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Employee Health Advisory Program (EHAP)

Summary plan description of the Employee Health Advisory Program (EHAP) as of January 1, 2022

This summary plan description (SPD) of the ExxonMobil Employee Health Advisory Program (EHAP or the Plan) does not contain all the Plan details. In determining the scope of the EHAP’s benefits, the full provisions of the EHAP plan document, as they exist now or as they may exist in the future, always govern. Copies of these documents are available for your review.

Applicability to represented employees is governed by collective bargaining agreements and any local bargaining requirements.

Introduction

The ExxonMobil Employee Health Advisory Program (EHAP) offers confidential, professional counseling for personal problems requiring limited intervention and clinical referral services for more complicated problems. Short-term counselling through EHAP is available in person, over the phone, using video chat, or via text messaging. You also have access to telephone coaching for personal growth, digital Cognitive Behavioral Therapy (CBT) web and mobile applications for common mental health conditions, an online platform and one-on-one education consulting for caregivers of children with special needs, and life assistance resources including legal services and community referrals.

EHAP coverage is automatic for eligible employees and family members at no cost to you.

EHAP is described in this SPD. These tools help you find specific information quickly and easily.

  • Information sources, places where you can get more information.
  • Plan at a glance, highlighting plan basics.
  • A list of Key terms containing definitions of some words and terms used in this SPD.

A careful review of this SPD will help you understand how the Plan works so you can make the best use of it.

You may obtain additional information through the sources shown in the Information sources section.


EHAP Services

You may call the service at any time, for any reason. Reasons for seeking assistance are as varied as the individuals calling. Some of the types of situations for which you may seek help include:

  • Crisis in the family, such as balancing career and family responsibilities, stress, relocation issues, divorce or separation, problems with children at school, serious illness, family violence, child abuse, problems with the legal system, death, or being a victim of crime.
  • Ongoing problems, such as chemical dependency, anxiety, depression, family conflict, parental responsibilities and other family situations, and other personal and/or work-related concerns that may require limited professional counseling services.
  • Special needs education consulting, including online resources and one-one-one sessions for caregivers of adolescents and children with anxiety, depression, learning difficulties, and other special needs.
  • Referral services to resources in your community that can help you find home health care, nursing homes, legal services, consumer credit and financial information are also available through Magellan's Life Assistance Resources.
  • Digital Cognitive-Behavioral Therapy (CBT), through interactive web-based programs and mobile applications that can help you learn and practice life skills such as dealing with anxiety or developing good sleep habits.

How to get the care you need

If you or an eligible family member needs help with mental health, substance use, or other personal or family issues, follow these steps to get the care needed:

  • Step 1: Call Magellan Healthcare at 800-442-4123 (24/7) and select the appropriate option to get the name of an EHAP counselor who can help you. A Magellan Master’s licensed clinician will ask you questions so that he or she can assess your situation. The Magellan clinician will provide you with the names and contact information for EHAP counselors who are part of the Magellan EHAP network offering services in your area or virtually over the phone, video chat, or via text messaging. The Magellan clinician will complete a registration and provide you with a registration number (MAT#).
  • Step 2: Contact the EHAP counselor you have selected to schedule an in-person or virtual appointment. Mention that you are a member of the Plan. Provide the clinician with the MAT# given to you by the Magellan clinician.
  • Step 3: Go to your appointment. You don’t have to file claim form. (If you need inpatient care or longer term treatment, your EHAP counselor or Magellan clinician will assist you to get the needed care).

EHAP professional counselors are located away from your workplace location, and Magellan does not reveal to the company the names of or reasons for individuals seeking EHAP assistance.

You may also select an EHAP counselor through the online self-referral process at www.magellanascend.com. To use the online self-referral process:

  • Enter the URL www.magellanascend.com and sign in with your user name and password (or follow the instructions for creating a user name and password). 
  • Select “Explore” and then “Counseling”.
  • Follow the online directions to “Find care in your area” including how to complete the online self-referral form. In the search tool, select the “ExxonMobil Life Assistance”, or “Telehealth EAP” provider list..

At your request, Magellan will send you a hard copy of the directory information; contact Magellan at 800-442-4123. If there are no network EHAP counselors near your home, you can access virtual care options or Magellan will locate a qualified provider for you.

In addition, effective January 1, 2022 EHAP will include a new digital emotional wellbeing program for life, mind and body, powered by NeuroFlow, at no additional cost to you. It includes breathing exercises, meditation, yoga; tracks mood, sleep, stress and pain, syncs with other trackers like Fitbit, Garmin and MyFitnessPal, among other features. Read more here, watch this video and/or check out the FAQ to learn more. We recommend you sign up for this digital program through the Magellan Ascend website. You just need to type Exxon under “Find My Company/Log In” and then click on the Digital Emotional Wellbeing icon in the Explore section.

Caregiver Guidance and Support for Special Needs Families

The Plan also provides services for caregivers raising children with emotional, behavioral, developmental, learning, or attention challenges through the Bright Horizons Family Resources Center. The program provides:

  • Guidance and support based on your child’s unique situation,
  • One-on-one personalized educational consulting from an experienced advisor that is matched to your family to address your child’s unique needs,
  • A website that provides tools to help your child to overcome emotional, learning, or developmental challenges, and
  • Live and on-demand programs with information to help in shaping your child’s future.

