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Family Adjustment, Family Income, Contributory Group Life Insurance (Grandfathered)

Summary plan descriptions for the Family Adjustment, Family Income and Contributory Group Life Insurance (Grandfathered) Plans as of January 2016

About the plans

This Summary Plan Description (SPD) is a summary of benefits for the Family Adjustment, Family Income and Contributory Life Insurance plans. These plans were discontinued as to new participants as of January 1, 2000.  Only retirees of Exxon Corporation and employees who met certain age and service requirements as of that date were permitted to remain in these plans. Employees hired after that date, are only eligible to participate in the ExxonMobil Life Insurance Plan.

This SPD does not contain all plan details. In determining your specific benefits, the full provisions of formal plan documents and any the insurance certificates, as they exist now or as they may exist in the future, always govern. You may obtain copies of these documents by making a written request to the Administrator- Benefits. 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, retiree, or survivor), you should contact the appropriate service center.

Phone numbers:
Employees call:
ExxonMobil Benefits Administration
Monday – Friday 8:00 a.m. to 3:00 p.m. 
(U.S. Central Time), except certain holidays 
800-262-2363 (toll free outside Houston)

Address:
ExxonMobil Benefits Administration
P.O. Box 64111
Spring, TX 77387-4111

Phone numbers:
Retirees and Survivors call:
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

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

CGLIC — Connecticut General Life Insurance Company issues the insurance policy for company-paid insurance and provides the conversion policy if your company-paid life insurance coverage ends.

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

  • ExxonMobil Me, the Human Resources Intranet Site — Can be accessed at work by 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

Prior to the merger of Exxon Corporation and Mobil Corporation, the Family Income Protection Program was one of the benefit plans sponsored by Exxon Corporation and it provided a wide range of benefits for survivors of employees and retirees.

Exxon Mobil Corporation continues to provide coverage under the following sections of the ExxonMobil Life Insurance Program: ExxonMobil Family Adjustment Plan, the ExxonMobil Family Income Plan and the ExxonMobil Contributory Group Life Insurance Plan to those eligible employees and retirees who had coverage before the merger.

These Plans provide benefits as follows:

  • Family Adjustment Plan: a cash benefit of up to one year of your final annualized monthly ExxonMobil benefit pay
  • Family Income Plan: a series of monthly benefits that can continue for an eligible survivor's life
  • Contributory Group Life Insurance Plan: a cash benefit equal to a multiple of your final annual ExxonMobil benefit pay

The company pays the contributions for the Family Adjustment Plan and the Family Income Plan, while you pay the contributions for the Contributory Group Life Insurance Plan.

A careful reading of this guide will help you understand how the Plans work so you can make the best use of them. You may obtain additional information from the sources shown in the Information sources section.

Overview

The following chart provides an overview of the coverage under the following plans:

  1. Family Adjustment Plan
  2. Family Income Plan
  3. Contributory Group Life Insurance Plan

Details are provided below.

Company Pays You Pay
Family Adjustment Coverage Family Income Coverage Contributory Group Life
Benefit: Benefit: Benefit:
Your beneficiary receives a lump sum payment – up to one year’s final annualized ExxonMobil monthly benefit pay depending on your age when you die. Eligible beneficiaries receive monthly payments – up to 20% of your monthly ExxonMobil benefit pay, depending on who receives the benefit. The period over which the payments are made also depends on who receives the benefit. Your beneficiary receives a lump sum payment - equal to a multiple of your final annualized ExxonMobil monthly benefit pay based on your age.
When Coverage Ends: When Coverage Ends: When Coverage Ends:
If you Retire With Retiree
Status-Continues for Life
If you Retire With Retiree
Status-Continues for Life
When you stop contributing or the first of the month in which you reach age 70, whichever is first.

If You Terminate Without Retiree Status:

Death Benefit - Ends when you leave ExxonMobil.
Life Insurance - Ends 31 days (up to one year if you are disabled) following the date you leave ExxonMobil.

If You Terminate Without Retiree Status:

Death Benefit - Ends when you leave ExxonMobil.
Life Insurance - Ends 31 days following the date you leave ExxonMobil.

 

When we refer to Family Adjustment and Family Income Coverage we refer to insurance and death benefits provided by these plans. You choose which form of coverage is best for you. Further details on insurance and death benefits can be found in the Insurance benefits versus death benefits section.

