When coverage ends
When coverage ends of the ExxonMobil Medical Plan – Aetna POS II A and POS II B options
Coverage for you and/or your family members ends on the earliest of:
The last day of the month in which:
- You terminate employment, retire, or die.
- A family member ceases to be eligible (for example, a child reaches age 26).
- You terminate employment after being rehired by ExxonMobil as an employee following retirement.
- You do not make any required contribution
OR
The effective date:
- The Plan ends.
- 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. See Loss of eligibility section for further details.
- You elect not to participate anymore (opt out),
- 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, from regular to expatriate).
- In which a Qualified Medical Child Support Order is no longer in effect for a covered family member.
- Your employer discontinues participation in the Plan.
You are responsible for ending coverage with the ExxonMobil Benefits Service Center when your enrolled spouse or family member is no longer eligible for coverage. If you do not complete your change within 30 days for most changes in status (and 60 days in the case of divorce or if you, your spouse or your covered dependent gains or loses eligibility for Medicaid or Children’s Health Insurance Program (CHIP) coverage, any contributions you make for ineligible family members will not be refunded.
Loss of eligibility
Fraud against the Plan
Any act, practice, or omission by a Plan participant that constitutes fraud or an intentional misrepresentation of material fact is prohibited by the Plan, and the Plan may rescind coverage retroactively as a result. Any such fraudulent statements, including on Plan enrollment forms and in electronic submissions, may invalidate any payment or claims for services and may be grounds for rescinding coverage. 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.