Eligibility and enrollment
Eligibility and enrollment details for the ExxonMobil Retiree Medical Plan – Open Access Aetna Select Network Only option
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.
The Administrator-Benefits determination of eligibility is final and no appeals are available, including decisions regarding whether a child age 26 or older meets the clinical definition of totally and continuously disabled. All decisions by Aetna confirming a dependent no longer meets the clinical definition of totally and continuously disabled are final.
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.
Coverage Tiers
You can choose coverage as an:
- Individual Only (Retiree, Spouse, Surviving Spouse, Surviving Child),
- Retiree and spouse,
- Individual and child(ren), or
- Family.
There are also coverage tiers 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.
Dual 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
- If you have waived coverage (see Other Employer Sponsored Coverage – Waiving EMRMP) and later lose coverage under another 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. If you are under 65 at the time of your retirement or you are about to turn 65 while participating in the Retiree Medical Plan option, and have other employer coverage, you must waive coverage to maintain eligibility (please refer to the Other Employer Sponsored coverage – Waiving EMRMP section).
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 30 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.
To enroll online visit Your Total Rewards portal.
You will 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.
Changing your coverage
You may cancel your coverage at any time; however, you may not re-enroll unless you experience 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 eligible3for 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
Event |
You are required/permitted to |
When |
Qualified status change |
||
Divorce Retiree and spouse enrolled in ExxonMobil Retiree Medical Plan |
You and your remaining eligible family members may change your medical plan option Note: You may not make a change to your coverage if you and your spouse become legally separated because there is no impact on eligibility. |
You must make these changes within 60 days of your divorce and you are not required to show documentation to drop dependents. If you do not to notify the ExxonMobil Benefits Service Center within 60 days, this 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:
|
Divorce Employee loses coverage under spouse’s medical plan. |
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 make these changes within 60 days following the date you lose coverage under your spouse’s plan. |
Death of a spouse or other eligible family member |
Death of a spouse: You are required to remove coverage for your former spouse but you may not remove coverage for yourself or other covered eligible family members. 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. If you and your family members are enrolled in the ExxonMobil Retiree 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. Death of dependent child: You are required to remove coverage for deceased child but no other changes are allowed. |
You must provide notice of your spouse’s death within 30 days of the date of death. No other election changes will be permitted for those currently enrolled in the Plan. If you were covered on your spouse’s plan you must make an election within 30 days of the date of death. |
Other loss of family member's eligibility (e.g., sole managing conservatorship of grandchild ends) |
Coverage continues through their last day of eligibility for any event the participant reports. In some cases, continuation coverage under COBRA may be available. (See Continuation coverage for more details about COBRA.) |
You must notify the ExxonMobil Benefits Service Center as soon as a family member is no longer eligible. If you fail to notify the ExxonMobil Benefits Service Center within 60 days, the family member will not be entitled to elect COBRA. 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. |
Other qualified changes |
||
Another parent is ordered to provide coverage to your covered child through a QMSCO |
Revoke or decrease the affected child’s election if coverage actually provided. The effective date will be the date of qualification or end of month if termination date is not listed. |
Within 30 days following the date of the event |
You are ordered to provide coverage to your eligible child through a QMCSO |
If you’re currently enrolled, your child will be automatically covered under your current options. If not currently enrolled, you and the affected child will be covered automatically under the lowest cost option in the applicable plan(s). You can change your medical option. |
You must make these changes within 30 days of the event. |
Eligible dependent gains eligibility under another employer's plan
|
If the eligible dependent has or will obtain coverage under the other employer plan, remove them from coverage. You may also cancel coverage for yourself, if health care coverage is obtained through your spouse’s employer plan. |
You must make these changes within 30 days of the event. |
A significant change in coverage or cost* of your, your spouse’s plan. *applies also to a significant increase in health care cost sharing.