Information sources

Care manager — Arranges for and provides counseling services.

Phone numbers:
Magellan Healthcare
800-442-4123
314-387-4700 (if international, call collect)
24 hours a day, seven days a week

Address:
Magellan Healthcare
14100 Magellan Plaza Drive
Maryland Heights MO 63043

Websites:
www.magellanascend.com

• Enter the URL www.magellanascend.com and sign in with your user name and password (or follow the instructions for creating a user name and password).

Bright Horizons Special Needs Program Family Resource Center

ExxonMobil Benefits Service Center – Provides plan-related information.

Phone: 800-682-2847
Hours: 8 a.m. to 6 p.m. ET, Monday through Friday, except certain holidays
Web: http://www.exxonmobil.com/benefits

Address:
P.O. Box 18025
Norfolk, VA 23501-1867

ExxonMobil sponsored sites – Provides employees and their family members access to plan-related information.

  • Employee Connect, the Human Resources Intranet Site — Can be accessed at work by current employees.
  • ExxonMobil Family, the Human Resources Internet Site — Can be accessed from home by everyone at www.exxonmobilfamily.com

Plan at a glance

Eligibility and enrollment  

You do not need to enroll — coverage begins for you and your eligible family members as soon as you meet the eligibility requirements regardless of enrollment in the ExxonMobil Medical Plan. See Eligibility and enrollment for more information.

How the Plan Works  

This Plan provides short-term counseling services to help you with relationships and other personal issues. You can call Magellan for a referral to an EHAP counselor. 

The Plan provides counseling visits and referral services. Up to eight counseling visits may be provided at no cost to you, as clinically appropriate. All counseling services are arranged by and provided through Magellan, the Care Manager for this Plan. Coaching for personal growth and access to online tools and resources, including digital CBT programs, do not count towards your eight visit limit.

Administrative and ERISA information  

This Plan is subject to rules of the federal government, including the Employee Retirement Income Security Act (ERISA), not state insurance laws. You and your family members who lose eligibility may continue EHAP coverage for a limited time in certain circumstances. See Administrative and ERISA information.

Key terms

This is an alphabetized list of words and phrases, with their definitions, used in this SPD. These words are underlined and linked throughout the SPD for easy identification. See Key terms.  

Eligibility and enrollment

Eligibility and enrollment details for the Employee Health Advisory Program (EHAP)

Most U.S. dollar-paid employees of Exxon Mobil Corporation and participating affiliates are eligible for EHAP. See eligible employees in the Key terms section. Your eligible family members may also participate. Coverage is automatic; you do not enroll.

Generally, you are eligible if:

Eligible family members

Eligible family members are generally your:

  • Spouse, 
  • A child who is described in any one of the following paragraphs (1) through (3):

1. has not reached the end of the month during which age 26 is attained, or

2. is totally and continuously disabled and incapable of self-sustaining employment by reason of mental or physical disability, provided the child:

    (a) meets the Internal Revenue Service's definition of a dependent, and

    (b) was covered as an eligible family member under this Plan immediately prior to age 26 when the child's eligibility would have otherwise ceased, and

    (c) met the clinical definition of totally and continuously disabled before age 26 and continues to meet the clinical definition through subsequent periodic reassessment reviews, or

3. is recognized under a qualified medical child support order as having a right to coverage under this Plan.

A child aged 26 or over who was disabled but who no longer meets the requirements of paragraph two (2) above, ceases to be an eligible family member 60 days following the date on which the applicable requirement is not met.

Please note: An eligible employee's parents are not eligible to be covered. 

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.

Refer to Key terms for definitions of eligible family members, child, spouse and Qualified Medical Child Support Order.

When coverage begins

Generally, your coverage begins on your first day of employment. Family members are covered on the later of the date you begin employment or the date your family member meets the eligibility requirements.

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 or are no longer classified as a regular employee of a participating employer. Your employment is deemed to continue for purposes of this Plan until the end of the period during which you are:
    • Absent due to a leave of absence approved by your employer, or
    • Receiving short-term disability benefits under a disability income plan sponsored by the company.
    • The date your family member ceases to be eligible.
  • The date:
    • You (as a covered employee or family member) are no longer eligible for benefits under this Plan.
    • Your employer discontinues participation in the Plan.
    • Your family member begins active duty in the armed forces of any country, state or international organization, or becomes a member of any civilian force auxiliary to any military force.
    • The Plan is terminated.
    • A Qualified Medical Child Support Order is no longer in effect for a covered family member.
    • A family member under a Qualified Medical Child Support Order becomes eligible for benefits under another plan providing benefits similar to this Plan.

Extended coverage 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.

Private and confidential

EHAP professional counselors are located away from your workplace location, and Magellan does not reveal to the company the names of or reasons for individuals seeking EHAP assistance. Unless your supervisor identifies and discusses with you a situation where EHAP benefits would be beneficial, you tell others, or the law requires disclosure, no one at the company will know that you are using the program. In situations involving real or potential harm to individuals (for example, child abuse cases or direct threats of violence against a person), laws require that certain notifications be made. EHAP counselors will comply with these laws and disclose required information.

