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Disability Plan

Summary plan description of the ExxonMobil Disability Plan as of January 2016

About the Disability Plan

This summary plan description (SPD) summarizes your benefits under the ExxonMobil Disability Plan. It does not contain all plan details. In determining specific benefits, the full provisions of formal plan documents, 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.

Information sources

When you need information, you may contact:

Benefits Administration – Customer Service Representatives can provide specialized assistance. References to Benefits Administration throughout this SPD pertain to either ExxonMobil Benefits Administration or ExxonMobil Benefits Service Center as listed below. Depending on your status (employee or retiree), you should contact the appropriate service center.

Phone Numbers: Address:
Active Employees
ExxonMobil Benefits Administration
Monday – Friday 8:00 a.m. to 3:00 p.m.
(U.S. Central Time), except certain holidays
713-680-5858 (Houston)
713-680-7070 (international, call collect)
800-262-2363 (toll free outside Houston)
ExxonMobil Benefits Administration
P.O. Box 64111
Spring, TX 77387-4111
Retirees
ExxonMobil Benefits Service Center
Monday – Friday 8:00 a.m. to 6:00 p.m.
(U.S. Eastern Time), except certain holidays
Toll-Free: 1-800-682-2847
or 800-TDD-TDD4 (833-8334) for hearing impaired
ExxonMobil Benefits Service Center
P.O. Box 199540
Dallas, TX 75219-9722
For Long-Term Disability Benefits
Life Insurance Company of North America, a Cigna Company (LINA)
P.O. Box 709015
Dallas, TX 75370-9015
1-800-352-0611


ExxonMobil sponsored sites
– Access to plan-related information for employees, retiree, and their family members.

  • ExxonMobil Me, 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.
  • Retiree Online Community Internet Site — Can be accessed from home by retirees and survivors only at www.emretiree.com.
  • ExxonMobil Benefits Service Center at Xerox Internet Site — Can be accessed from home by everyone at www.exxonmobil.com/benefits.

Introduction

The ExxonMobil Disability Plan provides income to you during periods when you cannot work due to illness, injury or pregnancy/childbirth. The Plan covers both short-term and long-term absences from work caused by on- or off-the-job illnesses and injuries. Besides providing income benefits, the Plan also makes a voluntary rehabilitation program available, when appropriate.

To help you find specific plan information quickly and easily, this SPD includes these helpful tools:

  • Plan at a glance, a quick user's guide highlighting plan basics.
  • References throughout the SPD to places you can get more information, such as the HR Intranet site.
  • A list of Key terms containing definitions of some words and terms used in this SPD.

A careful reading 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 under the Information sources section. 

Plan at a glance

Eligibility and enrollment

Once you are eligible, your participation is automatic. You do not enroll in this Plan. See Eligibility and enrollment

Short-term disability benefits

These benefits are paid while you are temporarily unable to work due to a disability — whether industrial or non-industrial. See Short-term disability benefits. 

Long-term disability benefits

If you are unable to return to work because of your disability, the Plan provides a continuing source of income. The availability, amount and duration of the benefit depends on a number of factors. See Long-term disability benefits.

Disqualification for benefits

You must meet the Plan's requirements. See Short and long-term disability benefits disqualification.

Guaranteed payments

The Plan makes a death benefit payment to a surviving beneficiary in certain situations. See When LTD benefits stop. 

Rehabilitation

This voluntary program is available if you want to participate and rehabilitation is a realistic goal. See Rehabilitation program.

Administrative and ERISA information

This plan is subject to rules of the federal government, including the Employee Retirement Income Security Act of 1974, as amended (ERISA), not state insurance laws. See Administrative and ERISA information Section.

Key terms

This is an alphabetized list of words and phrases, with their definitions, used in this SPD. See Key terms.

Eligibility and enrollment

Eligibility and enrollment details for the ExxonMobil Disability Plan

Q. Who is eligible to participate in the disability plan? 

A. U.S. dollar-payroll regular employees of Exxon Mobil Corporation and participating affiliates are eligible for this plan. If you meet the eligibility requirements, coverage for short-term disability benefits begins upon employment and coverage for long-term disability benefits begins after one year of benefit service. If your employment status changes from regular to non-regular (e.g., you become an extended part-time (enhanced non-regular employee) you will no longer be eligible.

Enrollment

You take no action; coverage is automatic.

Eligibility for benefits

If you are sick, injured or pregnant, to receive benefits you must be unable to work and:

  • Report your disability promptly to your supervisor.
  • Obtain proper medical care and follow instructions as to treatment.
  • When asked, give your employer a certificate from the physician who is caring for you.
  • Take medical examinations, if required by your employer.
  • Keep your employer advised of your location while disabled.
  • Take any other steps as required by the employer or Plan, including signing medical releases.

You are not eligible for benefits if you become disabled while you are absent for disciplinary reasons, without permission, or after you have been continuously absent for more than 30 days for any reason other than disability.

