An employee may add a family member effective the first day of a month if required contributions are made on a pre-tax basis and adding the family member does not change the coverage level. If you are enrolled on an after-tax basis, you may add an eligible family member to your existing option effective the first of the following month following receipt of your written election by Benefits Administration.
To make a change to your coverage you may also wait until Annual Enrollment or until you experience one of the following Changes in Status.
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. The only exception is death of an eligible family member. 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.
Important Note: Your election made due to a change in status cannot be changed after the form is received by Benefits Administration or the transaction is completed in EDA if it changes your pre-tax contributions.
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 enrolled in Health Plans||You must drop coverage for your former spouse and stepchild(ren) but you may not drop coverage for yourself or other covered eligible family members.|
|Divorce - Employee loses coverage under spouse's health plans||Enroll yourself and other family members who might have lost eligibility for spouse's health plans.|
|Gain a family member through birth, adoption or placement for adoption or guardianship||Enroll 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 drop 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 drop coverage for yourself or other 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 Health 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 (e.g., move out of plan's service area)||Change your Medical Plan Option and change level of coverage, or drop coverage for yourself or other eligible family members.|
|If you, your spouse, or family member becomes entitled to Medicare or Medicaid||You may 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.
(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 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 Health Plans.|
|You begin a leave of absence||Call Benefits Administration at 1-800-262-2363 to discuss permissible changes.|
|You return from a leave of absence of more than 30 days (paid or unpaid)||Call Benefits Administration at 1-800-262-2363 to discuss permissible changes.|
|Start an Expatriate assignment and change from an HMO Medical Plan option to POS II A or B||Increase or decrease your election.|
Changes will only be allowed if the medical/dental/vision enrollment form is received within 60 days of the event by the Benefits Administration Office or the change is made in EDA within 30 days. Unless otherwise noted, the effective date will be the first of the month after the forms are received or the transaction is completed in EDA.
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.
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 forms are received by Benefits Administration. Beginning the first day of the following month your deduction will be on a pre-tax basis.
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 family member, 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.
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.
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.
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. 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 dependents reaching the maximum eligibility age, you remain responsible for ensuring that the dependent is removed from coverage. If you fail to ensure that a family member is removed in a timely manner, there may be consequences for falsifying company records.
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.
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 Plan option to one that is available in your new location. For more information, call 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. If you choose not to continue your coverage while on leave, your coverage ends on the last day of the month in which your leave began 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.
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 co-payment.
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.
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 option. You may also discontinue medical coverage altogether.
Remember, if you make your contributions on a pre-tax basis and 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 changes 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 Retiree Medical Plan (RMP) 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 Supplement Plan (MSP).
If a covered family member lives away from home
Coverage is dependent upon whether the plan option offers service in that area. If your covered family member does not live with you (for instance, you have a child away at school), please contact Member Services to confirm whether service is available. (See Service Area in Key terms.)
If you are a retiree not yet eligible for medicare
If you are a retiree, you and your family members who are not eligible for Medicare can continue to participate in the Medical Plan. When you (as a retiree) or a covered family member of a retiree becomes eligible for Medicare, Medicare will become the primary plan for the retiree or other family member and benefits will be coordinated. You then are no longer eligible for the Medical Plan, but you are eligible to enroll in the ExxonMobil Medicare Supplement Plan (EMMSP). If you fail to enroll in the EMMSP when first eligible, then you will not be able to enroll at a later time without proof of having other employer provided coverage immediately prior to enrollment.
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 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.
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, Medicare eligible covered family members must change to the ExxonMobil Medicare Supplement Plan and enroll in Medicare Parts A and B. When a retiree or a retiree's covered eligible family member becomes eligible for Medicare, either due to age or Social Security disability status, that person cannot participate in any Medical Plan option but will be eligible for the ExxonMobil Medicare Supplement Plan.
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.
If you die
If you die while enrolled, your covered eligible family members can continue coverage. Their eligibility continues with the company contributions 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 ExxonMobil Medicare Supplement Plan.
- 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 ExxonMobil Medicare Supplement Plan.
Children of deceased employees may continue participation as long as they are an eligible family member. If your surviving spouse remarries, eligibility for your children also ends.
Eligible family members of deceased extended part-time employees are not eligible to continue to participate in the Medical Plan. These family members may be eligible to elect continuation coverage under COBRA provisions.
HMO specific events
Other than the events listed above and Annual Enrollment, other events may permit a change in coverage. Contact Member Services directly to determine if there are specific events that may apply to you.