-time) triggering eligibility under another employer's plan.	End other family member coverage and terminate their participation in health plans if the employee represents that they have or will obtain coverage under the other employer plan. You may also cancel coverage for yourself, if health care coverage is obtained through your spouse’s employer plan.
Change in worksite or residence affecting eligibility to participate in the elected Health Plan Option (e.g. move out of a Network-only option service area).	Change your Health Plans Options and change level of coverage. You may not cancel coverage for yourself or other eligible family members.
Judgment, decree or other court order requiring you to cover a family member (Begin a QMSCO).	Change your Health Plans Options and change level of coverage.
Termination or end of QMSCO	You may remove the affected the family member from coverage, change level of coverage and terminate their participation in health plans.
Termination of employment and rehire within 30 days or retroactive reinstatement ordered by court.	Enroll in the same health plans and Medical Plan option you had prior to termination.
Termination of employment and rehire after 30 days.	Enroll in the same health plans and Health Plans options you had prior to termination.
You are covered under your spouse's Health plan and plan changes coverage to a lesser coverage level with a higher deductible mid-year.	Enroll yourself and eligible family members in the Health Plans Options.
You begin a leave of absence.	Contact the ExxonMobil Benefits Service Center in advance of leave for more information. For quick reference, payment options are: For pre-tax treatment: you may elect to pre-pay your health plans and HCFSA contributions in a lump sum through payroll deduction from your final pre-leave paycheck. You may only contribute on a pre-tax basis for up to six months for the leave and only for the remainder of the Plan year in which your leave begins. For post-tax treatment: you may pay on a monthly basis. You will have to send monthly checks in order to pay for your health plans premiums during the Leave of Absence.
You return from a leave of absence of more than 30 days (paid or unpaid) in same calendar year Or You return from a leave of absence of more than 30 days (paid or unpaid) in following calendar year.	Contact the ExxonMobil Benefits Service Center. You are eligible to make updates to your Health Plans Options. If you are on leave during Annual Enrollment, you will still have the opportunity to make new elections.
You return from expatriate assignment outside of the U.S.	Change your Health Plans Options.

Changes will only be allowed if the change is made in ExxonMobil Benefits portal within 60 days of the event. Unless otherwise noted, the effective date will be the first of the month after the forms are received or the transaction is completed in ExxonMobil Benefits portal .

Loss of Other Health Coverage. You may enroll or add eligible family members when you or your dependent loses other health coverage. Enrollment can be requested when the individual loses eligibility for the other coverage. You must enroll within 60 days of the loss of coverage. The resulting coverage is effective on the first day of the first calendar month beginning after the date the completed request for enrollment is received. You may also change Health plan options at this time.

Entitlement to Medicare or Medicaid. If you, your spouse, or family member who is enrolled becomes entitled to coverage (i.e., becomes enrolled) under Part A or Part B of Title XVIII of the Social Security Act (Medicare) (Public Law 89-97 (79 Stat. 291)) or Title XIX of the Social Security Act (Medicaid) (Public Law 89-97 (79 Stat. 343)), other than coverage consisting solely of benefits under section 1928 of the Social Security Act (the program for distribution of pediatric vaccines), you may cancel coverage for that individual. 

Birth, Adoption or Placement for Adoption. If you gain a family member through birth, adoption or placement for adoption, you may add the new eligible family member to your current coverage. You may also enroll yourself, your spouse, and all eligible children. You also may change your plan option. Coverage is effective on the date of birth, adoption or placement for adoption provided you complete the enrollment process within 60 days. You must add the new family member within 60 days even if you already have family coverage.
If you enroll your new family member between 31 and 60 days from the birth or adoption and your coverage level changes, you will pay the cost difference on a post-tax basis until the end of the month in which the forms are received by the ExxonMobil Benefits Service Center. Beginning the first day of the following month your deduction will be on a pre-tax basis.

