Eligibility and enrollment

Most U.S. retirees, survivors and their eligible family members who reside in the Aetna Select service area are eligible to participate. The service area is determined by the retiree's home address zip code.

Generally you are eligible if:

• You are a retiree.
• You are a survivor/surviving spouse, which means an eligible family member of a deceased employee or retiree.
• You are a Long Term Disability Retiree and are not eligible for Medicare Part A or B.
• You are a Long Term expatriate with U.S. Company-sponsored green card (also called permanent resident visas or PRVs) who retires/retired at the end of your current U.S. assignment on or after July 1, 2020 and remain in the U.S. with a valid PRV. If you choose not to enroll, there will be no opportunity to enroll at a later point in time during retirement.

You are not eligible if:

• You participate in any other employer medical plan to which ExxonMobil contributes.
• You are eligible for coverage under the ExxonMobil Medical Plan.
• 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.
• You are eligible for Medicare as your primary plan.

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 (even if Medicare eligible). 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 the Benefits Service Center.
• Your totally and continuously disabled child(ren) aged 26 or over incapable of self-sustaining employment by reason of mental or physical disability that occurred prior to otherwise losing eligibility,  meets the Internal Revenue Service's definition of a dependent, and is not eligible to be enrolled in Medicare as their primary medical plan.
• A child or spouse of a Medicare-eligible retiree or survivor enrolled in the Medicare Supplement Plan or Medicare Primary option, as long as that spouse or child (aged 26 or over) is not eligible for Medicare.
• If you, your dependent, or your spouse become eligible for Medicare, you need to give notice of this event to the ExxonMobil Benefits Service Center (EMBSC) for purposes of benefits coordination.

Effective January 1, 2019, a totally and continuously disabled child over age 26 of a retiree, deceased retiree, or deceased employee who is entitled to be enrolled in Medicare as their primary medical plan is not eligible for coverage under the ExxonMobil Retiree Medical Plan, or any other ExxonMobil health plan available to retirees (such as Dental and Vision coverage).

More complete definitions of Eligible Family Members and Child appear in the Key Terms section of this guide.

Suspended retiree

A person who becomes a retiree due to incapacity within the meaning of the ExxonMobil Disability Plan and who begins long-term disability benefits under that plan, but whose benefits stop because the person is no longer incapacitated, is a suspended retiree and not eligible for coverage until the earlier of the date the person:

• Reaches age 55, or
• Begins his or her benefit under the ExxonMobil Pension Plan at which time the person is again considered a retiree and may enroll.

The family members of a deceased suspended retiree will be eligible for coverage under this Plan only after the occurrence of the earlier of the following:

• The date the suspended retiree would have attained age 55, or
• The date a survivor/surviving spouse begins receiving a benefit due to the suspended retiree's accrued benefit from the ExxonMobil Pension Plan.

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:

• Individual Only (Retiree, Spouse, Surviving Spouse, Surviving Child),
• Retiree and spouse,
• Individual and child(ren), or
• Retiree and family.

There are also classes of coverage for surviving spouses and family members of deceased employees and retirees, and spouses and family members of retirees covered by the Medicare Primary Option and the Medicare Supplement Plan option.

Each class of coverage described in this section has its own contribution rate. Retirees and survivors receiving monthly benefit checks from ExxonMobil pay by deductions from these checks on an after-tax basis. Other retirees or survivors and participants with continuation coverage pay by check or by monthly draft on their bank account.

Double coverage

No one can be covered more than once in the Retiree Medical Plan.  You and a family member cannot both enroll as retirees and elect coverage for each other as eligible family members. If you and your spouse or adult child are both retirees, you may both be eligible for coverage. Each of you can be covered as an individual retiree, or one of you can be covered as the retiree 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.

How to enroll

Retirees have three opportunities to enroll in the ExxonMobil Retiree Medical Plan:

• At retirement, or
• Upon loss of other employer coverage, or
• When first eligible to be enrolled in Medicare as your primary plan.

There is no opportunity to enroll yourself in the Plan at any other time, including during annual enrollment.

Eligible family members may be added to your coverage at one of the three enrollment opportunities listed above or if you experience a change in status. Eligible family members cannot be added to your coverage at any other time, including during annual enrollment.

All enrollments must be completed within 60 days of the enrollment event. Coverage is effective the first of the month following receipt of your election by the ExxonMobil Benefits Service Center (EMBSC), 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.

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 required time period, coverage for the family members will be cancelled the first of the following month. If you enroll family members who are not eligible for the Plan, for instance, by covering children who do not meet the eligibility requirements, you may lose eligibility for yourself and your family under all ExxonMobil health plans.

You may cancel your coverage at any time; however, you may not re-enroll unless you experience a corresponding change in status or you wait until one of the enrollment opportunities listed above. Coverage will be terminated at the end of the month in which your elected change has been received.

Eligible family members may also be removed from your coverage at any time; however, they may not be reinstated unless you experience a corresponding change in status or you wait until one of the enrollment opportunities listed above.

Note: You are required to remove family members who are no longer eligible for coverage at the time of loss of eligibility. To remove an ineligible family member (a divorced spouse for example) you are required to notify the Benefits Service Center within 60 days of the loss of eligibility or your ineligible family members will not be entitled to COBRA benefits continuation. If you fail to notify the Benefits Service Center, you may also lose eligibility for yourself and your family under all ExxonMobil health plans. In addition, you will be required to reimburse the Plans for any claims paid after the loss of eligibility for any ineligible person(s).