Administrative and ERISA information

Administrative and ERISA information for the Family Adjustment, Family Income and Contributory Group Life Insurance Plans

This section contains technical information about the ExxonMobil Life Insurance Program which includes the Family Adjustment Plan, the Family Income Plan and the Contributory Group Life Insurance Plan. 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.

Plan name

The formal name of the plan is The ExxonMobil Life Insurance Program

Plan sponsor and participating affiliates

The ExxonMobil Life Insurance Program is sponsored by:

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

All of Exxon Mobil Corporation's divisions and most of the major U.S. affiliates participate in the ExxonMobil Life Insurance 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.

Plan administrators

The Plan Administrator for the ExxonMobil Life Insurance Plan is the Administrator-Benefits. The Administrator-Benefits is the Manager-Global Benefits Design, Exxon Mobil Corporation. You may contact the Administrator-Benefits as follows:

For appeals on eligibility and uninsured death benefits:

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

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).

For service of legal process:

Corporation Service Co.
211 East 7th Street, Suite 620
Austin, Texas 78701-3218

Type of plan

The ExxonMobil Life Insurance Program is a welfare plan providing life insurance benefits as well as uninsured death benefits.

Plan number

The ExxonMobil Life Insurance Program is identified with government agencies under two numbers: The Employer Identification Number (EIN), 13-5409005 and the Plan Number (PN), 624.

Plan year

The plan year is January 1 through December 31.

Plan funding

Benefits are funded through employee and employer contributions.

Claims processor and claims fiduciary

The insurance company has fiduciary responsibility for all insured benefits under the plans. The Administrator-Benefits is the claims processor and the claims fiduciary for uninsured death benefits under the Family Adjustment Plan and Family Income Plan.

If the plans are amended or terminated

The company reserves the right at any time and for any reason to terminate, suspend, withdraw, amend or modify any benefit plan or its provisions. If the plan is terminated, any benefit to which you are entitled at the time of termination will be provided. Thus, termination of a life insurance or death benefit plan would end protection in the event of death thereafter.

Benefit claims

Filing claims under the Family Adjustment, Family Income and Contributory Group Life Insurance Plans

A claim must be filed in writing to the CGLIC Claims Office for Family Adjustment Insurance and Family Income Insurance, or MetLife for Contributory Group Life Insurance, or Benefits Administration for any uninsured benefit. CGLIC, MetLife or Benefits Administration, as appropriate, is responsible for determining entitlement to a benefit and any amount payable under the Plan. 

For Family Adjustment Insurance and Family Income, write to:

CGLIC Claims Office

P.O. Box 22328
Pittsburgh, PA 15222-0328

Written proof of loss must be given to CGLIC within 90 days after the date of the loss for which claim is made. If written proof of loss is not given in that time, the claim will not be invalidated nor reduced if it is shown that written proof of loss was given as soon as was reasonably possible.

For Contributory Group Life Insurance, write to:

MetLife

Utica Life Claims
P.O. Box 3016
Utica, NY 13504

For Contributory Group Life Insurance, written proof of a claim must be given to MetLife not later than 90 days after the date of the loss. If notice or proof is not given on time, the delay will not cause a claim to be denied or reduced as long as the notice or proof is given as soon as possible.

For any uninsured benefit claim, write to:

ExxonMobil Life Insurance Program

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

All uninsured death benefit claims should be filed within ten years of the date of death.  The appropriate claims administrator will review your claim and respond to you within a reasonable period of time, normally within 90 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 the claims administrator needs additional time to decide on your claim because of special circumstances, you will be notified within the 90-day period. You will receive a response no later than 180 days after your claim was received initially.

Filing a mandatory appeal

If your claim is denied, you, your beneficiary or your designated representative may file an appeal no later than 60 days from the date of the denial. File the appeal with CGLIC for Family Adjustment Insurance and Family Income Insurance, with MetLife for Contributory Group Life Insurance, and with the Administrator-Benefits for any uninsured benefit claim denial.

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. 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 60 days from the date the appeal was received.

If additional time to decide on your appeal is needed because of special circumstances, you will be notified within the 60-day appeal response period. 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).

Statute of limitations

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

Filing a voluntary appeal for an uninsured benefit only

If an appeal for an uninsured benefit is denied, an appeal to the Administrator-Benefits may be available. 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 Life Insurance Program is a guarantee of continued employment with the company.

Future of the Plan

ExxonMobil has the right to change, suspend, withdraw, amend, modify or terminate the Program or any of its provisions at any time and for any reason. A change may also be made to required contributions and 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.