Short Term Disability (STD) benefits

Short Term Disability benefits on the ExxonMobil Disability Plan

Q. What benefits apply if I get sick, hurt or become pregnant?

A. The Plan pays benefits while you are unable to work because of a disability. Different schedules of benefits apply for industrial and non-industrial disabilities. The amount and duration of benefits depends on a number of factors. Coverage under other benefit plans continues according to the terms of those plans while you receive short-term disability benefits.

Short-term disability benefits and a family and medical leave act (FMLA) absence will run concurrently if all eligibility provisions for both are met.

Non-industrial disability benefits

These benefits are payable when you are unable to work due to pregnancy/childbirth, or illness or injury that is not work-related.

When added to basic payments, benefits equal either full or half disability pay in accordance with the schedule below. At the end of the full-pay period, half-pay benefits may be payable if you are expected to return to work within six months.

The length of your non-industrial disability benefit period depends on your years of benefit service. That service continues to grow throughout the disability benefit period. It is important to understand, however, that if you are not actively at work on your service anniversary date, you will not become eligible for any additional weeks of benefits based on the increase in your benefit service until you return to work.

Here is the Plan's non-industrial disability benefit schedule:

Years of Benefit Service Maximum Weeks of
Full Pay Half Pay
< 1 6 0
1 6 4
2 8 6
3 10 6
4 12 8
5 16 10
6 16 15
7 16 20
8 16 25
9 16 30
10 or more 26 26

Example 1:

You have four years of benefit service and are injured off the job and you are unable to work. Under the non-industrial disability benefits schedule, based on your service, you may be eligible for full-pay benefits for up to twelve weeks and half-pay benefits for up to eight weeks.

This means that if you are unable to work for 15 weeks, you may receive full-pay benefits for twelve weeks and half-pay benefits for three weeks. The schedule would be reduced by any disability days you have used during the previous 26 weeks (see Industrial disability benefits - requalification section for information on requalifying for the full schedule).

Example 2:

You have two years of benefit service and you are at the end of your eighth month of pregnancy. You have used five days (one week) of disability in the previous 20 weeks. You develop complications and are no longer able to work so you receive disability benefits. After two weeks on disability, you deliver your baby by C-section and continue to be unable to work for 8 weeks following delivery.

Under the non-industrial disability benefits schedule, based on your service and the number of days recently used prior to the birth of your child, you may be eligible for full-pay benefits for five weeks after the birth of your child.  This would exhaust your eight weeks of full-pay benefits.  The remaining three weeks of your absence would be under your half-pay schedule.

Non-industrial disability benefits — requalification

Separate periods of absence due to non-industrial disability are added together to determine when you have exhausted your schedule of benefits.

You requalify for the full schedule of non-industrial benefits by working a total of 26 weeks since the last time you received full-pay non-industrial disability benefits. If you become disabled again before that 26 week period is completed— whether it is the same non-industrial disability or a different one — your schedule of benefits is only that portion of the schedule you have not already used. When you are receiving half-pay non-industrial disability benefits, separate periods of active employment following the end of full-pay non-industrial disability benefits are added together to determine when you have worked a total of 26 weeks and re-qualify for the full schedule of non-industrial benefits.

If you are still unable to work at the end of the non-industrial disability benefit period, what happens next depends on whether you are expected to recover and return to work.

If you are expected to recover, special disability benefits may be payable. If you are not expected to recover, you are separated from ExxonMobil service. If you had one year of benefit service at the time you became disabled, long-term disability benefits may be payable.

Non-industrial disability — special disability benefits

If you exhaust your full-pay and half-pay non-industrial disability benefit schedule and you are likely to be able to return to work within six months, special disability benefits may be payable.

Your employer decides if and when these special disability benefits are paid. The benefit amount is half pay, reduced by any government benefit being paid. Generally, these benefits may only be approved when the absence due to disability is unexpected.

Industrial disability benefits

These benefits are payable when you are disabled due to a work-related illness or injury.

If you are disabled because of an illness or injury related to your ExxonMobil work, regardless of the length of your service, you are eligible for industrial disability benefits for up to 52 weeks. The industrial disability benefits, when added to basic payments, is equal to your disability pay

Example:

You make $5,000 a month, are injured on the job and cannot work due to this injury. You are off work for four months. Because this is an industrial injury, you are eligible for full-pay benefits of $5,000 a month for the four months you are off work.

During this time, you receive $1,500 a month in workers' compensation. The Disability Plan pays $3,500 to bring your total monthly income to $5,000 for the four months you are off work.

If you are partially disabled as a result of an industrial injury or occupational illness — that is, you are able to work but cannot perform the full scope of the job you held at the time you became disabled — disability benefits are paid for a maximum of 16 weeks. The benefit amount equals the difference between your disability pay for your previous assignment and the pay for the work to which you are assigned.

