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Eligibility and enrollment

Eligibility and enrollment details for the ExxonMobil Employee Medical Plan– Open Access Aetna Select option

Most U.S. dollar payroll regular employees of Exxon Mobil Corporation and participating affiliates who work at a location where the Open Access Aetna Select is offered and reside in the Open Access Aetna Select service area are eligible to participate. The service area is determined by the employee's home address zip code.

Generally, you are eligible if:

  • You are a regular employee.
  • You are working for ExxonMobil after retirement as a regular or non-regular employee
  • You are a trainee as described in Key Terms section
  • You were an extended part-time employee and enrolled in the Plan on December 31, 2022 as long as you continue to participate in the Plan.

You are not eligible if:

  • 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.
  • Your child(ren) under age 26. Coverage ends at the end of the month in which they reach age 26. If your situation involves a family member other than your biological or legally adopted child, call the ExxonMobil Benefits Service Center.
  • Your totally and continuously disabled child(ren) who is incapable of self-sustaining employment by reason of mental or physical disability that occurred prior to otherwise losing eligibility at age 26 and meets the Internal Revenue Service's definition of a dependent.

More complete definitions of eligible family member and Child appear in the Key terms of this guide and in the definition of Qualified Medical Child Support Order.

The Administrator-Benefits determination of eligibility is final and no appeals are available, including decisions regarding whether a child age 26 or older meets the clinical definition of totally and continuously disabled. All decisions by Aetna confirming a dependent no longer meets the clinical definition of totally and continuously disabled are final.

Dual Coverage

No one can be covered more than once in the Plan. You and a family member cannot both enroll as employees and elect coverage for each other as eligible family members. If you and your spouse or adult child work for the company and both are eligible for coverage:

  • Each of you can be covered as an individual employee, or
  • One of you can be covered as the employee 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.

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

As a newly hired or newly eligible 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.

  • If you enroll within this 30-day period, 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 enrollment in ExxonMobil Benefits or through the ExxonMobil Benefits Service Center.

As a current employee, if you are not covered by a medical plan to which ExxonMobil contributes or were previously enrolled, canceled your coverage and wish to re-enroll, you can only do so during the next annual enrollment period or if you experience a qualified change in status. See Change your coverage for additional details.

Classes of coverage

You can choose coverage as an:

  • Employee only,
  • Employee and spouse,
  • Employee and child(ren), or
  • Employee and family.

Each class of coverage described in this section has its own contribution rate. Employees contribute to the Plan through monthly deductions from their pay on a pre-tax or after-tax basis.For employees on an approved leave of absence (LOA), the following will apply:

  • Military (voluntary): 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: 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

Changing your coverage 

To make a change to your coverage after your initial enrollment, you must wait until the next annual enrollment period or until you experience a qualified change in status.

Annual enrollment

Each year, during the fall, ExxonMobil offers an annual enrollment period. During this time, you can switch from your current medical plan option to another available option. This is also the time to make changes to coverage by adding or deleting family members. Changes elected during annual enrollment take effect the first of the following year.

During annual enrollment, changes to your EMMP coverage (option or contributions) do not automatically adjust your coverage or contributions to other plans such as the ExxonMobil Dental Plan, ExxonMobil Vision Plan, or the flexible spending accounts under the ExxonMobil Pre-Tax Spending Plan. Changes to those plans must be made separately.

If 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 each year during 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.

Note: 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.

Mid-Year changes

Another parent is ordered to provide coverage to your covered child through a QMSCO

Revoke or decrease your election if coverage actually provided

Within 60 days following the date of the event

You are ordered to provide coverage to your eligible child through a QMCSO

Enroll or Increase your election

Within 60 days following the date 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.

Within 60 days following the date 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

 

Make a corresponding prospective change in your election:

  • Change in coverage of this plan: You can cancel your election and be able to elect coverage under another medical plan option.

     

  • Change in coverage of your spouse´s plan: you will be able to sign up for medical coverage for yourself and your eligible family members.

Within 60 days following the date of the event.

HIPAA special enrollment provisions

Marriage

  • Enroll or increase your election because of the newly eligible spouse

Within 60 days following the date of the event.

Gain a family member through birth, adoption or placement for adoption,

 

Enroll or increase your election because of the newly eligible family member.

 

You must add the new family member within 60 days even if you already have family coverage. Coverage is effective on the date of birth, adoption, or placement for adoption

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 an after-tax basis until the end of the month in which the enrollment is completed in the ExxonMobil Benefits or though ExxonMobil Benefits Service Center.

Beginning the first day of the following month your deduction will be on a pre-tax basis.

 

You or a family member loses eligibility under another employer's group health plan or other employer contributions cease

Enroll yourself and other family members who might have lost eligibility. This only pertains to the medical plan. Change your level of coverage and change medical plan option.