Contributory group life insurance plan

Contributory group life insurance plan for the Family Adjustment, Family Income and Contributory Group Life Insurance Plans

This plan provides additional amounts of life insurance. To be eligible for this coverage you had to be enrolled in the plan at the time of your retirement.

To whom paid

You name a beneficiary. You may change your beneficiary at any time.

Coverage and cost to you

Your cost for this coverage is based on age at a monthly rate per $1,000 of coverage, as follows:

Age Rate
Under 30 $ 0.02
30-34 $ 0.03
35-39 $ 0.04
40-44 $ 0.05
45-49 $ 0.07
50-54 $ 0.12
55-59 $ 0.25
60-64 $ 0.48
65-69 $ 0.96

This rate reflects the maximum schedule of insurance. You may also choose one half or one quarter of the maximum coverage. This will reduce your cost accordingly.

You may change or discontinue coverage at any time. Once you cancel coverage, you will not be able to re-enroll. If you increase coverage, you must show evidence of good health. You may also change your beneficiary at any time.

Maximum schedule

Maximum coverage is your final annual ExxonMobil pay at the time of your retirement multiplied by a factor that varies according to your age. The amount shown for each age in the following table takes effect on the first day of the month in which you reach that age. Coverage ends at age 70 for retirees.

Age Multiple of Final ExxonMobil Pay Age Multiple of Final ExxonMobil Pay
25 and under 7.5 48 2.9
26 7.3 49 2.7
27 7.1 50 2.5
28 6.9 51 2.3
29 6.7 52 2.15
30 6.5 53 2.0
31 6.3 54 1.85
32 6.1 55 1.7
33 5.9 56 1.6
34 5.7 57 1.5
35 5.6 58 1.4
36 5.4 59 1.3
37 5.3 60 1.2
38 5.2 61 1.1
39 5.1 62 1.0
40 5.0 63 0.9
41 4.9 64 0.75
42 4.8 65 0.7
43 4.4 66 0.65
44 3.9 67 0.6
45 3.5 68 0.56
46 3.3 69 0.52
47 3.1 70 0.00

How paid

The plan ordinarily pays the benefit in a lump sum.

Changing coverage

You may discontinue or change your coverage at any time. Once you cancel coverage, you will not be able to re-enroll. If you select a lower amount of coverage, the change takes place as soon as administratively possible. If you select a higher amount, you must provide evidence of good health. Your higher coverage takes effect when your application is approved.

Coverage after retirement with retiree status

A retiree is generally one who retires with 15 or more years of benefit service and is at least 55 years old. Such a person is said to have attained retiree status. Retiree status is also given to those who terminate with 15 or more years of benefit service and who are entitled to long-term disability benefits under the ExxonMobil Disability Plan, regardless of age.  When you become a retiree, your protection automatically continues under the Family Adjustment and Family Income Coverage.

Family Adjustment Coverage

As with employees, the benefit for retirees begins to decrease when you reach age 65 and continues to do so until age 73 years and three months. At that time, the benefit reaches 50 percent of your final annualized ExxonMobil monthly benefit pay and remains at that level.

Family Income Coverage

While Family Income Coverage continues into retirement, there are some differences if you die as a retiree:

  • Family Income payments do not start until five years after the date of retirement.
  • If you die during the first 60 months that your pension is payable, Family Income Coverage payments will be reduced to take into account the amount of the ExxonMobil Normal Pension payable for that period.
  • In addition to the other conditions necessary to be a preference spouse (see Preference relatives), you and your spouse must have been married before you retired and remained married to each other continuously since retirement.

Contributory Group Life Insurance Plan

If you are a retiree and are participating in the Contributory Group Life Insurance Plan, you can continue coverage until age 70. Your pay at retirement determined your coverage and your cost.

Coverage after termination without retiree status

If you terminate without retiree status, your Family Adjustment Death Benefit and Family Income Death Benefit coverage end as soon as you leave ExxonMobil. Family Adjustment Insurance and Family Income Insurance continue for 31 days after your last day on the job and can be converted to an individual policy within 31 days.

Conversion options

To convert Family Adjustment Insurance and/or Family Income Insurance to an individual policy without a medical examination, you must apply within 31 days of termination and pay the premiums for the coverage appropriate for your age at the time of conversion. The policy will be a permanent form of insurance.

The conversion privilege does not apply to the Family Adjustment Death Benefit or the Family Income Death Benefit.