|
Make a corresponding prospective change in your election:
|
Within 30 days following the date of the event. |
HIPAA special enrollment provisions |
||
Marriage |
|
Within 30 days following the date of the event. |
Gain a family member through birth, adoption or placement for adoption |
|
You must add the new family member within 30 days even if you already have family coverage. Coverage is effective on the date of birth, adoption, or placement for adoption. |
You or a family member loses eligibility under another employer's group health plan |
Enroll yourself and other family members who might have lost eligibility, add affected dependents and change medical plan option. |
You must make these changes within 30 days of the event. |
A family member’s employer contributions cease. |
|
You must make these changes within 30 days of the event. |
The participant or the participant’s dependent becomes eligible for premium assistance under Medicaid or the Children’s Health Insurance Program (CHIP). |
If the participant is becoming eligible, they may drop coverage. If a dependent is becoming eligible, they may remove coverage for affected dependents only. |
Within 60 days of either:
|
Other Employer Sponsored coverage – Waiving EMRMP
A waiver process is in place to provide retirees and eligible family members with the option to waive coverage under the EMRMP when you or your eligible family members choose to participate in other employer-sponsored coverage. By completing the waiver, you will reserve your right to participate in the EMRMP at a later date upon proof of loss of coverage in the other employer’s plan, as long as the EMRMP is still available at that time. See scenarios below and how the waiver and reservation of rights apply:
How to Waive EMRMP Coverage at the Time of Your Retirement
If you have been actively participating in the ExxonMobil Medical Plan or the ExxonMobil International Medical and Dental Plan at the time of your retirement and you have access to other employer-sponsored coverage through either your own active employment or as a dependent of your spouse’s active employment, you/your spouse can choose to waive EMRMP coverage and reserve your right to participate upon the loss of such other coverage.
You must waive EMRMP coverage no later than 60 days from your retirement effective date. There are 2 ways to waive: you can contact the EMBSC at 1-833-776-9966 and indicate you want to waive, or you may also waive online in the EM Benefits portal by choosing the qualifying event named “Other Employer Sponsored Coverage”.
In order to enroll at a later date, you and/or your spouse will need to provide proof of loss of coverage and meet the following requirements:
- If you (and/or your spouse) lose other employer-provided coverage and you or your spouse are under 65 years of age, you have 60 days from loss of coverage to enroll in any of the Retiree Medical Plan options (Aetna POS II A or B, Aetna Select, Cigna OAPIN) of the EMRMP.
- If you (and/or your spouse) lose coverage and are 65 years of age or over, you or your spouse will have 90 days from loss of coverage to enroll in the Medicare Primary Option (MPO) of the EMRMP. Please refer to section of Eligibility and Enrollment of the Medicare Primary Option for a list of the MPO requirements. You must meet each of the requirements within the 90 days from the loss of coverage.
If you do not meet all requirements to enroll in the applicable option by the deadlines above, you/your spouse will not be eligible to enroll in the EMRMP at a later date.
How to Waive EMRMP Coverage if you Acquire Other Employer-Sponsored Coverage After Retirement
If after you have begun participating in the EMRMP you acquire other employer sponsored health plan coverage through either your own active employment or as a dependent of your spouse’s active employment, you/your spouse can notify the EMRMP by contacting the EMBSC of your change in status and waive coverage under the EMRMP. There are 2 ways to waive: you can contact the EMBSC at 1-833-776-9966 and indicate you want to waive, or you may also waive online in the EM Benefits portal by choosing the qualifying event named “Other Employer Sponsored Coverage”. You must waive no later than 60 days from loss of coverage from the EMRMP.
You/your spouse can then enroll in the EMRMP at a later date when the other employer sponsored health plan ends, with proof of loss of coverage. As described in subsections 1 and 2, above.
Important note: A waiver form is different from a cancellation form, while the waiver form allows you to preserve your eligibility for future enrollment (if the EMRMP is still an available option at that time), the cancellation form is final and you will no longer be eligible to enroll in any of the EMRMP options at a later date.
Dependent Children/Disabled Dependents
If your dependent child is participating in other-employer sponsored coverage at the time of your retirement or during your retirement and the child is under the age of 26, this children will be eligible upon the proof of loss of coverage to participate in the EMRMP and no waiver form is needed, assuming the child meets eligibility criteria.
No waiver process is available for dependents who were participating the EMMP or EMRMP as a disabled dependent over the age of 26 and who terminate coverage anytime at or after your retirement. Once a disabled dependent’s coverage is terminated for loss of eligibility or otherwise, the over age 26 child will not be eligible to participate in the EMRMP at a later date.
Survivor Coverage
If you are a surviving spouse or surviving family member participating in the EMRMP, you are not eligible to waive coverage and reserve your right to participate at a later date when you acquire other employer-sponsored coverage or are hired by ExxonMobil.
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 ExxonMobil Retiree Medical Plan – Open Access Aetna Select Network Only 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, or fail to waive coverage due to being enrolled in another employer sponsored health plan, 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.