Professional counselors

Magellan makes available the counseling and referral services offered by EHAP through a network of contracted EHAP counselors. Counselors include trained psychologists, family and marriage counselors, social workers and therapists who specialize in resolving personal problems.

No charge for EHAP services

Many problems can be resolved in just a few visits with an experienced counselor. EHAP may provide you or your eligible family members with up to eight visits in a calendar year for each problem.

If you need more counseling visits than are provided under EHAP - or if you need services that are not provided by EHAP - the EHAP counselor will refer you to outside services which may be a covered service under your medical plan. If the EHAP counselor determines that more intense services are needed, you may be immediately referred to an appropriate mental health provider. The cost of the additional or outside services is not covered under EHAP but may be partly covered by your medical plan; refer to the summary of benefits and coverage (SBC) for your medical plan or contact ExxonMobil Benefits Service Center (see Information sources at the front of this SPD) for information.

Continuation coverage

Continuation coverage for the Employee Health Advisory Program (EHAP)

Continuation coverage rights under COBRA

 Continuation of coverage under the ExxonMobil Health Advisory Program

Introduction

You are required to be given the information in this section because you are covered under a group health plan (the Medical Plan). This section contains important information about your right to COBRA continuation coverage, which is a temporary extension of coverage under the Plan under certain circumstances when coverage would otherwise end. This section generally explains COBRA continuation coverage, when it may become available to you and your family, and what you need to do to protect the right to receive it. 

The right to COBRA coverage was created by a federal law, the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA). COBRA coverage can become available to you when you would otherwise lose your group health coverage. It can also become available to your spouse and children, if they are covered under the Plan when they would otherwise lose their group health coverage or other rights under the Plan. This section does not fully describe COBRA coverage or other rights under the Plan. For additional information about your rights and obligations under the Plan and under federal law, you should review this SPD or contact the ExxonMobil Benefits Service Center at the telephone numbers or address listed under Benefits Administration in the Contacts for COBRA rights Under the ExxonMobil Medical Plan section.

You, your spouse and your family members may have other options available when you lose group health coverage. For example, you may be eligible to buy an individual plan through the Health Insurance Marketplace.  By enrolling in coverage through the Marketplace, you may qualify for lower costs on your monthly premiums and lower out-of-pocket costs.  Additionally, you may qualify for a 30-day special enrollment period for another group health plan for which you are eligible (such as a spouse’s plan), even if that plan generally doesn’t accept late enrollees.

Determination of Benefits Administration Entity to Contact:

  • Current ExxonMobil and XTO Employees or their covered family members should use ExxonMobil Benefits (http://www.exxonmobil.com/benefits) or contact the ExxonMobil Benefits Service Center;
  • Former Exxon, ExxonMobil or XTO Employees and their covered family members, who have elected and are participating through COBRA, contact the ExxonMobil COBRA Administration.

The contact information for each of these entities is as shown in the Contacts for COBRA Rights Under the ExxonMobil Medical Plan section.

What is COBRA coverage?

COBRA coverage is a continuation of Plan coverage when coverage would otherwise end because of a life event known as a qualifying event. Specific qualifying events are listed later in this section.  If a specific qualifying event occurs and any required notice of that event is properly provided to the ExxonMobil Benefits Service Center, COBRA coverage must be offered to each person losing coverage who is a qualified beneficiary.  You, your spouse, and your children could become qualified beneficiaries if coverage under the Plan is lost because of the qualifying event. Certain newborns, newly adopted children, and alternate recipients under QMCSOs may also be qualified beneficiaries. This is discussed in more detail in separate paragraphs below. Under the Plan, qualified beneficiaries who elect COBRA coverage must pay the entire cost of COBRA coverage (employee plus employer portions) plus a 2% administrative fee.

Who is entitled to elect COBRA?

If you are an employee, you will be entitled to elect COBRA, if you lose your coverage under the Plan because either one of the following qualifying events happens:

  • Your hours of employment are reduced, or
  • Your employment ends for any reason other than your gross misconduct.

If you are the spouse of an employee, you will be entitled to elect COBRA if you lose coverage under the Plan because any of the following qualifying events happens:

  • Your spouse dies,
  • Your spouse's hours of employment are reduced,
  • Your spouse’s employment ends for any reason other than his or her gross misconduct,
  • You become divorced from your spouse.  Also, if your spouse (the employee) reduces or eliminates your group health coverage in anticipation of a divorce, and a divorce later occurs, then the divorce may be considered a qualifying event for you even though your coverage was reduced or eliminated before the divorce.

A person enrolled as the employee’s child will be entitled to elect COBRA if he or she loses coverage under the Plan because any of the following qualifying events happens:

  • The parent-employee dies,
  • The parent-employee's hours of employment are reduced,
  • The parent-employee's employment ends for any reason other than his or her gross misconduct, or
  • The child stops being eligible for coverage under the Plan as a child.

When is COBRA coverage available?

When the qualifying event is the end of employment or reduction of hours of employment or death of the employee, the Plan will offer COBRA coverage to qualified beneficiaries.  You need to notify the ExxonMobil Benefits Service Center of any other qualifying events.