Industrial disability benefits — requalification

You requalify for the full schedule of industrial disability benefits when you have been back to work and receiving your regular pay for at least 26 weeks following receipt of benefits for that particular industrial disability. If you become disabled again because of the same ExxonMobil-work-related illness or injury before being back to work for 26 weeks, your schedule of benefits is only the portion of the schedule you have not already used. If the second industrial disability involves a different ExxonMobil-work-related illness or injury, you have the full schedule of industrial disability benefits available.

If you are still unable to work at the end of the industrial disability benefit period, what happens next depends on whether you are expected to recover and return to work.

If you are expected to recover, special disability benefits may be payable. If you are not expected to recover, you are separated from ExxonMobil service. If you had one year of benefit service at the time you became disabled, long-term disability benefits may be payable.

Industrial disability — special disability benefits

If you exhaust the 52 weeks of industrial disability benefits and you are likely to be able to return to work within six months, special disability benefits may be payable. Your employer decides if and when these special disability benefits are paid. The benefit amount is your disability pay, reduced by any government benefit or government disability benefit being paid.

State disability benefits

Employees in some states may have legally required state disability coverage. Benefits from these combine with Short-Term Disability Plan benefits so that payments from all sources do not exceed your level of disability pay.

Family medical leave

Approval of a day as Family Medical Leave does not automatically qualify the day as eligible for short term disability benefits. An employee who is absent for his or her own serious health condition must meet all Short Term Disability Plan requirements in order to have the day qualify as an absence with short term disability benefits.

Long Term Disability (LTD) benefits

Long Term Disability benefits on the ExxonMobil Disability Plan

Q. What happens if an illness or injury prevents me from returning to work at ExxonMobil?

A. The Plan provides benefits for long-term disabilities. The availability, amount and duration of the benefit depend on a number of factors described in this section.

Eligibility for benefits

You are eligible for long-term disability benefits only if you meet all of the following requirements:

  • You have at least one year of benefit service.
  • You become incapacitated.
  • You are no longer receiving short-term disability benefits.
  • Your employment ends as a result of your disability.
  • You obtain proper medical care and follow instructions as to treatment.
  • When asked, you give the claims administrator a certificate from the physician who is caring for you.
  • You have medical examinations, as required.
  • You keep the claims administrator advised of your location while disabled.
  • You take any other steps as required, including signing medical releases.

Benefit amount

The Plan pays a benefit, if necessary, to bring the total payments you receive to at least 50% of your monthly benefit pay. This total includes other benefits such as:

  • The offsettable amount of your company pensions (upon the earlier of commencement or age 65 normal retirement), cash surrendered pensions that you would have been eligible to receive, and relinquished pensions you would have been eligible to receive.  Cash surrendered pensions that you would have been eligible to receive and relinquished pensions include amounts assigned pursuant to a qualified domestic relations order or other valid assignment. At the time those assigned amounts are commenced, that amount becomes an offsettable amount even if you have not commenced your pension and you are under age 65 normal retirement.
  • Any Social Security disability benefit or retirement benefit to which you are entitled.
  • Other government (federal and state) disability benefits.
  • Any other benefit to which the company contributed (such as workers' compensation, Jones Act benefits.).
  • Rehabilitative wages — a wage amount equal to 10% of your last Monthly Benefit Pay will be ignored. Beyond that amount, each $2 of income reduces the long-term disability benefits by $1.
  • Non-rehabilitative wages — offsets the payment from the ExxonMobil Disability Plan dollar for dollar.

Social Security disability benefit means the monthly Social Security benefit you actually begin to receive or could receive if you applied for the benefit. This benefit is based on Social Security rules and formulas in effect when your long-term disability benefit starts.

When you become eligible to receive a long-term disability benefit, you are assumed to be not entitled to a Social Security disability benefit for the first six months of eligibility. This means that even if you are receiving a Social Security disability benefit, it is not taken into account in determining the amount of the first six monthly payments of your long-term disability benefit. After that period, entitlement to a Social Security disability benefit is assumed and an estimated Social Security benefit amount is deducted from your benefits under this Plan unless you present a Social Security denial of your claim.

You are required to complete the process for obtaining a Social Security disability award. The Claims Administrator provides assistance from Social Security specialists to help you apply for Social Security disability benefits. If Social Security denies your claim, the Plan will also help you through the process of appealing the denial. You may lose long-term disability benefits if you do not complete this process.

If you are receiving long-term disability benefits and you are not entitled to Social Security disability benefits, and you are age 62 or older, the Plan will offset the Social Security retirement benefit that is payable beginning at age 62.

If you are paid a benefit that is greater than the amount to which you are entitled under the Plan, that amount will be treated as a pre-payment of a benefit and will reduce future benefits until that advanced amount is recovered.

Example:

Here is an example of how long-term disability benefits reach 50% of your Monthly Benefit Pay. It assumes you have used all full-pay short-term disability benefits and your ExxonMobil employment has ended as a result of your disability.

