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 the first day of a month after enrollment is completed, except in the case of a birth or adoption of a child when changes will be effective on the date of the birth or adoption. If the change is made during Annual Enrollment, changes are effective the first day of the following year.
Changes in status
This section explains which events are considered changes in status and what changes you may make as a result. If you have a change in status, you must complete your change within 60 days. If you do not complete your change within 60 days, changes to your coverage may be limited. If you fail to remove an ineligible family member within 60 days of the event that causes the person to be no longer eligible, (e.g., divorce) you must continue to pay the same pre-tax contribution for coverage even though you have removed that ineligible person. Your pre-tax contribution for coverage will remain the same until you have another change in status or the first of the plan year following the next Annual Enrollment period. The only exception is death of an eligible family member.
Important Note: Your election made due to a change in status cannot be changed after the transaction is completed in EDA or the form is received by Benefits Administration. If you make a mistake in EDA, contact Benefits Administration at email@example.com immediately or no later than the first work day following the day on which the mistake was made.
The following is a quick reference guide to the Changes in Status that are discussed in more detail after the table.
|If this event occurs...||You may...|
|Marriage||Enroll yourself and spouse and any new eligible family members or change your Medical Plan option.|
|Divorce – Employee and spouse enrolled in ExxonMobil health plans||Change your level of coverage. You must remove coverage for your former spouse and stepchild(ren) but you may not remove coverage for yourself or other covered eligible family members.|
|Divorce - Employee loses coverage under spouse's health plans||Enroll yourself and other eligible family members who might have lost eligibility for spouse's medical plan.|
|Gain a family member through birth, adoption or placement for adoption, sole court appointed legal guardian or sole managing conservator||Enroll yourself and any eligible family members and change Medical Plan option.|
|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 who might have lost eligibility. This only pertains to the Medical Plan. Change your level of coverage and change Medical Plan option.|
|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||Your Medical 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 who may have lost eligibility under the spouse's or family member's plan in Medical Plan and change your Medical Plan option.|
|Your former spouse is ordered to provide coverage to your children through a QMCSO||End the family member's coverage, change level of coverage and terminate their participation in the Medical 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's coverage and terminate their participation in Medical Plan 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 Medical Plan option||Change your Medical Plan option and change level of coverage, or cancel coverage for yourself or other eligible family members. This only pertains to the Medical Plan.|
|You, your spouse, or family member becomes entitled to Medicare or Medicaid||You may choose to cancel coverage for you or change level of coverage related to the Medicare/Medicaid eligible family member.|
|Judgment, decree or other court order requiring you to cover a family member.
(e.g., begin a QMCSO)
|Change your Medical Plan option and change level of coverage.|
|Termination of employment and rehire within 30 days or retroactive reinstatement ordered by court||Enroll in the same Medical Plans you had prior to termination.|
|Termination of employment and rehire after 30 days||Enroll in the Medical Plan as a new hire.|
|You are covered under your spouse's medical plan and plan changes coverage to a lesser coverage level with a higher deductible mid-year||Enroll yourself and eligible family members in the Medical Plan.|
|You begin a leave of absence||Contact Benefits Administration to discuss permissible changes.|
|You return from a leave of absence of more than 30 days (paid or unpaid)||Contact Benefits Administration to discuss permissible changes.|
|You return from expatriate assignment outside of the U.S.||
If returning in the same year the assignment started, you will be defaulted to your previous Medical Plan Option.
If you return after the year the assignment started, you have 60 days to choose any Medical Plan Option available to you or you will be defaulted to your previous Medical Plan option*.
*If not valid with new address, you will be defaulted to POSII A.
If you are enrolled in the Medical Plan, you can enroll your new spouse and his or her eligible family members (your stepchildren) for coverage. You also may change your plan option. If you are not already enrolled for coverage, you can sign up for medical coverage for yourself, your new spouse, and your stepchildren. If you gain coverage under your spouse's health plan, you can cancel your coverage. You must make these changes within 60 days following the date of your marriage or wait until Annual Enrollment or another change in status.
In the case of divorce, your former spouse and any stepchildren are eligible for coverage only through the end of the month in which the divorce is final. You must notify and provide any requested documents to Benefits Administration as soon as your divorce is final. If you fail to notify and provide the appropriate forms to Benefits Administration within 60 days, the former spouse and family member will not be entitled to elect COBRA. There may also be consequences for falsifying company records. Please see the Continuation coverage section of this SPD.
