ExxonMobil Medical Plan
|
POS II A Option |
POS II B Option |
Aetna Select |
Cigna OAPIN |
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|---|---|---|---|---|---|---|
|
In-network you pay* |
Non-network you pay |
In-network you pay* |
Non-network you pay |
Network only you pay |
Network only you pay |
|
|
Annual deductible |
||||||
|
$500 |
$700 |
$300 |
$400 |
$0 |
$0 |
|
$1,000 |
$1,400 |
$600 |
$800 |
$0 |
$0 |
|
Preventive Care |
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|
$0 |
$0 |
$0 |
$0 |
$0 |
$0 |
|
||||||
|
Office visit |
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|
$40 copay |
45% |
$25 copay |
40% |
$25 copay |
$25 copay |
|
$60 copay |
45% |
$40 copay |
40% |
$40 copay |
$40 copay |
|
Telemedicine |
$40 copay |
— |
$25 copay |
— |
$25 copay |
$25 copay |
|
Urgent care |
$60 copay |
45% |
$40 copay |
40% |
$60 copay |
$60 copay |
|
Emergency care |
$100 copay |
$100 copay |
$100 copay |
$100 copay |
$150 copay |
$150 copay |
|
Inpatient care |
$300 deductible |
$600 deductible |
$200 deductible |
$400 deductible |
10% |
10% |
|
Outpatient care |
25% after |
45% after |
20% after |
40% after |
10% |
10% |
|
Annual medical out-of-pocket maximum |
(includes Rx) |
(includes Rx) |
||||
|
$4,500 |
$18,000 |
$3,000 |
$15,000 |
$3,000 |
$3,000 |
|
$9,000 |
$36,000 |
$6,000 |
$30,000 |
$6,000 |
$6,000 |
|
Prescription drugs Up to 34-day fills (from participating retail locations) |
||||||
|
30% |
30% |
$15 copay |
$15 copay |
||
|
30% |
30% |
30% |
30% |
||
|
50% |
50% |
50% |
50% |
||
|
Prescription drugs Up to 90-day fills (mail order or participating retail locations) |
||||||
|
25% |
25% |
$30 copay |
$30 copay |
||
|
25% |
25% |
25% |
25% |
||
|
50% |
50% |
50% |
50% |
||
|
Annual prescription drug out-of-pocket maximum |
||||||
|
$2,500 |
$2,500 |
Included in the medical out-of-pocket maximum |
|||
|
$5,000 |
$5,000 |
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If you are not able to find an In-network provider, contact Aetna Member Services for information on the Plan's alternate network deficiency benefit. If Aetna confirms a network provider is not available for the services you need, they will authorize use of a designated non-network provider for your care.
For more detailed plan information, review the Medical plan SPDs in the Spotlight below and the 2023 Benefits Coverage (SBC) here.
If you prefer to pay lower contributions from your paycheck, you should consider the POS II options. These options offer lower monthly contributions, but the deductibles and copays are higher, which means you will pay more when you get care.
Two plan options — Aetna Select and Cigna OAPIN — require you to use only network providers for care. Both options have extensive networks of providers and facilities, so if you see a non-network doctor or use a non-network facility, you will pay 100% of the cost. We strongly recommend you work with a primary care physician to coordinate your care.
The annual out-of-pocket is an important consideration if you’ve had extensive health care claims the last two years or expect high claims in the future. The ExxonMobil Medical Plan pays for 100% of eligible health care expenses after you reach the out-of-pocket maximum in a plan year.
The Network Only options have lower out-of-pocket maximums than the POS II options.
Important Savings Reminder
If you earn the Culture of Health (CoH) rate by fulfilling the requirements every year, you can reduce your monthly contributions for the next calendar year by:
- $30/month for participant only coverage
- $60/month for participant + spouse or children coverage
- $90/month for family coverage
Updated CoH rate eligibility for new hires
Starting in 2023, new hires who join before the end of the CoH rate period will get the CoH rate in their hire year and will have at least 30 days (even if it extends past the CoH deadline) to qualify for the CoH rate for the following year. New hires who join after the CoH rate period ends will be automatically given the CoH rate in their hire year and in the following year. See examples below:
- If an individual is hired on February 1, 2023, then they will receive the CoH rate in 2023, but would need to complete the CoH rate requirements by July 31, 2023 to obtain the CoH rate in 2024.
- If an individual is hired on July 15, 2023, then they will receive the CoH rate in 2023, but would need to complete the CoH rate requirements by July 31, 2023 or within 30 days of their hire date (whichever comes later; August 15 in this case) to obtain the CoH rate in 2024.
- If an individual is hired on September 1, 2023, then they will receive the CoH rate in 2023 and 2024, but would need to complete the CoH rate requirements in 2024 rate requirement period to obtain the CoH rate in 2025.
Employees who were hired between August 1 and December 31, 2022 will receive the Culture of Health Rate in 2023. This will not be reflected in the Benefits portal during Annual Enrollment, but the discounted rate will be applied starting January 1, 2023.
Annual deductible: The amount you must pay each year before the Plan begins to pay for covered health care expenses you incur
Annual out-of-pocket maximum: The most you have to pay for medical services in a plan year; includes the deductible, coinsurance and copays but does not include monthly contributions
Coinsurance: Your financial responsibility (percentage of the cost) after the deductible has been met
Copay: A fixed amount you pay at the time of service, in which you do not have to meet the deductible first
Network providers: A provider, facility or hospital that has negotiated with Aetna or Cigna to belong to their network; network providers charge less for their services because of those negotiated rates
Non-Network providers: Doctors or facilities who do not have a contract with Aetna or Cigna to belong to their network; using non-network providers will result in higher costs for you
Preventive care: Care typically covered at no cost to you, and includes services like annual health exams, immunizations, early warning screenings and certain medications
Surprise billing: When you get emergency care or get treated by a non-network provider at a network hospital or facility, you are now protected from “surprise billing.” Surprise billing is when you receive an unexpected bill or charge from a provider who you have no control over, such as an anesthesiologist or radiologist at an in-network facility. Your plan will treat this as a network charge, which reduces your financial exposure.