  • You are a 50-year-old worker who made $6,000 a month.
  • You had 13 years of service.
  • Your long-term disability target amount is $3,000 (50% of $6,000).
  • You receive $800 a month from workers' compensation.
  • You apply for disability benefits from Social Security. After six months, Social Security begins to pay you $800 a month.
  • You commence $100 a month as a company pension.

This chart illustrates a monthly payment of $3,000.

Each month you receive:

Payment Source
$ 800 Workers' compensation
$ 800 Social Security disability¹
$ 100 Company pension² (when commenced)
$ 1,300 LTD payment from disability plan
Total $ 3,000 Monthly LTD Target


1- Social Security Disability Benefit. A monthly Social Security benefit you actually begin to receive or could receive if you applied for the benefit. This benefit is based on Social Security rules and formulas in effect when you long-term disability benefit starts.

2 - Company Pension. Company pension means a pension (including a pre-Social  Security pension, or similar pension) that is attributable to pension service, or an other contributory time under a pension plan sponsored by a service-oriented employer.

You receive $1,700 from other sources. The Disability Plan pays the remaining $1,300 a month in order for you to reach your $3,000 LTD target.

Increases in government benefits which occur after these benefits are originally taken into account under this plan will not reduce future plan payments.

Continuation of LTD benefits

The Plan's Claims Administrator (LINA) conducts a review called the benefits continuation test near the end of the Initial period of disability.

The initial period of disability is the two-year period starting from the last day you were actively at work for the company. This period includes short-term disability time. Long-term disability benefits continue only if the test determines that you are incapacitated. This means that your physical or mental health impairment at the time the test is done prevents you from performing any work for compensation or profit for which you are or may become reasonably fitted by education, training or experience and such inability is expected to continue for six months. If it is determined that there are jobs which you can perform for any employer, the Claims Administrator determines if compensation for any such job would replace at least 60% of your monthly benefit pay. This is called "productive employment".

The definition of incapacitated is not the same definition as that used under Social Security disability. This means that you could qualify for benefits under the Plan even though you do not qualify for Social Security benefits or vice versa.

After the initial benefits continuation test, Cigna periodically reviews your situation to determine if your benefits continue.

If you fail the benefits continuation test

If the test determines that you are able to engage in productive employment, whether for ExxonMobil or any other employer, your LTD benefits end. ExxonMobil has no obligation to rehire you; you must reapply for employment.

If you had more than 15 years of service when long-term disability benefits began:

  • Unless you have reached age 55, you become a suspended retiree
  • If you are 55 or older or you have commenced your ExxonMobil Pension Plan benefit, you become a retiree.

Transition benefits

If you are a retiree and you fail the benefits continuation test, you receive a monthly transition benefit equal to your LTD benefits for six months.

If you become a suspended retiree solely as a result of failing the benefits continuation test, you receive a monthly transition benefit equal to your LTD benefits for six months.

Transition benefits may be denied if you engage in employment other than rehabilitative employment without notifying the LTD Claims Administrator of such employment.

Short and long-term disability benefits disqualification

Short and long-term disability benefits disqualification information for the ExxonMobil Disability Plan

Q. What can prevent my receiving disability benefits?

A. Benefits can stop entirely or they can be reduced if you do not meet the Plan's requirements.

When you are disqualified from receiving STD or LTD benefits

You are not eligible for benefits if you become disabled while you are absent for disciplinary reasons, without permission, or after you have been continuously absent for more than 30 days for any reason other than disability

In addition, there are also some causes of disability which may disqualify you from receiving benefits. These include:

  • The use of narcotics or intoxicants
  • An unlawful act.
  • Willful intent to injure yourself or another person, except in self defense
  • If you are disabled while employed on an outside job
  • In the case of an industrial disability, lack of due care for the safety of yourself or others or lack of compliance with company safety regulations.

The determination as to whether you are disqualified from receiving STD and LTD benefits is made by your employer and is retroactive to the date of disability.

When STD benefits stop

In addition to requirements shown in the Eligibility and enrollment section, short-term disability benefits stop if:

  • You exhaust your schedule of benefits,
  • You return to work,
  • Your employment is terminated, or
  • You die.

When LTD benefits stop

Generally, long-term disability benefit payments stop immediately for any period in which:

  • You do not obtain proper medical care and follow instructions as to treatment.
  • When asked, you do not give the Claims Administrator a certificate from the physician who is caring for you.
  • You do not submit to medical examinations if requested by the Claims Administrator.
  • You fail to cooperate in an appeal of a denial of your application for disability under the U.S. Social Security Act.
  • You do not keep the Claims Administrator advised of your location while disabled.
  • You do not take any other steps as required by the Claims Administrator, including submitting any requested information (e.g., forms, medical releases).

Once these requirements are met, benefits may be reinstated prospectively.

