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Appendix A
Appendix A to the ExxonMobil medical fully-insured HMO Plan
Southern California
Kaiser Foundation Health Plan, Inc.
Stockton Call Center
1350 Tommydon Street
Stockton, CA 95210
Member Services
1-800-464-4000
Member Services
1-800-777-7902
www.kaiserpermanente.org
Benefits guaranteed under an insurance policy issued by Kaiser Permanente, a fully-insured HMO.
Illinois
HMO Illinois (Chicago)
Customer Service
P.O. Box 1364
Chicago, IL 60690
Member Services
1-800-892-2803
Benefits Administration - The following sets out the contact numbers based on your status under the ExxonMobil Medical Plan. It is your responsibility to contact the correct Benefits Administration entity with any required notices and address changes. If your status is not listed, call ExxonMobil Benefits Administration/Health Plan Services for assistance or contact them at hr.medical.dental.questions@exxonmobil.com.
| Phone Numbers: | Address: |
|---|---|
| Employees and their covered family members: | |
|
ExxonMobil Benefits Administration/ 800-262-2363 (toll free) |
ExxonMobil Benefits Administration / Health Plan Services ExxonMobil BA BSC USBA P. O. Box 64111 Spring, TX 77387-4111 |
| Former employees and family members who have elected and are participating through COBRA: | |
|
ExxonMobil COBRA Administration 800-526-2720 |
Wageworks National Accounts Services
ExxonMobil COBRA Administration P. O. Box 2968 Alpharetta, GA 30023-2968 Fax: 833-514-6416 |
Benefits administration / ExxonMobil sponsored sites - Access to plan-related information including claim forms for employees, retirees, survivors, and their family members.
- ExxonMobil Me, the Human Resources Intranet Site — Can be accessed at work by employees.
- ExxonMobil Family, the Human Resources Internet Site — Can be accessed from home by everyone at www.exxonmobilfamily.com.
- ExxonMobil Benefits Service Center at Xerox Internet Site — Can be accessed from home by everyone at www.exxonmobil.com/benefits.