For the other qualifying events (divorce of the employee resulting in the spouse or a child losing eligibility for coverage), a COBRA election will be available to you only if you notify and provide the appropriate forms to the ExxonMobil Benefits Service Center or ExxonMobil COBRA Administration within 60 days after the later of (1) the date of the qualifying event or (2) the date on which the qualified beneficiary loses (or would lose) coverage under the terms of the Plan as a result of the qualifying event. Current employees may give notice of qualifying events by logging onto ExxonMobil Benefits located on the  Employee Connect intranet site. (Effective February 1, 2022, the internal EDA site has retired, so all changes and notices of qualifying events from current or former employees should be made through the ExxonMobil Benefits Service Center, where forms are also available.)

Please note:  Notice is not effective until either a change is made on ExxonMobil Benefits or the proper information is received by the ExxonMobil Benefits Service Center. If notice is not submitted during the 60-day notice period, then all qualified beneficiaries will lose their right to elect COBRA.

Election of COBRA

Each qualified beneficiary will have an independent right to elect COBRA. Covered employees and spouses (if the spouse is a qualified beneficiary) may elect COBRA on behalf of all qualified beneficiaries, and parents may elect COBRA on behalf of their children. Any qualified beneficiary for whom COBRA is not elected within the 60-day election period specified in the Plan’s COBRA election notice WILL LOSE HIS OR HER RIGHT TO ELECT COBRA.

How long does COBRA coverage last?

COBRA coverage is a temporary continuation of Plan coverage that lasts between 18-36 months depending on the qualifying event.

You, your spouse and covered dependents may qualify for up to 18 months of continuation coverage, if you qualify due to one of the following qualifying events:

  • Your employment ends for any reason other than termination for gross misconduct;
  • Your work hours are reduced and you are no longer eligible to participate in the Plan ; or
  • Unpaid Leave of Absence

Your covered spouse and covered dependent may qualify for up to 36 months of continuation coverage, if they qualify due to one of the following qualifying events:

  • You die;
  • You and your spouse get a divorce; or

    An enrolled child no longer meets the definition of “child” under the terms of the Plan.

Second qualifying event extension COBRA coverage

If your family experiences another qualifying event while receiving COBRA coverage as a result of the covered employee’s termination of employment or reduction of hours (including COBRA coverage during a disability extension as described above), the covered spouse and children in your family can get up to 18 additional months of COBRA continuation coverage, for a maximum of 36 months, if notice of the second qualifying event is properly given the COBRA Administrator. This extension may be available to the spouse and any children receiving COBRA coverage if the employee or former employee dies, gets divorced, or if the covered child stops being eligible under the Plan as a child. This extension is not available under the Plan when a covered employee becomes entitled to Medicare after his or her termination of employment or reduction of hours.  This extension due to a second qualifying event is available only if you notify the correct benefits administration entity within 60 days of the date of the second qualifying event.

Disability extension of 18-month COBRA continuation coverage

The 18-month continuation period may be extended for you and your covered family members if the Social Security Administration determines that you or another family members, who is a qualified beneficiary, is disabled at any time during the first 60 days of continuation coverage.  If all of the following requirements are met, coverage for all family members who are qualified beneficiaries as a result of the same qualifying event can be extended for up to an additional 11 months (for a total of 29 months):

  • This extension is available only for qualified beneficiaries who are receiving COBRA coverage because of a qualifying event that was the covered employee’s termination of employment or reduction of hours.
  • The disability must have started at some time before the 61st day after the covered employee’s termination of employment or reduction of hours and must last at least until the end of the period of COBRA coverage that would be available without the disability extension (generally 18 months, as described above).
  • A copy of the Notice of Award from the Social Security Administration is provided to the COBRA Administrator [ExxonMobil Benefits Service Center] within 60 days of receipt of the notice and before the end of the initial 18 months of continuation coverage.
  • If the disabled qualified beneficiary elects continuation coverage, you must pay an increased premium of 150 percent of the monthly cost of Plan coverage that’s continued, beginning with the 19th month of continuation coverage.

Extension Due to Medicare Eligibility

Coverage may also last up 36 months for a covered spouse or covered dependent when loss of coverage is the result of a qualifying event that is the end of the employee’s employment or the reduction of the employee's hours of employment, and the employee became entitled to Medicare benefits less than 18 months before the qualifying event.  In this case, COBRA coverage under the Plan for qualified beneficiaries (other than the employee) may last until up to 36 months after the date of the employee’s Medicare entitlement. For example, if a covered employee becomes entitled to Medicare 8 months before the date on which his employment terminates, COBRA coverage for his spouse and children who lost coverage as a result of his termination can last up to 36 months after the date of Medicare entitlement, which is equal to 28 months after the date of the qualifying event (36 months minus 8 months). This COBRA coverage period is available only if the covered employee becomes entitled to Medicare within 18 months BEFORE termination or reduction of hours. 

When COBRA Coverage Ends

COBRA coverage may be terminate before the maximum period if one of the following occurs:

  • The premium for your continuation coverage is not paid on time.
  • If after electing continuation coverage, you become covered by another group health plan, unless the plan contains any exclusions or limitations with respect to any pre-existing condition you or your coverage dependents may have.
  • If after electing continuation coverage, you first come eligible for and enroll in Medicare Part A , Part B or both.
  • You extend coverage for up to 29 months due to a qualified beneficiary’s disability and there has been a final determination by the Social Security Administration that the qualified beneficiary is no longer disabled. In this case, continuation coverage will end on the first of the month that begins more than 30 days after the final determination o by the Social Security Administration that the qualified beneficiary is no longer disabled. This will be the case only if the qualified beneficiary has been covered by continuation coverage for at least 18 months.
  • Exxon Mobil Corporation no longer provides group health coverage to any of its eligible employees or eligible retirees.