Long-term disability benefits will stop and not be reinstated if:

  • You fail to meet the requirements for continued benefits under the benefits continuation test, or
  • You do not report non-rehabilitative wages (income earned for work other than in conjunction with a rehabilitation program).

In addition, if you are a retiree and fail to report non-rehabilitative wages, there is no six-month transition benefit.

LTD death benefit guaranteed payments

If at the time of death, you are a retiree receiving an LTD benefit and less than 60 full monthly installments of the LTD benefit had become payable to you, monthly installments equal to the guaranteed amount shall be paid to your beneficiary until the month for which the 60th full monthly installment amount of the LTD benefit would have been paid if you had not died.

If at the time of death, you are a covered employee with 15 or more years of benefit service, the Plan provides 60 monthly installment payments beginning with the month following that in which the death occurs.

Determining the guaranteed payment amount

The amount of the benefit is 50% of your last monthly benefit pay less the monthly amount of your pension benefit under the ExxonMobil Pension Plan (including the pre-Social Security pension), regardless of whether or not the pension benefit has commenced, calculated as follows:

  • The pension benefit shall be calculated without taking into account any offsetting pensions (as defined in the ExxonMobil Pension Plan)
  • If the person dies as a covered employee, the pension benefit shall be calculated as if the person were a retiree at death;
  • The monthly amount of the pension benefit shall be based on the normal form amount as defined in the ExxonMobil Pension Plan, reduced, if applicable, for the person's age at the time of death.

If you die before age 50, early commencement factors shall be extended at your age at death based on the same rate of reduction as set out in the ExxonMobil Pension Plan.

Recipient of guarantee payments

Surviving designated beneficiary

If there is a surviving designated beneficiary, the beneficiary or beneficiaries in the order of distribution specified on the beneficiary designation form receive the guarantee amount. Upon the death of the last surviving designated beneficiary, that beneficiary's estate receives the remaining installment payments.

No surviving designated beneficiary

If there is no surviving designated beneficiary, the guarantee amount shall be paid to the first of the following groups that has at least one member that survives the deceased:

  • Your spouse.
  • Your children who are born prior to your date of death. In this event, the benefit will be divided equally among the children who survive you as well as the children who die before you leaving children of their own who survive you. In the case of your child dying before you, leaving children of his or her own who survive you, such child's share shall be divided equally among his or her surviving children.
  • Your parents. In this event, the benefit will be divided equally between the parents who survive you.
  • Your brothers and sisters. In this event, the benefit will be divided equally among the brothers and sisters who survive you as well as the brothers and sisters who die before you leaving children of their own who survive you. In the case of a brother or sister who dies before you leaving children of his or her own who survive you, such brother or sister's share shall be divided equally among his or her surviving children.
  • Your executors or administrators.

Your spouse shall include only someone who is your legal spouse under United States federal law, and your child, parent, brother, or sister shall include only someone who is your legitimate blood relative or whose relationship with you was established by virtue of a legal adoption.

Special rule for estates

When an estate is to receive the installment payments, the net present value of the payments shall be paid in a lump sum. The interest rate used in calculating net present value shall be the prevailing prime rate in effect on the date of the retiree's or designated beneficiary's death as reported in the Wall Street Journal.

Designating beneficiary

You may at any time designate a beneficiary, or revoke a former designation, to the extent permitted by regulations of the Administrator-Benefits. Contact Benefits Administration for information on how to designate a beneficiary.

Pregnancy and childbirth

Pregnancy and childbirth information for the ExxonMobil Disability Plan

The Short Term Disability Plan provides benefits when you are unable to work for medical reasons, including pregnancy/childbirth. Short Term Disability benefits may be paid before and/or after the baby is delivered. 

The length of your available disability benefit period depends on your years of benefit service and the number of disability days already used. (See Non-Industrial Disability Benefits for the maximum schedule of benefits and Non-Industrial Disability Benefits – Requalification for details on requalifying for the full schedule.)

Your available Short Term Disability schedule is used only when you are unable to work for medical reasons. If your available schedule exceeds the amount of time you are disabled, before or after giving birth, you only receive disability benefits for the time you are disabled.

Rehabilitation program

Rehabilitation information for the ExxonMobil Disability Plan

Q. Will the Plan help me return to work?

A. The Plan provides help in assessing your potential for rehabilitation and for returning to productive work at ExxonMobil or elsewhere. This program is entirely voluntary.

A voluntary program is available when rehabilitation or retraining is a realistic goal. If you are offered and choose to participate in the Rehabilitation Program, a LINA specialist works with you to develop a plan designed to return you to employment. Generally, this rehabilitation effort begins as soon as possible after the disability begins.

