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Eligibility and enrollment

Eligibility and enrollment details for the ExxonMobil International Medical and Dental Plan

All regular full-time or part-time expatriates whose home country is the U.S. (“expatriates”)  and all regular full-time or part-time expatriates whose host country is the U.S. (“impatriates”) and eligible dependent(s) of those individuals under the ExxonMobil expatriate guidelines are eligible to be enrolled in the International Medical and Dental 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 lose eligibility as described under the Loss of eligibility section.
  • Your coverage is prohibited under applicable law.

Eligible dependents

You may also elect coverage for your eligible dependent(s) including:

Married Spouses and Domestic Partners

Married spouses and domestic partners may be eligible to receive benefits under expatriate guidelines, if s/he meets the following criteria:

  • Eligible for benefits under the employee’s home country benefit plans (if any) at a level equal to that provided to a legally married spouse
  • Able to reside permanently in the employee’s home country
  • Can secure a residency visa (not a tourist or visitor’s visa) in the host country

In order to be eligible for coverage under the host or expatriate health care plan, married spouses/domestic partners must reside full-time (more than 50%) at the host country. If they continue to reside in your home country, they should continue to qualify for coverage under your home country health care plan.

Exceptions and special cases may arise for spouses and domestic partners:

  • If a spouse or eligible dependents of an expatriate remain in the U.S., the spouse or eligible dependents will be eligible to be enrolled in this Plan while the expatriate is on assignment and will not be allowed to enroll in a different domestic ExxonMobil Medical Plan option.
  • If an U.S. impatriate working temporarily in the U.S. is married to a regular U.S. employee, the regular U.S. employee may enroll the impatriate as a dependent under the domestic ExxonMobil medical plan option that he or she participates in.

Dependent Children

Eligible dependents may include your biological, adopted, and stepchildren who are under the age of 26.

Domestic partners’ children may only be allowed to participate if such dependents are eligible for benefits under the employee’s home country benefit plan and expatriate guidelines.   

A totally and continuously disabled child(ren) age 26 or older who is incapable of self-sustaining employment by reason of mental or physical disability may be eligible to participate in this Plan as determined by the Administrator-Benefits.

Classes of coverage

You can choose coverage as an:

  • Employee only,
  • Employee plus one,
  • Employee plus 2 or more

Each class of coverage described in this section has its own contribution rate. Employees contribute to this Plan through monthly deductions from their pay on a pre-tax or after-tax basis as applicable.

Double coverage

No one can be covered in more than one medical plan sponsored by Exxon Mobil Corporation or its affiliates. If your spouse or adult child work for the company each of them can be covered:

  • As an individual in the U.S. domestic plans,
  • As eligible dependents in this Plan
    • If you become eligible for other ExxonMobil-sponsored health plans mid-month, coverage becomes effective when you are newly eligible for the new health plan or as otherwise determined by the Administrator-Benefits.

How to enroll

All regular full-time or part-time U.S. expatriates will be automatically enrolled in the medical portion of this Plan as of the first day of the assignment.

U.S. impatriates will be automatically enrolled in the medical portion of this plan as Participant Only. An enrollment form may need to be completed for eligible dependents, as applicable.  

The dental portion is optional and an election may be made within 60 days.

Any eligible dependent(s) will become eligible on the effective date of your assignment.

Dependents of U.S. Expatriates (home country U.S.) will be automatically enrolled in Cigna International if already enrolled in the employee’s U.S. Medical Plan and Dental Plan elections, regardless of their status as an accompanying family member. If a U.S. expatriate (home country U.S.) had previously elected dental coverage in the U.S., but wishes to opt out of Cigna International dental coverage, they must do so within 30 days by contacting the ExxonMobil Benefits Service Center.

U.S. Impatriates (host country U.S.) are required to enroll any accompanying dependents into the International Medical and Dental Plan by contacting the ExxonMobil Benefits Service Center. U.S. Impatriates can also to enroll in Dental coverage for themselves (if desired) by contacting the ExxonMobil Benefits Service Center within 60 days. If any enrollment occurs after the start of the assignment (i.e. a dependent joins the assignment as an accompanying dependent after assignment start date), coverage will not begin until the 1st of the month following when they join the U.S. impatriate on assignment.