Coverage after retirement with retiree status

Information about coverage after retirement with retiree status for the Family Adjustment, Family Income and Contributory Group Life Insurance Plans

A retiree is generally one who retires with 15 or more years of benefit service and is at least 55 years old. Such a person is said to have attained retiree status. Retiree status is also given to those who terminate with 15 or more years of benefit service and who are entitled to long-term disability benefits under the ExxonMobil Disability Plan, regardless of age. When you become a retiree, your protection automatically continues under the Family Adjustment and Family Income Coverage.

Family Adjustment Coverage

As with employees, the benefit for retirees begins to decrease when you reach age 65 and continues to do so until age 73 years and three months. At that time, the benefit reaches 50 percent of your final annualized ExxonMobil monthly benefit pay and remains at that level.

Family Income Coverage

While Family Income Coverage continues into retirement, there are some differences if you die as a retiree:

  • Family Income payments do not start until five years after the date of retirement.
  • If you die during the first 60 months that your pension is payable, Family Income Coverage payments will be reduced to take into account the amount of the ExxonMobil Normal Pension payable for that period.
  • In addition to the other conditions necessary to be a preference spouse (see Preference relatives), you and your spouse must have been married before you retired and remained married to each other continuously since retirement.

Contributory group life insurance plan

If you are a retiree and are participating in the Contributory Group Life Insurance Plan, you can continue coverage until age 70. Your pay at retirement determined your coverage and your cost.

Coverage after termination without retiree status

If you terminate without retiree status, your Family Adjustment Death Benefit and Family Income Death Benefit coverage end as soon as you leave ExxonMobil. Family Adjustment Insurance and Family Income Insurance continue for 31 days after your last day on the job and can be converted to an individual policy within 31 days.

Conversion options

To convert Family Adjustment Insurance and/or Family Income Insurance to an individual policy without a medical examination, you must apply within 31 days of termination and pay the premiums for the coverage appropriate for your age at the time of conversion. The policy will be a permanent form of insurance.

The conversion privilege does not apply to the Family Adjustment Death Benefit or the Family Income Death Benefit.

Eligibility and enrollment

Eligibility and enrollment details for the Family Adjustment, Family Income and Contributory Group Life Insurance Plans

About eligibility

Participants in the Family Adjustment Plan, the Family Income Plan or the Contributory Group Life Insurance Plan are those retirees who had coverage when they retired on or after January 1, 1971.

Participants in the Family Adjustment Plan and the Family Income Plan also include those covered employees;

  • Who participated in the plan on the day prior to the merger of Exxon Corporation and Mobil Corporation
  • Whose age and years of benefit plan service as of December 31, 1999 total at least 70
  • Who did not elect to participate in the Basic Life Coverage under the ExxonMobil Life Insurance Plan
  • Who are not participants in the ExxonMobil Executive Life Insurance and Death Benefit Plan

Family adjustment and family income coverage

Family adjustment and family income coverage information for Family Adjustment, Family Income and Contributory Group Life Insurance Plans

Family Adjustment Coverage

If you die as an employee or retiree before age 65, your Family Adjustment Coverage equals one year of your final annualized ExxonMobil monthly benefit pay. The benefit declines by 0.5 percent per month starting the first of the month in which you reach age 65 and continues to reduce until it reaches 50% at age 73 and 3 months.

If you terminate without retiree status due to disability, you retain this coverage for up to one year if you remain disabled.

Form of payment

Family Adjustment Coverage ordinarily pays the benefit in a lump sum.

Whom paid

Your beneficiary may be anyone you choose.

Family Income Coverage

Family Income Coverage provides monthly income for certain eligible surviving family members when you die.

To whom paid

Most often, the benefit, an amount equal to 20 percent of your final ExxonMobil monthly benefit pay, is paid monthly to a surviving spouse. Unlike Family Adjustment Coverage, which permits you to name a beneficiary, benefits under Family Income Coverage are paid to surviving relatives according to a fixed schedule. If you have no eligible surviving relatives, benefits are not paid.  The plan divides eligible survivors into two categories: preference relatives and dependent, non-preference relatives.

Preference relatives

  • A preference spouse is someone to whom you have been married at least one year and who meets either of these two conditions:
  • lives with you when you die, or
  • lives apart from you when you die but receives support from you equal to 20 percent of your final annualized ExxonMobil monthly benefit pay or in the case of a retiree, receives support equal to 20% of

your prior year adjusted gross income for the 12 months prior to your death.