You may not make a change to your coverage if you and your spouse become legally separated because there is no impact on eligibility.
If you lose coverage under your spouse's health plan because of divorce, you can sign up for medical 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 or wait until Annual Enrollment or another change in status.
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. You must add the new family member within 60 days even if you already have family coverage. See the Changing coverage section for additional circumstances in which changes can be made.
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 enrollment is completed in EDA or the forms are received by Benefits Administration. Beginning the first day of the following month your deduction will be on a pre-tax basis.
CAUTION: SHOULD YOU DECIDE TO RETROACTIVELY CHANGE TO A DIFFERENT MEDICAL PLAN OPTION, SUCH AS FROM THE CIGNA OPTION TO A POS II OPTION, YOUR BENEFITS FOR ANY MEDICAL SERVICES WHICH WERE RECEIVED ON OR AFTER THE EFFECTIVE DATE OF COVERAGE FOLLOWING THE BIRTH, ADOPTION OR PLACEMENT FOR ADOPTION MAY NOT BE COVERED OR MAY BE REIMBURSED AT A LOWER BENEFIT LEVEL. MAKE SURE YOU FULLY UNDERSTAND THE IMPACT OF CHANGING OPTIONS BEFORE MAKING YOUR ELECTION.
Death of a spouse
If you lose coverage under your spouse's health plan, you can sign up for Medical Plan coverage for yourself and your eligible family members. You must make these changes within 60 days following the date you lose coverage or wait until Annual Enrollment or another change in status. If you and your family members are enrolled in the ExxonMobil Medical Plan, any stepchildren will cease to be eligible upon your spouse's death unless you are their court appointed guardian or sole managing conservator.
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. If you choose to revoke your elected coverage option, you may be able to elect coverage under another Medical Plan option. This provision also applies to a significant increase in health care deductible or copayment.
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 medical 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.
Sole legal guardianship or sole managing conservatorship
If you (or your spouse, separately or together) become the sole court appointed legal guardian or sole managing conservator of a child and the child meets all other requirements of the definition of an eligible child, you have 60 days from the date the judgment is signed to enroll the child for coverage. You must provide a copy of the court document signed by a judge appointing you (or your spouse separately or together) guardian or sole managing conservator.
When a child is no longer eligible
If an enrolled family member is no longer an eligible family member, 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. (See Continuation coverage for more details about COBRA.) You must notify and provide the appropriate forms to Benefits Administration as soon as a family member is no longer eligible. If you fail to notify and provide the appropriate forms to Benefits Administration within 60 days, the family member will not be entitled to elect COBRA. While we have an administrative process to remove dependent children reaching the maximum eligibility age, you remain responsible for ensuring that the dependent child is removed from coverage. If you fail to ensure that an ineligible family member is removed in a timely manner, there may be consequences for falsifying company records.
Transfer or change residence
If you move from one location to another, and the move makes you no longer eligible for the selected Medical Plan option (e.g., move out of the OAPIN service area), you may change from your current Medical option to one that is available in your new location. However, if you move into a location where Aetna POS II options are available and you are enrolled in one of those options, you are not eligible to enroll until Annual Enrollment. For more information, contact Benefits Administration.
Leave of absence
If you are on an approved leave of absence, you can continue coverage by making required contributions directly to the Medical 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 Benefits Administration 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 Leave of Absence 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, call Benefits Administration.
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 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 option. You may also discontinue medical coverage altogether.
Remember, if you experience any of the events mentioned previously, or if you are newly eligible as a result of a change or loss of coverage under your spouse's health plan, it is your responsibility to complete your change within 60 days of experiencing the event. If you miss the 60-day notification period, you will not be able to make changes until Annual Enrollment or until you experience another change in status.
Other situations that may affect your coverage
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 the Medicare Primary Option (MPO) option of the EMRMP.
Effective January 1, 2019: 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 Cigna Customer Service 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 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 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 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 are an extended part-time employee
If you terminate employment as an extended part-time employee, you are not eligible to continue to participate in the Medical Plan. You may be eligible to elect continuation coverage for yourself and your eligible family members 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. 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 or retirees may continue participation as long as they are an eligible family member. If your surviving spouse remarries, eligibility for your stepchildren also ends.
Eligible family members of deceased extended part-time employees are only eligible to elect continuation coverage under COBRA provisions. See Continuation coverage for details.