Marriage. You may enroll or add eligible family members after marriage. You must enroll within 60 days of the marriage and enrollment is effective on the first day of the first calendar month beginning after the date the enrollment is processed in the ExxonMobil Benefits portal. You may also change health plan options at this time. 

Loss of Dependent. 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 60 days, any contributions you make for ineligible family members will not be refunded and your pre-tax contributions will not be reduced until the beginning of the next calendar year.

Transfer or Change in Residence. If you move from one location to another, and the move makes you no longer eligible for your selected Health Plan option, you may change from your current Health Plan option to one that is available in your new location. For more information, call the ExxonMobil Benefits Service Center.

Coverage Change. If you are covered under your spouse's health plan and the plan's coverage changes to a lesser coverage with a higher deductible mid-year, then you may enroll and add eligible family members. If the cost for coverage under your spouse's health plan significantly increases or there is a significant curtailment of coverage that permits revocation of coverage during a plan year and you drop that coverage, you will be able to sign up for health coverage for yourself and your eligible family members. You must enroll within 60 days following the date you lose coverage under your spouse's plan.

Significant Curtailment of Benefits with Loss of Coverage. If during the year it is determined by the Administrator-Benefits that there has been a substantial decrease in the health care providers available under an option or a reduction in the benefits for a specific type of medical condition or treatment with respect to which you or your spouse or family member is currently in a course of treatment; or any other similar fundamental loss of coverage, then you may be allowed to elect to participate under another benefit package option providing similar coverage or to drop coverage if no similar benefit package option is available.

Changes to your Health Care FSA

The Plan permits you to increase, decrease, revoke or elect to participate in the Health Care FSA during the plan year only as provided in the following chart.

Changes in your elections must be consistent with the changes in status and the change must be made within 60 days of the event.  

If this event occurs...	You may...
Marriage	Enroll or increase your election because of the newly eligible spouse.
Divorce	Revoke or decrease your election because your spouse is no longer eligible.
Divorce - Employee loses coverage under Spouse's Health Plans.	Enroll or increase your election.
Gain a family member through birth, adoption or placement for adoption, marriage, or guardianship.	Enroll or increase your election because of the newly eligible family member.
Move or change residence.	You are not eligible to make any changes.
Change in medical or your financial condition.	You are not eligible to make any changes.
Loss of family member's eligibility (e.g., no longer a tax dependent).	Revoke or decrease your election.
You lose eligibility because of a change in your employment status, (e.g., regular to non-regular or you begin a leave of absence).	Revoke your election. You may continue the coverage during the leave on an after-tax basis until the end of the year in which the leave commenced.
You gain eligibility because of a change in your employment status, (e.g. non-regular to regular).	Enroll.
Termination of Employment by spouse or other family member or other change in their employment status (e.g., change from full-time to part-time) triggering loss of eligibility under spouse or family member's plan.	Enroll or increase your election.
Your family member becomes eligible for Medicare or Medicaid.	Revoke or decrease your election.
Commencement of Employment by spouse or other family member or other change in their employment status (e.g., change from part-time to full-time) triggering eligibility under spouse or family member's plan.	May decrease or cease election if you gain eligibility under spouse's or family member's plan. Your election to cease or decrease coverage for that individual (including yourself) corresponds only if coverage for that individual becomes effective or is increased under the other employer's plan.
Job transfer requiring relocation including one affecting eligibility to participate in the Medical Plan.	You are not eligible to make any changes.
Provider leaves plan option.	You are not eligible to make any changes.
Termination of employee and rehire within 30 days or retroactive reinstatement ordered by court.	Elections effective at termination are automatically restored unless another event has occurred which allows a change.
Termination of employment and rehire after 30 days.	Enroll as a new hire.
You are covered under your spouse's medical plan and plan change's coverage to a lesser coverage with a higher deductible mid-year.	You are not eligible to make any changes.
You begin a leave of absence.	Contact the ExxonMobil Benefits Service Center to discuss permissible changes. You can continue or cancel your HC FSA contributions. If you continue, please review option payments in chart “Changes to Medical, Dental and Vision plans (health plans) pre-tax contributions”
You return from a leave of absence of more than 30 days (paid or unpaid) during the same plan year	You have the right to reinstate coverage at prior coverage level (and make-up unpaid contributions) or at a level reduced pro rata for the missed contributions. The make-up contributions may be made on a pre-tax basis even if they span more than one year. In either case, you may not submit expenses for the period during which you did not continue your coverage.
If you return after the end of the plan year.	You may have already made your new elections during Annual Enrollment. If no election was made during Annual Enrollment, you will be allowed to make a new election. Contact the ExxonMobil Benefits Service Center for further information.
Death of a spouse or other eligible family member.	Revoke or decrease your election.
Death of a spouse where employee is covered by spouse's employer's group health plan.	Enroll or increase or decrease your election.
Judgment, decree or other court order requiring you to cover a family member. (Begin a QMSCO).	Enroll or Increase your election.
Another parent is ordered to provide coverage to your child through a QMSCO.	Revoke or decrease your election if coverage actually provided.
Start an Expatriate assignment and change from current ExxonMobil Medical Plan option to ExxonMobil International Medical and Dental Plan	You are not eligible to make any changes.
You return from expatriate assignment outside of the U.S.:
If you return during the same plan year	Your prior elections are reinstated.
If you return after the end of the plan year	You will be allowed to make a new election upon the end of the expatriate assignment.

