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Eligibility and enrollment

Eligibility and enrollment details for the ExxonMobil Employee Medical Plan - POS II A and POS II B Options

Q. What are the Plan's eligibility requirements?

A. Most U.S. dollar payroll regular employees of Exxon Mobil Corporation and participating affiliates are eligible for this Plan.  

Generally, you are eligible if:

  • You are a regular employee.
  • You are an extended part-time 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 an expatriate employee required to participate in the Plan until July 1st, 2021. Effective July 1st, 2021, expatriate employees are no longer eligible to participate in the Plan and will be required to participate in the ExxonMobil International Medical and Dental Plan. 

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.

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, call Benefits Administration. 
  • 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. 

Refer to Key Terms for definitions of eligible family member, child, spouse, and 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 dependent 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
  • Employee and family.

There are also classes of coverage for extended part-time employees and employees on certain types of leaves of absence.

For employees on an approved leave of absence, their contribution rate will change from the employee contribution rate to the Leave of Absence contribution rate as shown in the table below.

Leave of Absence Contribution Rate Begins Immediately No later than
after 6 months
No later than after 12 months
Type of Leave
Military (voluntary)  O    
Civic Affairs O    
Health / Dependent Care    O  
Education    O  
Personal      O

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.

Double coverage

No one can be covered more than once in the 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 employee, 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 enroll in the 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 EDA or receipt of enrollment forms by Benefits Administration. You must enroll everyone in the same 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 EDA, or receipt of the forms by Benefits Administration.

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 requested 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 EMMP option. In addition, you may enroll yourself or your family members in any available EMMP 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 the child 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 EMMP 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 receipt of the forms by Benefits Administration.

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 removed for any reason but they must be removed as soon as they are no longer eligible. Changes elected during annual enrollment take effect the first of the following year.

Note: Do 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 Pre-Tax Spending Plan to pay monthly contributions on a pre-tax basis 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 EMMP 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 the next annual enrollment period 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 are required to 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 are required to continue paying the same pre-tax contribution for coverage even though you have removed the ineligible person(s).  Your pre-tax contribution for coverage will remain the same until you have another change in status or until the first day of the plan year following the next annual enrollment period. In addition, you will be required to reimburse the Plans for any claims paid after the loss of eligibility for any ineligible person(s). The only exception is death of an eligible family member.

Important Note: Your election 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 hr.health.welfare@exxonmobil.com or call them at 1-800-262-2363 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 are required to 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 or strike/ lockout 
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 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 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 Plan option 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
You return from a leave of absence of more than 30 days (paid or unpaid) Contact Benefits Administration
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. 
 

Marriage

If you are enrolled in the 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.

Divorce

In the case of divorce:

  • Your former spouse and any stepchildren are only eligible for coverage through the end of the month in which the divorce is final.
  • You are required to remove coverage for your former spouse and stepchild(ren) within 60 days of your divorce
  • You must notify and provide any requested documents to Benefits Administration as soon as your divorce is final.
  • If you do not to notify and provide requested forms to Benefits Administration within 60 days will result in your former spouse and stepchild(ren) not being entitled to elect COBRA.
  • If you fail to remove your spouse and any stepchild(ren) within 60 days of the event you will continue to have pay the same pre-tax contribution for coverage even though you have removed your former spouse and stepchild(ren).
  • Your pre-tax contribution for coverage will remain the same until you have experienced another change in status or the first of the plan year following the next Annual Enrollment period.
  • You will be required to reimburse the Plans for any claims paid after the loss of eligibility for any ineligible person.

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 your 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 an after-tax basis until the end of the month in which the enrollment is completed in EDA or 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 EMMP OPTION, SUCH AS FROM AN AETNA SELECT OR 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 RETROACTIVELY 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 cancel 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. 

Leave of absence

If you are on an approved leave of absence, you can continue coverage by making required contributions directly to the 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, contact 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 Medical Plan option providing similar coverage or to cancel 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 cancel 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 (MSP) 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 Aetna Member Services 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 becomes Medicare eligible, either due to age or Social Security disability status, are eligible to participate in any Medical Plan option as long as they 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 participating in the 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. They are not eligible to continue to participate in the Plan except through COBRA. 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.

When coverage ends

Coverage for you and/or your family members ends on the earliest of the following dates:

  • The last day of the month in which:

You terminate employment, retire, or die.

You elect not to participate.

A family member ceases to be eligible (for example, a child reaches age 26).

You are no longer eligible for benefits under this Plan (e.g., from non-represented to represented where you are no longer eligible for this Plan).

You terminate employment after being rehired by ExxonMobil as an employee following retirement.

A Qualified Medical Child Support Order is no longer in effect for a covered family member.

Your employer discontinues participation in the Plan.

An expatriate employee's assignment to the United States ends before July 1st, 2021

You Start an expat assignment outside the U.S. effective July 1st, 2021.

OR

  • The date:

The Plan ends.

You do not make any required contribution.

You enrolled an ineligible family member and in the opinion of the Administrator-Benefits, the enrollment was a result of fraud or a misrepresentation of a material fact.

You are responsible for ending coverage with Benefits Administration when your enrolled spouse or family member is no longer eligible for coverage. If you do not complete your change within 60 days, any contributions you make for ineligible family members will not be refunded.

Loss of eligibility

Fraud against the Plan 

Everyone in your family may lose eligibility for Medical Plan coverage, and you may be subject to disciplinary action up to and including termination of employment if you commit fraud against the Medical Plan, for instance, by filing claims for benefits to which you are not entitled. Coverage may also be terminated if you refuse to repay amounts erroneously paid by the Medical Plan on your behalf or that you recover from a third party. Additionally, coverage may be terminated if you fail to reimburse the Plan for any amount owed to the Plan, or if you receive and fail to report to the Claims Processor any discounts, write-offs or other arrangements with providers that result in misrepresentation of your out-of-pocket costs. Your participation may be terminated if you fail to comply with the terms of the Medical Plan and its administrative requirements. You may also lose eligibility if you enroll persons who are not eligible, for instance, by covering children who do not meet the eligibility requirements. This includes failing to provide timely notification of when a covered family member loses eligibility, e.g., spouse loses eligibility due to divorce.

Extended benefits at termination

You are entitled to extended coverage for as much as a year if you are terminated due to disability with fewer than 15 years of service. This coverage is provided at no cost to you. This is considered a portion of the COBRA continuation period. In order to assure coverage beyond this extension period, you must elect COBRA upon termination of employment.

Several conditions must be met:

  • The disability must exist when your employment terminates.

  • The extension lasts only as long as the disability continues, but no longer than 12 months.

This extension applies only to the employee who is terminated because of a disability. Continuation coverage for eligible family members may be available through COBRA.

During annual enrollment, changes to your EMMP 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.

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