Administrative and ERISA information

Administrative and ERISA information for the ExxonMobil Disability Plan

Q. What other information do I need to know about the Plan?

A. 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 Disability Plan.

Plan sponsor and participating affiliates

The Plan is sponsored by:

ExxonMobil 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 Disability Plan. 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 Disability Plan 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

P.O. Box 64111
Spring, TX 77387-4111

For service of legal process:

Corporation Service Company
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 Disability Plan in its application to any participant or beneficiary, and to decide any and all claim appeals.

Incorrect computation of benefits

If you or your beneficiary receives a distribution of any amount from the Plan to which you are not entitled, you or your beneficiary will be required to repay the amount of the overpayment to ExxonMobil or the Plan. The Administrator-Benefits may make reasonable arrangements with you for repayment.

Type of plan

The ExxonMobil Disability Plan is a welfare plan providing disability benefits.

Plan numbers

The Plan is identified with government agencies under these numbers: the Employer Identification Number 13-5409005, the Plan Number 559.

Plan year

The Plan year is the calendar year.

Plan funding

Benefits are funded through employer contributions.

Benefit claims

All benefit claims must be filed within one year of the date of loss. A claim must be filed in writing to your human resources contact for short-term disability benefits or LINA for long-term disability benefits. Your employer or LINA is responsible for determining and informing you of your entitlement to a benefit and any amount payable to you under the Plan.

For long-term disability benefits:

LINA
Cigna Group Insurance
LTD Claims
P.O. Box 709015
Dallas, TX 75370-9015

LINA will review your claim and respond to you within a reasonable period of time, normally within 45 days after receiving your claim. If your claim is denied completely or partially, you or your beneficiary will receive written notice of the decision. The notice will describe:

  • The specific reasons for the denial,
  • Any additional information or material that is needed to validate the claim and the reason that information is required, and
  • The process for requesting an appeal.

If LINA needs additional time to decide on your claim because of special circumstances, you will be notified within the 45-day period. You will receive a response no later than 75 days after your claim was initially received.

Filing a mandatory appeal

If your claim is denied, you, your beneficiary or your designated representative may appeal the denial of long-term benefits to LINA, and appeal the denial of short-term disability benefits to the Administrator-Benefits. The written appeal should include the reasons why you believe the benefit should be paid and information that supports, or is relevant to, your claim (written comments, documents, records, etc). The written appeal may also include a request for reasonable access to, and copies of, all documents, records and other information relevant to your claim. Your written appeal should be made within 180 days after you receive any denial notice. The review will take into account all comments, documents, records and other information submitted relating to the claim, without regard to whether such information was submitted or considered in the initial benefit determination. You will receive a response to the appeal within 45 days.

If additional time is needed to decide your claim because of special circumstances, you will be notified within the 45-day claim response period. Although, an extension may be requested the law stipulates that no additional time must be allowed.

If the appeal is denied, you will receive written notice of the decision. 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.
  • A statement of the voluntary appeal procedure and your right to obtain information about such procedure or a description of the voluntary appeal procedure.
  • A statement of your right to bring an action under section 502(a) of the Employee Retirement Income Security Act (ERISA).

Claims processor and the appeal of denied claims for Long Term Disability (LTD) benefits under the Disability Benefits Program of Mobil Oil Corporation

Effective December 1, 2002, the Disability Benefits Program of Mobil Oil Corporation (Mobil Plan) was merged with the Plan.  Any claims incurred on or before December 31, 2002, are calculated under the terms of the Mobil Plan.  Otherwise generally, the administrative terms of the Plan apply to the Mobil Plan with the following exceptions described in this section.  

The Mobil Plan LTD Claims Processor is Metropolitan Life Insurance Company (MetLife).  Their address is:

MetLife Insurance Co.
Long Term Disability Plan
Claims Administrator
P.O.Box 3017
Utica, NY 13504-3017

If you are receiving Mobil Plan LTD benefits, but the Claims Administrator subsequently finds that you are no longer qualified for LTD benefits, you will be informed in writing of the reason for the denial of future LTD benefits.  The Claims Administrator’s decision will provide a written explanation of the specific reasons for the denial, a specific reference to applicable Mobil Plan provisions on which the denial is based, a description of any additional information required for you to obtain reconsideration of your claim for continued benefits, including why such information is necessary, and an explanation of the procedure for review and appeals.

You should submit your request for reconsideration to the Claims Administrator with any additional information within 60 days following your receipt of the claim denial.Once the Claims Administrator has completed its investigation of your request for reconsideration of your claim for continued benefits and considered any additional information you may have submitted, it will send you a written decision within 60 days of its receipt of the last written document you have provided.

If after the above, you receive a denial of your claim in whole or in part, and it is believed that the claim for benefits has been improperly denied, you may submit a written appeal to the Administrator-Benefits.  The address is as follows:

For appeals:

Administrator-Benefits
P.O. Box 64111
Spring, TX 77387-4111

For service of legal process:

Administrator-Benefits
P.O. Box 64111
Spring, TX 77387-4111

You will receive a written response to your appeal within 60 days after your appeal is received unless unusual circumstances determined by the Administrator-Benefits require an additional 60 days to complete the review.