An additional requirement applies to the spouse of a retiree (see Coverage after retirement with retiree status).

Preference children are children under age 21 or who have become incapable of self-support prior to age 21: and who either:

  • live with you when you die, or
  • live apart from you but receive support from you equal to 20 percent (10 percent if only one child) of your final annualized ExxonMobil monthly benefit pay, or in the case of a retiree, receives support equal to 20% of your prior year adjusted gross income for the 12 months prior to your death.
  • A preference parent is one who receives support from you equal to 10 percent of your final annualized ExxonMobil monthly benefit pay, or in the case of a retiree, receives support equal to 20% of your prior year adjusted gross income for the 12 months prior to your death.

Dependent, non-preference relatives

If a spouse, child under age 21 or parent does not qualify as a preference relative, he or she may be included in the dependent, non-preference class. Dependent, non-preference relatives include any eligible relative by blood or marriage who received support from you of at least 10 percent of your final annualized ExxonMobil monthly benefit pay or the U.S. Federal Estate Tax Annual Gift Exclusion ($14,000 in 2014) for the tax year immediately preceding the year of your death, whichever is less.

“Eligible” means living, and a spouse who has not remarried, or a parent, or in the case of any other preference relative or non-preference relative, has not reached ineligible status upon attaining age 21, unless the person becomes permanently incapable of self-support prior to attaining age 21, and remains so at the time of your death.

Payment priorities

The plan considers surviving preference relatives in this order:

  • If you have an eligible preference spouse, he or she receives the benefit.
  • If there is no eligible preference spouse, the benefit is paid to eligible preference children.
  • If there are no eligible preference children, the benefit is paid to eligible preference parents.
  • If there are no preference relatives at the time of your death, the plan considers dependent, non-preference relatives. First priority is paid to a dependent, non-preference spouse. If there is none, benefits are divided equally among all other dependent, non-preference relatives.

A special rule for remarriage

If a preference spouse remarries, remaining benefits are transferred to the next preference relative eligible to receive them. If there are none, the remarried spouse receives a one-time payment of 12 times the amount of the monthly benefit he or she was receiving before remarrying.

When payments begin and how long they continue

If you die as an employee, benefits start in the month following your death. (See Coverage after retirement with retiree status for special rules for retirees). Once payments begin, the maximum period over which they can continue depends on who the benefit is payable to.

The following charts summarize the factors that determine the amount of the benefit and how long it will be paid.  If you have no survivors eligible under this plan, benefits are not paid.

Preference Relatives
Monthly Amount Of Benefit Duration of Payment
Preference Spouse 20% of your last ExxonMobil monthly benefit pay. For life or until remarriage.
Preference Children 20% of your last ExxonMobil monthly benefit pay divided equally among such children. For one child benefits equal 10% of your final ExxonMobil monthly benefit pay. For each child, stops at the end of the month in which the child reaches age 21 unless the child is permanently incapable of self support prior to attaining age 21, in which case payments continue for as long as the child is incapacitated.

Preference Parent

10% of your last ExxonMobil monthly benefit pay. If payable to both parents, 20% of such compensation divided equally among them.

For life or until marriage.

 

Non-Preference Relatives
Monthly Amount Of Benefit Duration of Payment
Non-Preference Spouse Up to the same amount payable to a preference spouse, but not more than the average monthly support provided by you.

In all cases, payments continue until the earliest of:

  • The date your last surviving eligible relative dies.
  • The date payments would stop if the person were a preference relative.
  • The date of the 60th installment.
All Other Dependent
Non-Preference Relatives
Up to 20% (10% if only one such relative) of your last ExxonMobil monthly benefit pay, but not more than your total average monthly support for all eligible recipients. Each person receives a pro-rated share of the monthly benefit in proportion to his or her share of your total monthly support.

Insurance benefits versus death benefits

Insurance benefits versus death benefits information for Family Adjustment, Family Income and Contributory Group Life Insurance Plans

For Family Adjustment and Family Income Coverage, you may choose between an insurance benefit and a death benefit. While there are differences between insurance benefits and death benefits, the amount of your coverage is identical. Unless you choose the death benefit option, you are automatically enrolled in the life insurance option.

You may change from one to the other at any time. You may also elect an insurance benefit for one coverage and the death benefit for the other coverage.  For example, you can elect an insurance benefit for Family Adjustment and the death benefit for Family Income Coverage.  A change from life insurance to a death benefit will be effective the first of the month following the date your properly completed election form is received by the company. To change from the death benefit option to the life insurance option, you must provide evidence of good health. Your change will be effective the first of the month following the date the company receives confirmation that the insurance company has received satisfactory evidence of good health.

