Most U.S. dollar payroll regular employees of Exxon Mobil Corporation and participating affiliates who work at a location where the ExxonMobil Medical Plan Cigna option is offered and reside in the service area are eligible for this option. The employee's home address zip code is used to determine whether the employee resides in the service area and is therefore eligible for the Cigna option.

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 are not eligible if:

• You are eligible for coverage under the ExxonMobil Retiree Medical Plan.
• You participate in any other employer medical 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.
• 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, contact 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 Members and Child appear in the Definitions section of this guide and in the definition of Qualified Medical Child Support Order.

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 family member as long as that person's eligibility for coverage as a dependent under a Mobil-sponsored plan would have continued.

Classes of coverage

You can choose coverage as an:

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

Double coverage

No one can be covered more than once in the ExxonMobil Medical 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 you may both be eligible for coverage. Each of you can be covered as an individual, 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 employee, if you complete your enrollment in the ExxonMobil Medical Plan 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 enrollment in ExxonMobil Benefits portal or through the ExxonMobil Benefits Service Center.  If you enroll in the Cigna option, your eligible family members can only enroll in this option.

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 class of coverage must remain in effect for the entire plan year, unless you experience a change in status. (See Annual enrollment and Changing your coverage sections.)

As a current employee, if you are not covered by a medical plan to which ExxonMobil contributes you may enroll at the next annual enrollment. You may also enroll if you experience a corresponding change in status. Coverage is effective the first of the month following completion of enrollment in ExxonMobil Benefits portal or through the ExxonMobil Benefits Service Center. 

You may 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). 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 and you may be subject to discipline up to and including termination of employment for falsifying company records.

If you have originally enrolled in other group health plan coverage and you/your family members lose eligibility (or the employer stops contributing toward you and/or your family member(s) coverage), you may enroll yourself or your family members in any available ExxonMobil Medical Plan option.  In addition, you may enroll yourself or your family members in any available ExxonMobil Medical Plan option within 60 days after marriage (with coverage effective the first of the following month) or after birth, adoption or placement for adoption (with coverage retroactive to the birth, adoption or placement for adoption).

You must enroll each new child for them to be covered, even if you already have family coverage.

Under the Children's Health Insurance Program (CHIP) Reauthorization Act of 2009 you may change your ExxonMobil Medical 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 the ExxonMobil Benefits portal or through the ExxonMobil Benefits Service Center.

Annual Enrollment

Each year, during the fall, ExxonMobil offers an annual enrollment period. During this time, you can switch from your current option to another available option. This is also the time to make changes to coverage by adding or deleting family members. Family members may be added or deleted for any reason, but they must be deleted if they are no longer eligible. Changes elected during annual enrollment take effect the first 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.

Employees are automatically enrolled in the ExxonMobil Pre-Tax Spending Plan to pay monthly contributions on a pre-tax basis pursuant to ExxonMobil’s Section 125 Cafeteria Plan unless this feature is declined.  This choice is only available during the annual enrollment period or with a change in status.

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 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 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.

During annual enrollment, changes to your ExxonMobil Medical Plan 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 during annual enrollment.

Changing your coverage

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 the ExxonMobil Benefits portal or the form is received by the ExxonMobil Benefits Service Center. If you make a mistake in the ExxonMobil Benefits portal, contact the ExxonMobil Benefits Service Center 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 ExxonMobil 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 ExxonMobil 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 ExxonMobil Medical Plan. Change your level of coverage and change ExxonMobil 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 ExxonMobil 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. In the case of trainees (already eligible for health plans upon hire date), when becoming regular employees, they are also permitted to enroll upon switching to regular status. Since enrollment would not be upon original hire date, contributions would be on a post-tax basis if applied retroactively
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 ExxonMobil Medical Plan and change your ExxonMobil 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 ExxonMobil Medical Plan.
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 ExxonMobil 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 ExxonMobil Medical Plan option	Change your ExxonMobil Medical Plan option and change level of coverage, or cancel coverage for yourself or other eligible family members.This only pertains to the ExxonMobil 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 ExxonMobil 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 ExxonMobil Medical Plan you had prior to termination.
Termination of employment and rehire after 30 days	Enroll in the ExxonMobil 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 ExxonMobil Medical Plan.
You begin a leave of absence	Contact the ExxonMobil Benefits Service Center to discuss permissible changes.
You return from a leave of absence of more than 30 days (paid or unpaid)	Contact the ExxonMobil Benefits Service Center to discuss permissible changes.
You return from expatriate assignment outside of the U.S.	You will be defaulted to Aetna POS II A of the ExxonMobil Medical Plan. If you wish to enroll in a different medical plan option, you have 60 days since your repatriation date to update your election. Any changes done within this period will be effective upon your repatriation date and there would be no gap in coverage. If no action is taken, the next opportunity to change you medical plan option will be during Annual Enrollment.

Marriage

If you are enrolled in the ExxonMobil Medical Plan, you can enroll your new spouse and their 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.

Divorce

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 the ExxonMobil Benefits Service Center as soon as your divorce is final. If you fail to notify the ExxonMobil Benefits Service Center 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 ExxonMobil Benefits or through the ExxonMobil Benefits Service Center . 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 impacts 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 ExxonMobil 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 the ExxonMobil Benefits Service Center (through the ExxonMobil Benefits portal or by phone) as soon as a family member is no longer eligible. If you fail to notify and provide the appropriate information to the ExxonMobil Benefits Service Center 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 ExxonMobil 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 A/B 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 the ExxonMobil Benefits Service Center.

Leave of absence

If you are on an approved leave of absence, you can continue coverage by making required contributions directly to the ExxonMobil 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 the 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 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 the ExxonMobil Benefits Service Center. 

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 Aetna POS II A/B 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 Plan is your primary plan. Medicare benefits, if you sign up for them, will be your secondary benefits. Please see the Coordination of benefits section for further information. 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 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.