[COBRA coverage can end before the end of the maximum coverage period for several reasons, such as for the failure to timely pay premiums, eligibility for other employer-provided coverage or reaching Medicare-eligibility during your COBRA period.]

Are there other coverage options besides COBRA continuation coverage?

Yes.  Instead of enrolling in COBRA continuation coverage, there may be other coverage options for you and your family through the Health Insurance Marketplace, Medicaid, or other group health plan coverage options (such as a spouse’s plan) through what is called a special enrollment period. Some of these options may cost less than COBRA continuation coverage. You can learn more about many of these options at www.healthcare.gov.

More information about individuals who may be qualified beneficiaries during COBRA

A child born to, adopted by, or placed for adoption with a covered employee during a period of COBRA coverage is considered to be a qualified beneficiary provided that, if the covered employee is a qualified beneficiary, the covered employee has elected COBRA coverage for himself or herself.

The child's COBRA coverage begins when the child is enrolled in the Plan, whether through special enrollment or open enrollment, and it lasts for as long as COBRA coverage lasts for other family members of the employee. To be enrolled in the Plan, the child must satisfy the otherwise-applicable Plan eligibility requirements (for example, regarding age).

Alternate recipients under QMCSOs

A child of the covered employee who is receiving benefits under the Plan pursuant to a qualified medical child support order (QMCSO) received by ExxonMobil during the covered employee's period of employment with ExxonMobil is entitled to the same rights to elect COBRA as an eligible child of the covered employee.

Cost of COBRA coverage

A person who elects continuation coverage may be required to pay 102% of the cost to the Plan to maintain the coverage, unless the person is entitled to extended coverage due to disability. If the person becomes entitled to such extended coverage due to disability, the person may be required to contribute up to 150% of contributions after the initial 18-month's coverage until coverage ends. A person who elects continuation coverage must pay the required contributions within 45 days from the date coverage is elected retroactively to the date benefits terminated under the Plan.

If you have questions

Questions concerning your Plan or your COBRA continuation coverage rights should be addressed to the contact or contacts identified below.  For more information about your rights under the Employee Retirement Income Security Act (ERISA), including COBRA, the Patient Protection and Affordable Care Act, and other laws affecting group health plans, contact the nearest Regional or District Office of the U.S. Department of Labor’s Employee Benefits Security Administration (EBSA) in your area or visit www.dol.gov/ebsa.  (Addresses and phone numbers of Regional and District EBSA Offices are available through EBSA’s website.)  For more information about the Marketplace, visit www.healthcare.gov. 

Keep your plan informed of address changes

In order to protect your family's rights, you should keep ExxonMobil Benefits Service Center informed of any changes in your address as well as the addresses of family members. You should also keep a copy, for your records, of any notices you send.

Contacts for COBRA rights under the ExxonMobil Medical Plan

The following sets out the contact numbers based on your status under the ExxonMobil Medical Plan. FAILURE TO NOTIFY THE CORRECT ENTITY COULD RESULT IN YOUR LOSS OF COBRA RIGHTS.

If your status is not listed, call the ExxonMobil Benefits Service Center for help.

 
Contacts: Address:
Employees and their covered family members:

ExxonMobil Benefits Service Center

Phone: 1-800-682-2847

Monday – Friday  8:00 a.m. to 6:00 p.m. (U.S. Eastern Time)

Web: ExxonMobil Benefits (http://www.exxonmobil.com/benefits)

ExxonMobil Benefits Service Center
P.O. Box 18025
Norfolk, VA 23501-1867
Former employees and family members who have elected and are participating through COBRA:

ExxonMobil COBRA Administration
Monday - Friday except certain holidays
8:00 a.m. to 7:00 p.m. (U.S. Central Time)

800-526-2720

Wageworks National Accounts Services
ExxoMobil COBRA Administration

P.O. Box 2968
Alpharetta, GA 30023-2968
Fax: 833-514-6416
Employees, retirees, their survivors and covered family members (not participating in COBRA coverage):

ExxonMobil Benefits Service Center
Monday – Friday except certain holidays
8:00 a.m. to 6:00 p.m. (U.S. Eastern Time)

800-682-2847 (toll free)
800-TDD-TDD4 (833-8334) for the hearing impaired

ExxonMobil Benefits Service Center
P.O. Box 18025
Norfolk, VA 23501-1867

COBRA participants:

ExxonMobil COBRA Administration
Monday - Friday except certain holidays
8:00 a.m. to 7:00 p.m. (U.S. Central Time)

(800) 526-2720

Wageworks National Accounts Services
ExxonMobil COBRA Administration

P. O. Box 2968
Alpharetta, GA 30023-2968
Fax: 833-514-6416

Administrative and ERISA information

Administrative and ERISA information for the Employee Health Advisory Program (EHAP)

This section contains technical information about the Plan and identifies its administrator. It also contains a summary of your rights with respect to the Plan and instructions about how you can submit an appeal if your claim for benefits is denied.