Changes to your Dependent Care FSA

The Plan permits an employee to increase, decrease, revoke or elect to participate in the Dependent Care FSA during the plan year only as provided in the following chart.

Changes in your elections must be consistent with the change in status and the change must be made within 60 days of the event.

If this event occurs...	You may...
Marriage	Revoke or decrease your election (e.g., spouse does not work and cares for the children at home). Enroll of increase (e.g., children are brought into family who now need daycare).
Divorce or Death of Spouse.	Enroll or increase (e.g., now need daycare). Revoke or decrease (e.g., stepchildren no longer qualifying children).
Gain a family member through birth, adoption or placement for adoption, marriage, or guardianship.	Enroll or increase your election if newly eligible family member needs care.
Move or change residence.	You are not eligible to make any changes.
A family member is no longer considered an eligible family member.	You can revoke or decrease your election (e.g., stepchildren no longer qualifying children).
You or your spouse change to or from part-time or full-time employment.	Enroll, increase, revoke or decrease your election.
You or your spouse change work schedules which change either hours of dependent care required or the amount of dependent care costs.	Enroll, increase, revoke or decrease your election amount consistent with the change in dependent care costs.
Job transfer with or without relocation.	Enroll, increase, revoke or decrease your election amount only if the relocation results in a change to dependent care costs.
Change in the amount paid for dependent care.	Enroll, increase, revoke or decrease your election amount consistent with the change in dependent care costs (e.g., awarded a scholarship or other subsidy for childcare).
Change from one dependent care center to another one that charges a different rate.	Enroll, increase, revoke or decrease your election amount consistent with the change in qualified dependent care expense.
Your child reaches age 13 and is no longer a qualifying family member.	Revoke or decrease your election amount consistent with the change in dependent care costs.
Change in home dependent care provider, (e.g., change to a nanny-sharing arrangement).	Enroll, increase, revoke or decrease your election amount consistent with the change in dependent care costs.
Loss of family member's eligibility (e.g., no longer a tax dependent).	Revoke or decrease your election.
You lose eligibility because of a change in your employment status, (e.g., regular to non-regular).	Revoke your election.
You begin a leave of absence.	Contact the ExxonMobil Benefits Service Center You are not eligible for the Dependent Care FSA while on a leave of absence. If you are enrolled in the DC FSA, the elections will be cancelled effective the starting date of your leave and any expenses incurred during your leave will not be eligible for reimbursement.
You return from a leave of absence of more than 30 days (paid or unpaid) during the same calendar year.	Contact the ExxonMobil Benefits Service Center. You have the right to reinstate coverage at prior coverage level or at a different level (in line with maximum annual deduction amount).
You return from a leave of absence of more than 30 days (paid or unpaid) in the following calendar year.	You will be allowed to make a new election. Contact the ExxonMobil Benefits Service Center for further information.
Death of a qualifying family member.	Revoke or decrease (e.g., care no longer needed).