If you fail to enroll your eligible dependent(s) in the medical or dental portions within 60 days, the next opportunity to enroll will be during annual enrollment with an effective date of the first day of the following year or upon a change in status event.

In the event of marriage, adoption or newborn child, please make sure you complete enrollment within 60 days of the event.   In this case of marriage,  coverage will be effective as of the first day of the month following enrollment. In the case of adoption or birth of a child, coverage will be retroactive to the date of the event for the first 30 days and from day 31 to 60 will be effective as of the first day of the month following enrollment.

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

You may be requested to provide documents at some future date to prove that the eligible dependent(s) 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 eligible dependent(s) 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. Please also refer to the Loss of eligibility section – Fraud against the Plan.

Annual Enrollment

Each year, ExxonMobil offers an annual enrollment period. During this time, you will only be able to:

  • Add or delete eligible dependents. Changes elected during annual enrollment take effect the first of the following year.
  • Opt in/out from the dental portion of this Plan.

NOTE: You should not wait until annual enrollment to remove a dependent who loses eligibility; they should be removed at the time eligibility is lost. For consequences of covering an ineligible eligible dependent, see Loss of Eligibility.

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.

For U.S. expatriates, if you fail to remove an ineligible dependent(s) within 60 days of the event that causes the person to no longer be 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 dependent.

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 your spouse and any new eligible dependent(s) .

Divorce – Employee and spouse enrolled in ExxonMobil International Medical and Dental Plan

Change your level of coverage. You must remove coverage for your former spouse and stepchild(ren).

Gain an eligible dependent through birth, adoption or placement for adoption, sole court appointed legal guardian or sole managing conservator

Enroll any eligible dependent(s) and change your level of coverage, if needed.

Death of a spouse or other eligible dependent

Change your level of coverage. You may not cancel coverage for yourself or other covered eligible dependents.

An eligible dependent loses eligibility under another employer's plan or other employer contributions cease which creates a "HIPAA special enrollment" right

Enroll your eligible dependents who might have lost eligibility under another employer’s plan. Change your level of coverage, if needed.

Other loss of eligible dependent'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 dependents.

Your former spouse is ordered to provide coverage to your children through a QMCSO

End the eligible dependent's coverage, change level of coverage and terminate their participation in the ExxonMobil International Medical and Dental Plan.

Commencement of Employment by spouse or other eligible dependent or other change in their employment status (e.g., change from part-time to full-time) triggering eligibility under a different employer sponsored plan.

End spouse or eligible dependent's coverage and terminate their participation in the ExxonMobil International Medical and Dental Plan.

Your spouse, or eligible dependent becomes entitled to Medicare or Medicaid.

You may choose to change level of coverage related to the eligible dependent as long as they are eligible to enroll in Medicare/Medicaid.

Judgment, decree or other court order requiring you to cover a eligible dependent.
(e.g., begin a QMCSO)

Change level of coverage.

You begin a leave of absence

Contact ExxonMobil Benefits Service Center to discuss permissible changes.

You return from a leave of absence of more than 30 days (paid or unpaid)

Contact ExxonMobil Benefits Service Center to discuss permissible changes.

Your expatriate assignment outside of the U.S. ends.

If returning in the same year the assignment started, you will be defaulted to your previous domestic Medical Plan option, Dental and Vision Plans elections.

If you return after the year the assignment started, you have 60 days to choose any domestic Medical Plan option available to you or you will be defaulted to your previous domestic Medical Plan option, and Dental and Vision Plans (if previously enrolled)*.

*If you were not enrolled in any previous domestic medical plan option or you don´t have a valid new address, you will be defaulted to a POS option.

 

Marriage

If you are enrolled in the ExxonMobil International Medical and Dental Plan, you can enroll your new spouse and stepchildren for coverage, if they are considered eligible dependents. You must make these changes within 60 days following the date of your marriage or wait until Annual Enrollment or another change in status.

Note: You are not allowed to opt-out of the International Medical and Dental plan if you gain coverage under your spouse's health plan.