The formal name of the Plan is the ExxonMobil Employee Health Advisory Program.

Plan sponsor and participating affiliates

The ExxonMobil Employee Health Advisory Program is sponsored by:

Exxon Mobil Corporation
5959 Las Colinas Boulevard
Irving, Texas 75039-2298

All of Exxon Mobil Corporation's divisions and most of the major U.S. affiliates participate in the ExxonMobil Health Advisory Program. A complete list of participating affiliates is available from the Administrator-Benefits upon written request. 

Certain employees covered by collective bargaining agreements do not participate in the Plan.

Basic Plan information

Plan administrator

The Plan Administrator for the ExxonMobil Health Advisory Program is the Administrator-Benefits. The Administrator-Benefits is the Manager-Global Benefits Design, Exxon Mobil Corporation. You may contact the Administrator-Benefits at the following address. Legal process may be served upon the Administrator-Benefits c/o Exxon Mobil Corporation by serving the Corporation's Registered Agent for Service of Process, Corporation Service Company (CSC).

Administrator-Benefits
ExxonMobil Health Advisory Program
P.O. Box 18025
Norfolk, VA 23501-1867

For service of legal process:
Corporation Service Co.
211 East 7th Street, Suite 620
Austin, Texas 78701-3218

Authority of Administrator-Benefits

The Administrator-Benefits (and those to whom the Administrator-Benefits has delegated authority) has the full and final discretionary authority to determine eligibility for benefits, to construe and interpret the terms of the Employee Health Advisory Program in its application to any participant or beneficiary, and to decide any and all claim appeals.

Claims Fiduciary and appeals

The Claims Fiduciary is the person to whom all appeals are filed. For the ExxonMobil Employee Health Advisory Program, the Claims Fiduciary is the Care Manager, Magellan Healthcare. The Care Manager will decide all appeals for denied benefits. File any appeals with:

Magellan Healthcare 
P.O. Box 2128 
Maryland Heights MO 63043

Type of plan

The ExxonMobil Employee Health Advisory Program is a welfare plan under ERISA providing professional counseling for personal problems requiring limited intervention and referral services for more complicated problems.

Plan numbers

The ExxonMobil Employee Health Advisory Program is identified with government agencies under two numbers: the Employer Identification Number 13-5409005 and the Plan Number 609.

Plan year

The plan year is the calendar year, January 1 through December 31.

Plan funding

Benefits are funded through employer contributions.

Benefit claims 

If Magellan determines that you need urgent care, Magellan will provide telephonic crisis counseling and make an appropriate referral to your benefit plan and/or emergency resources in the community. The EHAP does not provide urgent care.

Because Magellan pays all EHAP providers directly, you should not make any payment to a provider for EHAP services. In the event that you mistakenly pay a provider for EHAP services, Magellan will make a determination on your request for reimbursement within 15 days after receipt of the Claim (if EHAP services have not yet been received) or with 30 days after receipt of the Claim (if the EHAP services have already been received). Magellan will notify you of its determination telephonically, and, if you consent to written notice, in writing, within the 15 day or 30 day period, as applicable.

To use EHAP, call Magellan toll free. You do not pay for or file claim forms for your EHAP counseling sessions. If you require additional services beyond that provided by EHAP, those services may be provided under your medical plan.

If you have a problem with a plan benefit, contact Magellan. The Care Manager is responsible for determining and informing you of your entitlement to a benefit.

The following categories of claims for benefits apply to the ExxonMobil Employee Health Advisory Program, and according to the type of claim submitted, Magellan will review your claim and respond within a designated response time. If Magellan needs additional time (an extension) to decide on your claim because of special circumstances, you will be notified within the claim response period.

Urgent care means care needed to avoid serious jeopardy to your life or health or to regain maximum function (or required to avoid severe pain), as determined by Magellan or your treating physician. Magellan does not make Claim determinations relating to urgent care.

Pre-service claims are any claims for benefits where the Plan provisions require approval before care is obtained.

Post-service claims are claims made after care is received and apply to claims under the ExxonMobil Employee Health Advisory Program.

Type of Claim Response Time Extension

Urgent care claims

Not applicable  
Pre-service claims 15 days An additional 15 days. However, if an extension is necessary due to incomplete information, you must provide the additional information within 45 days from the date of receipt of the extension notice.
Post-service claims 30 days An additional 15 days. However, if an extension is necessary due to incomplete information, you must provide the additional information within 45 days from the date of receipt of the extension notice.

 

Denied claims

If your claim for benefits is denied completely or partially, and you authorize written communication to you, Magellan will provide written notice to you, your beneficiary, or designated representative. The notice will describe:

  • The specific reason(s) for the denial for the denial decision,
  • Identify Plan provisions on which the decision is based,
  • Describe any additional material or information necessary for an appeal review and an explanation of why it is necessary,
  • Explain the review procedure, including time limits for appealing the decision and to sue in federal court,
  • Identify your right to receive, free of charge, upon your request, any internal rule, guidelines, protocol or similar criterion relied on in making the decision, and
  • Identify your right to receive, free of charge, upon your request, an explanation of the clinical judgment on which the decision is based (if the denial is based on exclusion of experimental treatment services or because EHAP services are not clinically appropriate).