Annual enrollment

Each year, as part of the annual enrollment process, you will receive enrollment instructions. You must enroll by the published deadline in order to participate in one or both of the flexible spending accounts for the next year.  

Changing your election

The Plan is governed by federal and state income tax laws and regulations, and the provisions of the Plan document. Once you make an election — contributions on a pre-tax or after-tax basis and/or amounts to the flexible spending accounts — your election must remain in effect for the entire plan year unless you have a change in status or you made a mistake.

When you have a change in status, you can make changes as follows:

Election for medical, dental and vision plan contributions paid on a pre-tax or after-tax basis.

• Your contributions are paid on a pre-tax basis when you enroll for medical, dental and vision plan coverage. You may change this election (pay after-tax) when you enroll or within 60 days of a change in status. On the other hand, if you are paying your contributions on an after-tax basis, you may elect to pay on a pre-tax basis with a change in status. Also, if you are paying on an after-tax basis and you change your level of coverage (i.e. employee to family), in order to continue paying on an after-tax basis, you must elect to opt out again.
• Make your election on ExxonMobil Benefits portal. Your election must be done within 60 days of the event. Depending on the event, the change to your election is effective as of the first of the month following election through ExxonMobil Benefits portal.
• You are not allowed to make changes after the 60-day period until the next annual enrollment period or until another change in status.

HCFSA and/or the DCFSA election.

• As stated in the charts in the Changes to Medical, Dental and Vision plans pre-tax contributions, with a change in status, you may increase, decrease or cancel an election of pre-tax dollars for unreimbursed, out-of-pocket, eligible expenses in either one or both accounts - the HCFSA (medical/dental/vision expense) and/or the DCFSA (dependent care). Your elections to the HCFSA and/or DCFSA must be made separately within 60 days of the event.
• Make your election at the ExxonMobil Benefits portal. Your election must be made within 60 days of the event. Your adjusted spending account election is generally effective the first of the month following your election. Any change in election affecting annual contributions to the HCFSA or to the DCFSA will only change the amount available for reimbursement from the respective account for the portion of the plan year remaining following the effective date of the change. Any increase in the amount available for reimbursement under the HCFSA or the DCFSA after such an election change may not be used to reimburse expenses incurred prior to the effective date of such change. You may only reduce your election for the remainder of the year to an amount greater than or equal to the amount already contributed. If you cancel your election (reduce to zero), you may only file claims for eligible expenses incurred before you changed your election.
• If your election is not made through the ExxonMobil Benefits portal or by calling the ExxonMobil Benefits Service Center within 60 days of the change in status, you may not make a new pre-tax spending account election or change your current pre-tax spending account election until you have another change in status or until the next annual enrollment period.

Special rule applies for birth, adoption or placement for adoption

Covered expenses under the Medical Plan can only be reimbursed effective from the date of the birth, adoption, or placement for adoption of a child if the event is processed by the ExxonMobil Benefits Service Center within 60 days. Retroactive increases to the HCFSA and DCFSA are only effective if the event is processed through ExxonMobil Benefits portal within 30 days of the date of the birth, adoption, or placement for adoption.

The plan year is the calendar year, January 1 through December 31. 

Effective date of change

Your election is effective on a pre-tax basis on the actual date of the event only for births, adoptions, and placements for adoption if the election is received by the ExxonMobil Benefits Service Center within 30 days of the event. With regard to all other events, your election is effective the first of the month following receipt of your election, but if the transaction is completed through the ExxonMobil Benefits Service Center on the first day of a month, it is effective that day. Annual elections cannot be decreased to less than the amount already contributed at the time the election is received.