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 documents if requested to the ExxonMobil Benefits Service Center as soon as your divorce is final. If you fail to notify or provide the requested documentation to the ExxonMobil Benefits Service Center within 60 days, the former spouse and eligible dependent will not be entitled to elect COBRA. Please see the Continuation coverage section of this SPD. There may also be consequences for falsifying company records. 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 do not complete your change within 60 days, any contributions you make for ineligible dependents will not be refunded. For US expatriates,  pre-tax contributions will not be reduced until the beginning of the next calendar year. Any claims paid after the loss of eligibility must be repaid by you.

Birth, adoption or placement for adoption

If you gain an eligible dependent through birth, adoption, or placement for adoption you may add the new eligible dependent to your current coverage. Coverage is effective on the date of birth, adoption or placement for adoption if you enroll your eligible dependent within the first 30 days. If you enroll your new eligible dependent between 31 and 60 days from the birth or adoption, the changes will be effective the first day of the following month following enrollment. If you miss to enroll your eligible dependents within 60 days, the next opportunity to enroll will be during annual enrollment and the effective date of coverage shall be the first day of the following year.

You must add the new eligible dependent within 60 days even if you already have family coverage.

Death of a spouse

If you and your eligible dependents are enrolled in the ExxonMobil International Medical and Dental Plan, any stepchildren will cease to be eligible upon your spouse's death unless you are their court appointed guardian or sole managing conservator.

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 eligible dependent no longer meets the eligibility criteria, 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 the ExxonMobil Benefits Service Center as soon as a eligible dependent is no longer eligible. If you fail to notify and provide the appropriate forms to the ExxonMobil Benefits Service Center within 60 days, the eligible dependent 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 remove the ineligible dependent in a timely manner, there may be consequences for falsifying company records. 

Leave of absence

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

Other situations that may affect your coverage

If you retire

If you are a U.S. expatriate and you decide to retire, you may be eligible for the ExxonMobil Retiree Medical Plan (EMRMP) or you may elect COBRA to stay in this Plan for the duration of COBRA coverage. If you retire as a regular employee and you are Medicare-eligible, you may be eligible to enroll in the Medicare Primary Option (MPO) option of the EMRMP. Please refer to the EMRMP Summary Plan Description for eligibility and enrollment requirements.

If a U.S. expatriate continues to work beyond the date of eligibility for Medicare

If you are eligible for Medicare while you are still on an active expatriate assignment, this Plan will be primary to your Medicare benefits, if any. Refer to www.medicare.gov to learn more about Medicare while you are still employed.

If your covered eligible dependents become Medicare eligible for any reason

Eligible dependents of a U.S. expatriate who become Medicare eligible, either due to age or Social Security disability status, are eligible to continue to participate in this Plan as their primary plan option as long as the U.S. expatriate remains on assignment.

If the U.S. expatriate 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 medical 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 are a U.S. expatriate and die while enrolled, your covered surviving spouse may be eligible to continue coverage under 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, the surviving spouse may continue coverage through the Medicare Primary Option only until the end of the applicable period.  

Children of deceased U.S. expatriates may continue participation as long as they are eligible dependents. The length of their coverage will depend on the years of service of the U.S. expatriate as described above. Stepchildren will lose eligibility if the U.S. expatriate surviving spouse remarries.

If you are a U.S. impatriate, COBRA continuation coverage may be  available for your dependents up to 36 months from the date of the event.

How this Cigna International Medical and Dental Plan works

Open Access Plus Medical Benefits provide coverage for care inside the United States (in-network and out-of-network) and internationally (outside the United States). To receive Open Access Plus Medical Benefits, you and your eligible dependents may be required to pay a portion of the covered expenses for services and supplies such as a copayment, deductible or coinsurance, if any. Please refer to the in-network benefits schedule found on www.cignaenvoy.com for details.

If you are unable to locate an in-network provider in your area who can provide you with a service or supply that is covered under this Plan, you must call the number on the back of your ID card to obtain authorization for out-of-network provider coverage. If you obtain authorization for services provided by an out-of-network provider, benefits for those services will be covered at the in-network benefit level.

For full information about covered and non-covered expenses and plan limitations for your medical, dental, vision and prescription plan benefits, refer to the Certificate on the Cigna website at www.cignaenvoy.com

You can search this SPD section by section or click here to create a single searchable document.