If you do not authorize written notice, Magellan will furnish this information to you or your Authorized Representative by telephone.

Filing a mandatory appeal

If you believe your Claim for EHAP benefits was denied in error, you may appeal the decision. Your appeal must be submitted in writing to Magellan within 180 days following your receipt of a denial notice. 

Your appeal should state the reasons why you feel your Claim for EHAP benefits is valid and include any additional documentation that you feel supports your Claim for EHAP benefits. You can also include any additional questions or comments. You may submit written comments, documents, records and other information relating to your appeal, whether or not the comments, documents, records or information were submitted in connection with the initial Claim for EHAP benefits. On your request, Magellan will make relevant documents available to you. 

The review of the initial decision will consider all new information, whether or not it was presented or available for the initial decision. The person who conducts the appeal review will be different from the person(s) who originally denied your Claim for EHAP benefits and will not report directly to the original decision maker or prior reviewer. 

You or your Authorized Representative will be notified of the appeal decision within the following time frames:

  • If the case involves an adverse determination on a request for EHAP services or a pre-service adverse determination relating to reimbursement, within thirty (30) days of Magellan's receipt of the request for appeal;
  • If the case involves a post-service adverse determination relating to reimbursement, within sixty (60) days of Magellan's receipt of the request for appeal.

If Magellan needs additional time to decide on your claim because of special circumstances, you will be notified within the claim response period. However, an extension may be requested, but the law stipulates that no additional time will be allowed.

If you authorize written communication, Magellan will give you or your Authorized Representative the decision on the appeal in writing. If the denial is upheld on appeal, the notice will set forth:

  • The specific reason(s) for the denial and the Plan provisions upon which the denial is based.
  • A statement that you are entitled to receive, upon request and free of charge, reasonable access to, and copies of, all documents, records and other information relevant to the claim.
  • Notice of your right to receive, free of charge, upon your request, any internal rule, guidelines, protocol or similar criterion relied on in making the decision.
  • Notice of your right to receive, free of charge, upon your request, an explanation of the clinical judgment on which the decision is based (if the denial is based on exclusion of experimental treatment services or because EHAP services are not clinically appropriate).
  • A statement of your right to bring an action under section 502(a) of the Employee Retirement Income Security Act (ERISA).

If you do not authorize written notification, Magellan will furnish this information to you or your Authorized Representative by telephone.

If you do not agree with the final decision of Magellan, you may bring a lawsuit in federal district court within one year of the final decision. You cannot bring legal action unless your Claim has been reviewed and denied by Magellan.

Legal actions

No action at law or in equity to recover benefits under the Plan shall be brought unless the mandatory appeal process has been completed. In any event, no such action shall be brought after the expiration of one year from the time an appeal is decided by Magellan.

No implied promises

Nothing in the ExxonMobil Employee Health Advisory Program gives you a right to remain in employment or affects ExxonMobil’s right to terminate your employment at any time and for any reason (which is hereby reserved).

Future of the ExxonMobil Employee Health Advisory Program

ExxonMobil has the right to change, suspend, withdraw, amend, modify or terminate the Plan or any of its provisions at any time and for any reason. A change also may be made to required contributions and future eligibility for coverage, and may apply to those who retired in the past, as well as those who retire in the future. If any material changes are made in the future, you will be notified.

For health plans, certain rules apply regarding what happens when a plan is changed, terminated or merged.

Claims incurred before the effective date of a plan change or termination will not be affected. Claims incurred after a plan is terminated won't be covered.

Your rights under ERISA

As a participant in EHAP, you have certain rights and protections under the Employee Retirement Income Security Act of 1974 (ERISA). ERISA provides that as a plan participant, you shall be entitled to:

Receive information about your plan and benefits

  • Examine, without charge, at the office of the Administrator-Benefits and at other specified locations, such as worksites and union halls, all documents governing EHAP, including collective bargaining agreements, and a copy of the latest annual report (Form 5500 Series) filed by EHAP with the U.S. Department of Labor and available at the Public Disclosure Room of the Employee Benefits Security Administration.
  • Obtain, upon written request to the Administrator-Benefits, copies of documents governing the operation of EHAP, including collective bargaining agreements, and copies of the latest annual report (Form 5500 Series) and updated summary plan description. The administrator may require a reasonable charge for the copies.
  • Receive a summary of EHAP's annual financial report. The Administrator-Benefits is required by law to furnish each participant with a copy of this summary annual report.

Prudent actions by EHAP fiduciaries

In addition to creating rights for EHAP participants, ERISA imposes duties upon the people who are responsible for the operation of the employee benefit plan. The people who operate EHAP, called fiduciaries, have a duty to do so prudently and in the interest of you and other EHAP participants and beneficiaries. No one, including your employer, your union, or any other person, may fire you or otherwise discriminate against you in any way to prevent you from obtaining a plan benefit or exercising your rights under ERISA.

Enforce your rights

If your claim for a benefit is denied or ignored, in whole or in part, you have a right to know why this was done, to obtain copies of documents relating to the decision without charge, and to appeal any denial, all within certain time schedules.

Under ERISA, there are steps you can take to enforce the above rights. For instance, if you request a copy of EHAP documents or the latest summary annual report from the EHAP and do not receive them within 30 days, you may file suit in a Federal court. In such a case, the court may require the Administrator-Benefits to provide the materials and pay you up to $110 a day until you receive the materials, unless the materials were not sent because of reasons beyond the control of the administrator.