Post-Retirement changes in status

If this event occurs...	You may...
Marriage	Add your spouse and any new eligible family members.
Divorce – Retiree and spouse enrolled in ExxonMobil health plans	You required to remove coverage for your former spouse and any stepchild(ren).
Divorce – Retiree loses coverage under spouse’s health plans	Enroll yourself and add other eligible family members who might have lost eligibility for spouse’s plan.
Gain a family member through birth, adoption or placement for adoption, sole court appointed legal guardian, or sole managing conservator	Add new eligible family members.
Death of a spouse	You must remove coverage for any stepchild(ren) unless you are their court appointed legal guardian or sole managing conservator.
You or a family member loses eligibility under another employer's group health plan	Enroll yourself and add eligible family members.
You lose eligibility because of a change in your employment status, e.g., retiree to rehired employee.	Your Retiree Medical Plan participation will automatically be suspended at the date of rehire and you will be covered under the ExxonMobil Medical Plan.
You gain eligibility because of a change in your employment status, e.g., employee to retiree.	Enroll yourself and add eligible family members.
You change your residence affecting your eligibility to participate in your elected Retiree Medical Plan option	Change your Retiree Medical Plan option.
You or your spouse become entitled to enroll in Medicare as your primary plan	You or your spouse lose eligibility under the Retiree Medical Plan options but may enroll in the Medicare Primary Option.
Your disabled child (aged 26 or over) becomes entitled to enroll in Medicare as their primary plan, even if your child is not actually enrolled in Medicare	You must remove coverage for your child.
Judgment, decree, or other court order requiring you to cover a family member. (e.g. begin a QMCSO)	Add new eligible family members.

Changes at retirement

If you were enrolled in the ExxonMobil Medical Plan, your enrollment and your covered family members will transfer to the ExxonMobil Retiree Medical Plan. If you were enrolled in the Aetna Select option as an employee, you will maintain claims, deductibles and out of pocket history as a retiree. However, as a retiree, you will pay your contributions on an after-tax basis via payroll deduction (if eligible), check, or bank draft.

If you are not covered by a medical plan to which ExxonMobil contributes and would like to enroll in the ExxonMobil Retiree Medical Plan, or if you would like to change your Retiree Medical Plan option, you may must do so within 60 days of your retirement date. Coverage is effective the first of the month following receipt of your election by the Benefits Service Center. 

Annual enrollment

Each year, during the fall, ExxonMobil offers an annual enrollment period. During this time, you can switch from your current Retiree Medical Plan option to another available option. Changes elected during annual enrollment take effect the first of the following year.

Retirees cannot enroll in health benefits or add eligible family members during annual enrollment. Eligible family members can only be added to your coverage at one of the enrollment opportunities listed above or if you experience a corresponding change in status.

Do not wait to remove a family member who loses eligibility; they should be removed as soon as their eligibility is lost. For consequences for covering an ineligible family member, see Loss of Eligibility.

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.

Changing your coverage

Changing your coverage on the Retiree Medical Plan - Aetna Select option

Other situations that may affect your coverage

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 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 medical 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.

Transfer or change residence

If you move from one location to another, and the move makes you no longer eligible for the selected Retiree Medical Plan option (e.g., move out of the Aetna Select service area), you may change from your current Plan option to one that is available in your new location.

Addition or improvement of plan options

If a new Retiree 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 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 Aetna Select options.  You may also discontinue medical coverage altogether. 

If a covered family member lives away from home

Coverage depends on whether the plan option you are enrolled in as a retiree 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 or your covered spouse become eligible for Medicare

If you are a retiree, you and your family members who are not eligible for Medicare participate in the Retiree Medical Plan. When you (as a retiree) or a covered spouse of a retiree becomes eligible for Medicare as your primary plan, you or your spouse will no longer be eligible for the POS II, Aetna Select and Cigna OAPIN options in the Retiree Medical Plan, but you or your spouse may be eligible to enroll in the Medicare Primary Option (MPO). If you fail to enroll in the MPO when first eligible, then you will not be able to enroll at a later time without proof of having other employer provided medical coverage immediately prior to enrollment. 

If you die

If you die while enrolled, your covered eligible family members can continue coverage through the Retiree Medical Plan. Eligibility continues for your spouse until your spouse remarries, or becomes eligible for Medicare.  Upon eligibility for Medicare as their primary plan, your spouse can continue coverage through the Medicare Primary Option.

Children of deceased retirees may continue participation as long as they are an eligible family member and are not eligible to be enrolled in Medicare as their primary medical plan. If your surviving spouse remarries, eligibility for your stepchildren also ends. Special rules may apply to family members of individuals who become retirees due to disability. See Suspended Retiree below.

If you become a suspended retiree

If you are a retiree and you would otherwise lose coverage because you have become a suspended retiree under the ExxonMobil Disability Plan, you may continue coverage for yourself and all your family members who were eligible for Medical Plan participation before you became a suspended retiree for either 12 or 18 months.

Coverage continues for 12 months from the date coverage would otherwise end if you received transition benefits under the ExxonMobil Disability Plan.

However, if you did not receive transition benefits under the ExxonMobil Disability Plan, coverage continues for 18 months from the date coverage would otherwise end. The cost of this continued coverage is 102% of the combined participant and company contributions.