Check Within 60 days following the date 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).

You may change your EMMP 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 the ExxonMobil Benefits portalor through the ExxonMobil Benefits Service Center phone line.

 

Addition or improvement of medical plan options

If a new Medical Plan option is added or if benefits under an existing option are significantly improved during a plan year, you may be able to cancel your current election in order to make an election for coverage under the new or improved option.

Loss of option

If a service area under the Plan is discontinued, you will be able to elect either to receive coverage under another medical plan option providing similar coverage or to drop medical coverage altogether if no similar option is available. For example, if an option is discontinued, you may elect another option that has service in your area or you may elect to participate in the POS II options.  You may also discontinue medical coverage altogether.

Other situations that may affect your coverage

Leave of absence

If you are on an approved leave of absence, you can continue coverage by making required contributions directly to the Plan by check or, if applicable, pre-pay your benefits. If you chose not to continue your coverage while on leave, your coverage ends on the last day of the month in which the cancelation form is received by ExxonMobil Benefits Service Center and you will be required to pay for the entire month's contributions. If you fail to make required contributions while on leave, coverage will end.

If the company should make any payment on your behalf to continue your coverage while you are on leave and you decide not to return to work, you will be required to reimburse the company for required contributions.

If you are on an approved leave of absence and the COBRA Contribution Rate begins, you may continue your coverage by making your required contribution.

If you were on a leave that meets the requirements of the Family and Medical Leave Act of 1993 (FMLA) or the Uniformed Services Employment and Reemployment Rights Act (USERRA) and your coverage ended, re-enrollment is subject to FMLA or USERRA requirements.

For more information, contact ExxonMobil Benefits Service Center. 

If you retire

If you retire as a regular employee on or after age 55 with 15 or more benefit years of service, you are eligible for the ExxonMobil Retiree Medical Plan (EMRMP) or you may elect COBRA to stay in the ExxonMobil Medical Plan for the duration of COBRA Coverage. If you retire as a regular employee and are Medicare-eligible, you are eligible to enroll in Medicare Primary Option (MPO) option of the EMRMP.

If you decline enrollment in the ExxonMobil Retiree Medical Plan at retirement, you will have limited opportunities to enroll at a later date. See the Summary Plan Description for the EMRMP option of your choice for more information.

If a covered family member lives away from home

Coverage depends on whether the plan option you are enrolled in as an employee offers service in the area where you live. If your covered family member does not live with you (for instance, you have a child away at school), please contact Aetna Member Services to confirm whether service is available where your family member lives. (See Service area in Key terms.)

If you work beyond when you become eligible for Medicare 

If you continue to work for ExxonMobil after you become eligible for Medicare, although you are eligible for Medicare, your ExxonMobil employee coverage remains in effect for you and eligible family members and the ExxonMobil Medical Plan is your primary plan. Medicare benefits, if you sign up for them, will be your secondary benefits. Refer to www.medicare.gov to learn more about Medicare while you are still employed.

If your covered family members become Medicare eligible for any reason

Employees or family members of an employee who become Medicare eligible, either due to age or Social Security disability status, are eligible to participate in any ExxonMobil Medical Plan option as long as the employee remains as a regular employee.

If the employee retires or dies, and coverage is available under the EMRMP:

  • Medicare eligible covered spouses must enroll in the Medicare Primary Option, including enrolling in Medicare Parts A and B.
  • All eligible dependent children under the age of 26 (including those that are Medicare eligible) and those over the age of 26 who are totally and continuously disabled and not Medicare eligible, may enroll in the Retiree Medical Plan options of the EMRMP.
  • Medicare eligible dependent children over the age of 26 are not eligible for coverage under any ExxonMobil Health plan available to retirees.  You may be eligible to elect continuation coverage for your Medicare eligible dependent child under COBRA provisions. See Continuation coverage for details. 

If you die

If you die while enrolled, your covered eligible family members may be eligible for the ExxonMobil Retiree Medical Plan. They are not eligible to continue to participate in the ExxonMobil Medical Plan except through COBRA. Their eligibility continues with the EMRMP 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, becomes eligible for Medicare or dies. Upon eligibility for Medicare, your spouse can continue coverage through the Medicare Primary Option.
  • If you have less than 15 years of benefit service, eligibility continues for twice your length of benefit service or until your spouse remarries, becomes eligible for Medicare, or dies, whichever occurs first. Upon eligibility for Medicare, your spouse can continue coverage through the Medicare Primary Option.

Children of deceased employees may continue participation as long as they are an eligible family member. If your surviving spouses remarries, eligibility for your stepchildren also ends.

See Continuation Coverage for details.

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