If you have a claim and an appeal for benefits, which are denied or ignored, in whole or in part, you may file suit in a state or Federal court. Any such lawsuits must be brought within one year of the date on which an appeal was denied. Such lawsuit must be filed in the United States District Court for the Southern District of Texas, Houston, Texas, or in the United States District Court for the federal judicial district where the employee currently works. If a retiree or terminee, the suit must be filed in the last location worked prior to termination of employment. Beneficiaries must also file in the same federal judicial district that the employee or retiree would be required to file. The court will decide who should pay court costs and legal fees. If you are successful, the court may order the person you have sued to pay these costs and fees. If you lose, the court may order you to pay these costs and fees, for example, if it finds your claim is frivolous.

Assistance with your questions

If you have any questions about EHAP, you should contact the Care Manager or contact ExxonMobil Benefits Service Center. If you have any questions about this statement or about your rights under ERISA, or if you need assistance in obtaining documents from the Administrator-Benefits, you should contact the nearest office of the Employee Benefits Security Administration, U.S. Department of Labor, listed in your telephone directory or the Division of Technical Assistance and Inquiries, Employee Benefits Security Administration, U.S. Department of Labor, 200 Constitution Avenue N.W., Washington, D.C. 20210. You may also obtain certain publications about your rights and responsibilities under ERISA by calling the publications hotline of the Employee Benefits Security Administration.

Key terms

List of key terms in the Employee Health Advisory Program (EHAP)

Barred employee

An employee who is covered by a collective bargaining agreement except to the extent participation is provided under such agreement.

Care Manager

Magellan Healthcare or its successor as designated by ExxonMobil Corporation.

Child

A person under age 26 who is;

  • A naturally or legally adopted child of a regular employee or retiree,
  • A grandchild, niece, nephew, cousin, or other child related by blood or marriage over whom a regular employee, retiree, or the spouse of a regular employee or retiree (separately or together) is the sole court appointed legal guardian or sole managing conservator,
  • A child for whom the regular employee or retiree has assumed a legal obligation for support immediately prior to the child's adoption by the regular employee or retiree, or
  • A stepchild of a regular employee or retiree.

Child does not include a foster child.

Eligible employees

Most U.S. dollar-paid employees of Exxon Mobil Corporation and participating affiliates are eligible. Full-time employees not hired on a temporary basis (also called regular employees) are eligible. Extended part-time employees, as classified on the employer's books and records, are also eligible.

The following are not eligible to participate in the Plan: employees of Station Operators, Inc. (SOI), leased employees as defined in the Internal Revenue Code, barred employees, or special agreement persons as defined in the plan document. Generally, special-agreement persons are persons paid by the company on a commission basis, persons working for an unaffiliated company that provides services to the company, and persons working for the company pursuant to a contract that excludes coverage of benefits.

Eligible family members

Eligible family members are generally your:

  • Spouse,
  • A child who is described in any one of the following paragraphs (1) through (3):
  1. has not reached the end of the month during which age 26 is attained, or
  2. is totally and continuously disabled and incapable of self-sustaining employment by reason of mental or physical disability, provided the child:

a) meets the Internal Revenue Service's definition of a dependent, and

b) was covered as an eligible family member under this Plan immediately prior to age 26 when the child's eligibility would have otherwise ceased, and

c) met the clinical definition of totally and continuously disabled before age 26 and continues to meet the clinical definition through subsequent periodic reassessment reviews, or

4. is recognized under a qualified medical child support order as having a right to coverage under this Plan.

A child aged 26 or over who was disabled but who no longer meets the requirements of paragraph two (2) above, ceases to be an eligible family member 60 days following the date on which the applicable requirement is not met.

Please note: An eligible employee's parents are not eligible to be covered.

Extended part-time employee 

An employee who is classified as a non-regular employee, but who has been designated as an Extended Part-Time employee under his or her employer's employment policies relating to flexible work arrangements.

Qualified Medical Child Support Order 

A Qualified Medical Child Support Order (QMCSO) is a court decree under which a court order mandates health coverage for a child. A QMCSO must include, at a minimum:

  • Name and address of the employee covered by the health plan.
  • The name and address of each child for whom coverage is mandated.
  • A reasonable description for the coverage to be provided.
  • The time period of coverage.
  • The name of each health plan to which the order applies.

You may obtain, without charge, a copy of the Plan's procedures governing QMCSO determinations by written request to the Administrator-Benefits.

Regular employee

An employee of a participating employer, whether or not the person is a director, who, as determined by the participating employer, regularly works a full-time schedule, and is not employed on a temporary basis. The definition includes a person who regularly works a full-time schedule but who, for a limited period of time, is approved for a part-time regular work arrangement under the participating employer’s work rules relating to part-time work for regular employees.

Spouse; marriage

All references to marriage shall mean a marriage that is legally recognized under the laws of the state or other jurisdiction in which the marriage takes place, consistent with U.S. federal tax law. All references to a spouse or a married person shall refer to individuals who have such a marriage.

Trainee

An employee who is classified as a non-regular employee, but who has been characterized as a Trainee and has graduated from high school.

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