Statute of limitations

After you have received the response to the mandatory appeal, you may bring an action under section 502(a) of ERISA. Such action must be filed within one year of the date on which your mandatory appeal was decided.

Filing a voluntary appeal

If your appeal is denied, you may submit a voluntary appeal to the Administrator-Benefits. New information pertinent to the claim is required for the voluntary appeal to be considered. You must submit your voluntary appeal within 30 days of the denial of your mandatory appeal. The statute of limitations or other defense based on timeliness is suspended during the time that a voluntary appeal is pending.

You will be notified within 15 days after your request was received that such information was considered or is not pertinent. If it is determined that there is new relevant information, a decision will be made within 60 days after the Administrator-Benefits receives your request for a voluntary appeal. If it is determined that there is no new information pertinent to your claim, your voluntary appeal will not be considered.

No implied promises

Nothing in this SPD says or implies that participation in the ExxonMobil Disability Plan is a guarantee of continued employment with the company.

If the Plan is amended or terminated

The company reserves the right at any time and for any reason to terminate, suspend, withdraw, amend or modify the Plan or any of its provisions. Any benefit to which you are entitled at the time of termination will be provided. If any material changes are made in the future, you will be notified.

Your rights under ERISA

As a participant in the ExxonMobil Disability Plan, 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 the Plan, including collective bargaining agreements, and a copy of the latest annual report (Form 5500 Series) filed by the Plan 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 the Plan, 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 the Plan'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 Medical Plan fiduciaries

In addition to creating rights for Plan participants, ERISA imposes duties upon the people who are responsible for the operation of the employee benefit plan. The people who operate your Plan, called  "fiduciaries" of the Plan, have a duty to do so prudently and in the interest of you and other Plan 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 Plan documents or the latest summary annual report from the Plan 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 Federal court. If it should happen that Plan fiduciaries misuse the Plan's money, or if you are discriminated against for asserting your rights, you may seek assistance from the U.S. Department of Labor, or you may file suit in a Federal court. 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 the Plan, you should contact Benefits Administration. 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

A list of key terms in the ExxonMobil Disability Plan

Basic payments

Compensation paid by your employer as well as any government benefits to which the employee is entitled for the period and disability in question including, but not limited to state disability laws.

Benefit service

Generally, all the time from the first day of employment until you leave the company's employment.

Excluded are:

  • Unauthorized absences;
  • Leaves of absence of over 30 days (except military leaves or leave under the Federal Family and Medical Leave Act);
  • Certain absences from which you do not return;
  • Periods when you work as a non-regular employee, as a special agreement person, in a service station, car wash, or car-care center operations; or
  • When you are covered by a contract that requires the company to contribute to a different benefit program, unless a special authorization credits the service

Company pension

"Company pension" means a pension (including a pre-Social Security pension, or similar pension) that is attributable to pension service, or any other contributory time under a pension plan sponsored by a service-oriented employer.

Dependent child

An unmarried person who was born before your death, who is not employed on a regular and full-time basis, not reached the end of the month in which age 24 is attained provided the child is chiefly dependent on the covered person for support and maintenance.

Disability

A condition in which an employee is unable to work because of pregnancy/childbirth, or illness or injury. If the disability is total and continuous, is expected to last at least six months from the time of determination, and extends beyond the period during which short-term disability benefits are payable, then long-term disability benefits may be payable. This is called incapacitated in the plan documents.

Disability pay

Is the amount that an employee would have received based on the person’s assigned or substitution-planned work schedule if the person had not been absent due to disability, before any reduction for the person’s deferred pay contributions or contributions pursuant to salary reduction. Such amounts exclude planned scheduled overtime pay and planned scheduled shift differential pay unless the person’s local pay practices specify otherwise. For purposes of this definition, the amounts of pay that are received under an assigned or substitution-planned work schedule shall be conclusively determined by the person’s employer.

  • For certain seagoing SeaRiver Maritime, Inc. employees, Disability Pay is based on the individual’s base pay (including amounts designated a Continuous Service Bonus by the employer) and Saturday, Sunday and holiday (SSHOT) pay, if applicable.
  • Each employer makes the determination of an employee’s Disability Pay and such determination shall be conclusive on an employee.

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. Regular employees are eligible their first day of employment.

The following are not eligible to participate in the Plan:

  • Leased employees as defined in the Internal Revenue Code.
  • Temporary or part-time employees (also called "non-regular employees").
  • Barred employees or special agreement persons as defined in the plan document.

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.

Government benefit

Government benefit means amount, as established by the person's employer, of a pension, benefit or allowance payable to the person in question under any law, other than war veterans' legislation. It includes any no fault payment to the person for loss of earnings from work. In this connection, "no fault payment" means payment:

  • Pursuant to any governmental no fault insurance law, and
  • The cost of which is borne by a service oriented employer either directly or by means of insurance paid for by such employer.