Choosing between life insurance and a death benefit

Life Insurance

Generally, life insurance proceeds are not subject to income tax.  When you die, such proceeds may be subject to federal estate taxes, but are not taxed as income except for the interest portion of the Family Income Insurance benefit.

To the extent that your employer-provided insurance coverage under the Family Income Insurance Plan and the Family Adjustment Insurance Plan exceeds $50,000, the cost of such coverage (computed in accordance with income tax regulations) constitutes income for federal income tax and wages for Social Security tax purposes. The IRS calls this imputed income. As you get older, the amount of imputed income generally increases.

ExxonMobil provides you with the amount of your imputed income on your pay statement and/or on your W-2 form. Social Security taxes, often referred to as FICA taxes, are required on imputed income for employees and for retirees who retired on or after January I, 1989.

If you worked for ExxonMobil during 1983, were employed by ExxonMobil on January 1, 1984, and were then age 55 or older, imputed income is no longer charged when you reach age 60 as a retiree.

Death Benefits

Instead of paying premiums to an insurance company, ExxonMobil agrees to pay your survivors from its own funds the same amount as under the insurance plan. Death benefit coverage provided under the Family Income Plan and the Family Adjustment Plan does not result in imputed income for federal tax purposes. Death benefits, however, are subject to income tax and may also be subject to estate taxes.  There are important differences between "insurance" plans and "death benefit" plans.

Taxes: a summary

Tax information and responsibilities for the Family Adjustment, Family Income and Contributory Group Life Insurance Plans

Your beneficiaries should be aware of tax responsibilities they might have regarding benefits paid to them. Determining federal income and estate tax liabilities can be complex.

FAMILY INCOME INSURANCE proceeds are potentially subject to federal estate tax.  The ability to select the death benefit alternative may be viewed by the IRS as subjecting this previously excludable benefit to estate taxation. The interest portion of your beneficiary's monthly installment will be subject to federal income tax.

FAMILY ADJUSTMENT INSURANCE proceeds typically are not subject to federal income tax when paid in a single lump sum. However, selection of an optional mode of settlement may generate an income tax liability. These proceeds are subject to federal estate tax unless you fully assign ownership of your coverage to another party at least three years before your death.  Such assignment may have gift tax implications.

FAMILY INCOME and FAMILY ADJUSTMENT DEATH BENEFITS are subject to federal estate taxes and to income taxes when received by a beneficiary.

An exception to the rules above is that if your spouse receives death benefits or insurance proceeds from your estate, or if you assign insurance coverage to your spouse, federal estate or gift tax would generally not be applicable because of the unlimited marital deduction.

CONTRIBUTORY GROUP LIFE INSURANCE proceeds typically are not subject to federal income tax when paid in a single lump sum. However, selection of an optional mode of settlement may generate an income tax liability. These proceeds are subject to federal estate tax unless you fully assign ownership of your coverage to another party at least three years before your death. Such assignment may have gift tax implications.

The tax summaries in this guide are general overviews of current federal income and estate tax law. State and local taxes have not been discussed. Tax laws are complex and subject to change. They contain many conditions and exceptions that have not been included in this guide You should consider obtaining professional tax counsel on how survivor benefits may be taxed on the choices you make.

Your rights under ERISA

Your rights under ERISA for the Family Adjustment, Family Income and Contributory Group Life Insurance Plans

As a participant in the ExxonMobil Life Insurance Program, 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 ExxonMobil Life Insurance Program, including collective bargaining agreements, and a copy of the latest annual report (Form 5500 Series) filed by the ExxonMobil Life Insurance Program 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 ExxonMobil Life Insurance Program, 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 ExxonMobil Life Insurance Program's annual financial report. The Administrator-Benefits is required by law to furnish each participant with a copy of this Summary Annual Report.

In addition to creating rights for participants, ERISA imposes duties upon the people who are responsible for the operation of the employee benefit plan. The people who operate your Life Insurance Program, called "fiduciaries" of the Life Insurance Program, have a duty to do so prudently and in the interest of you and other Life Insurance Program 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 and do not receive them within 30 days, you may file suit in a Federal court.  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.   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 elected the death benefit option, and 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 lawsuit 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 your benefits, 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.

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