Correcting enrollment mistakes

If you have elected to participate in the DCFSA when you don't have any children under the age of 13, and your written request to revoke your election is received within the first 90 days after the effective date of the election, the ExxonMobil Benefits Service Center may revoke your election if the supporting evidence clearly shows that the election was a mistake.

If you discover any other enrollment/election mistake, it may be possible to allow a change, but only if (1) there is "clear and convincing evidence" that you made a mistake, (2) the mistake is of a type that can be corrected, and (3) the correction is appropriate. Notify the ExxonMobil Benefits Service Center as soon as you realize that you made a mistake. If you fail to contact the ExxonMobil Benefits Service Center during the first 90 days after the effective date of your election, you will need to submit an appeal to the Administrator-Benefits to have the correction considered by filing an appeal as described in the section on Benefit claims procedures for HCFSA & DCFSA.

Leaves of absence and FSA

During a paid leave you may continue to participate in the HCFSA. You would continue your monthly contributions, file claims and receive reimbursement for eligible expenses, subject to claim filing deadlines.

However, during an unpaid Leave of Absence you may not continue to participate in the DCFSA. 

If you choose to continue participating in the HCFSA during an unpaid leave, you may continue to file claims and receive reimbursements for eligible expenses. Your contributions must be paid monthly on an after-tax basis during your leave or in a lump sum on a pre-tax basis (if taxable compensation is available) prior to beginning your leave.

You may also choose to revoke your election and discontinue your participation in the Plan. If you revoke your election while on leave of absence, expenses you incur during the period of revocation will not be reimbursable from the Plan. 

Leaves that last less than 30 days do not affect your eligibility to participate in either the HCFSA or the DCFSA, and such, a leave is not a change in status which permits changes. Once you return to work, contributions will be adjusted for the time you were absent. 

Upon return from a leave that lasts more than 30 days, if you return in the same calendar year, you will be reinstated to your prior coverage at a level reduced pro rata for the missed contributions. For example, assume that Maria elected $1,200 in health FSA coverage for the plan year and paid $100 per month for the coverage. On April 1, after submitting no claims for reimbursement, Maria begins a three-month leave. She does not elect to continue coverage. When Maria returns on July 1, she elects to re-enroll under Health FSA. She will have $900 reinstated ($1,200 minus $300 of paid contributions from January through March in missed contributions) at a cost of $150 per month for the remainder of the year. Expenses incurred during the period that the HCFSA was not in force are not eligible for reimbursement.

Participation when employment ends

When you leave ExxonMobil, your coverage under the Plan (Pre-Tax contributions for your premiums) will end on the last day of the month in which your termination or retirement date occurs. Reimbursement from the HCFSA for expenses you incur after your termination or retirement is not permitted unless you are offered and elect COBRA coverage for the HCFSA. Health care expenses you incur prior to termination or retirement will be reimbursed up to the amount of your projected election for the year. Dependent care expenses you incur prior to termination or retirement will be reimbursed up to the amount you contributed.

If you die as a participating employee, your surviving spouse, the executor or administrator of your estate or a court-appointed party may file claims for eligible expenses incurred before your death.

Continuation coverage (COBRA)

Under COBRA (Consolidated Omnibus Budget Reconciliation Act of 1985), you may be entitled to continue coverage in the HCFSA for the remainder of the year and to receive reimbursement for eligible expenses incurred following termination or retirement. You will be allowed to elect COBRA coverage only if the maximum amount available to you from the HCFSA for the remainder of the year is greater than or equal to your required contribution for the remainder of the year. During the period of COBRA coverage, you continue your contributions to the Plan for the amount of your current election for the HCFSA plus a two percent administrative fee. Because you would no longer be receiving taxable pay from which your elected amount can be deducted, your contributions would be made on an after-tax basis. Please see the Continuation coverage section for more information.