Incapacitated

Unable to perform work according to these standards:

  • During the employee's initial period of disability (defined below), the person is incapacitated if:
  • The person is wholly and continuously unable — by reason of a physical or mental health impairment — to perform any work suitable to the person's capabilities, training and experience, that the person's employer has available, and
  • Such inability to perform work is reasonably expected to last at least six months from the date the person's ability to perform work is determined.
  • After the initial period, a person is incapacitated if the person is wholly and continuously unable, by reason of a physical or mental health impairment, to perform any work for compensation or profit for which the person is or may become reasonably fitted by education, training or experience. The determination of whether a person is incapacitated will be reviewed periodically.

Industrial disability

A disability resulting from an accidental injury or occupational disease that is compensable under applicable workers' compensation law or if no worker's compensation law is applicable, would be compensable under the workers' compensation law that the person's employer designates, if that law were applicable.

Initial period of disability

The two-year period measured from the last day the person was actively at work for the company.

Maximum amount

"Maximum amount" of any annuity means full amount of the annuity, except that it means accreted amount of the annuity if:

(A) there is an accreted amount,

(B) the principal annuitant is not permitted to select the normal maturity time of the annuity as the time it will begin, and

(C) it begins after its normal maturity time.

Monthly benefit pay

Generally, pay associated with your regular work schedule and rate of pay.  Except for SeaRiver fleet employees, regular work schedule and rate of pay do not include temporary job assignments, regardless of how long an employee has filled a temporary job assignment. For SeaRiver fleet employees, the rate of pay is that used for pay purposes as of month end.

This amount will be adjusted as follows:

  1. If you are a regular employee who is not a SeaRiver fleet employee and either (a) classified in your employer’s payroll system as not exempt from the application of the overtime rules under the U.S. Fair Labor Standards Act, or (b) covered under your employer’s First-Line Supervisor program, the value based on your regular work schedule and rate of pay will be increased by 20%.
  2. If you are a non-regular employee, SeaRiver fleet employee or other regular employee not described in paragraph (1) above, your monthly benefit pay is the amount based on your regular work schedule and rate of pay.

Non-industrial disability

The inability to work that arises out of an illness or injury that is not work-related.

Non-regular employee

Temporary or part-time employee of a participating employer who otherwise would be a covered employee but for the fact, as determined by the participating employer, that the person either does not regularly work a full-time schedule or is employed on a temporary basis. Non-regular employees include extended part-time (enhanced non-regular) employees. Non-regular employees do not include employees designated by their employer as part-time regular.

Non-rehabilitative wages

Any income earned during a period of disability that are not rehabilitative wages.

Normal retirement time

The time when a covered employee approaches age 65.

Normal form amount

The amount of an annuity, if any, that would be paid if the annuity were payable as other than a Qualified Joint and Survivor Annuity and the principal annuitant had neither selected any extended period certain for the annuity, nor designated a joint annuitant.

Offsettable amount

For purposes of determining the amount by which the monthly amount of a person's Long-Term Disability Benefit or Transition benefit is decreased for company pensions, cash surrendered pensions and relinquished pensions, use the following rules:

(1) If the offsetting annuity begins when the Long-Term Disability Benefit begins, it means the normal form amount of the offsetting annuity.

(2) If the offsetting annuity does not begin when the Long-Term Disability Benefit begins, it means the normal form amount of the offsetting annuity as of the earlier of its actual commencement time or the person's normal retirement time.

(3) In either event, it means no greater amount than the maximum amount, except with respect to any portion of any offsetting annuity an early commencement amount of which would not have been computed according to an actuarial table.

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.

Rehabilitative benefits

Rehabilitative Benefits Rehabilitation costs incurred by a person receiving benefits under the Plan (including short-term and long-term disability benefits) that are incurred in connection with a program of rehabilitation approved by either LINA or the Administrator-Benefits, and the cost of which are not reimbursable through another source.

Rehabilitative wages

Any income earned as a result of any work performed in conjunction with a LINA approved rehabilitative program.

Retiree

Generally, a person at least 55 years old who retires as a regular employee with 15 or more years of benefit service and who has not thereafter recommenced employment as a covered employee or a non-regular employee. Retiree status may also be attained by someone who is retired by the company as a regular employee and entitled to long-term disability benefits under the ExxonMobil Disability Plan after 15 or more years of benefit service, regardless of age.

Employees who terminate while non-regular (including extended part-time employees) are not eligible for retiree status regardless of age or service.

Social security disability benefit

A monthly Social Security benefit you actually begin to receive or could receive if you applied for the benefit. This benefit is based on Social Security rules and formulas in effect when your long-term disability benefit starts.

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.

Transition benefits

A monthly payment equal to your Long Term Disability Benefit, payable for six months following the period you cease to be incapacitated.

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