Q. What are the Plan's eligibility requirements?
A. Most U.S. dollar payroll regular employees of Exxon Mobil Corporation and participating affiliates are eligible for this Plan.
Generally, you are eligible if:
- You are a regular employee.
- You are an extended part-time employee.
- You are a trainee as described in the Key Terms section.
- You are a retiree.
- You are a survivor, which means an eligible family member of a deceased regular or extended part-time employee or retiree.
You are not eligible if:
- You participate in any other employer dental plan to which ExxonMobil contributes.
- You fail to make any required contribution toward the cost of the Plan.
- You fail to comply with general administrative requirements including but not limited to enrollment requirements.
- You lost eligibility as described under the Loss of eligibility section.
Eligible family members
You may also elect coverage for your eligible family members including:
- Your spouse. When you enroll your spouse for coverage, you may be required to provide proof that you are legally married.
- Your child(ren) under age 26. Coverage ends at the end of the month in which they reach age 26. If your situation involves a family member other than your biological or legally adopted child, call Benefits Administration.
- Your totally and continuously disabled child(ren) who is incapable of self-sustaining employment by reason of mental or physical disability, that occurred prior to otherwise losing eligibility and meets the Internal Revenue Service's definition of a dependent.
- A child or spouse of a Medicare-eligible retiree enrolled in the ExxonMobil Medicare Supplement Plan.
A person who becomes a retiree due to incapacity within the meaning of the ExxonMobil Disability Plan and who begins long-term disability benefits under that plan, but whose benefits stop because the person is no longer incapacitated is considered a suspended retiree and is not eligible for coverage until the earlier of the date the person:
- Reaches age 55, or
- Begins his or her retirement benefit under the ExxonMobil Pension Plan, at which time the person is again considered a retiree and may enroll.
The family members of a deceased suspended retiree will be eligible for coverage under this Plan only after the occurrence of the earlier of the following:
- The date the suspended retiree would have attained age 55, or
- The date a survivor begins receiving a benefit due to the suspended retiree's accrued benefit from the ExxonMobil Pension Plan.
Special eligibility rules
A person who otherwise is not a spouse but who, as a dependent of a former Mobil employee who participated in or received benefits under a Mobil-sponsored plan or program prior to March 1, 2000, is considered an eligible dependent as long as that person's eligibility for coverage as a dependent under a Mobil-sponsored plan would have continued.
Classes of coverage
You can choose coverage as an:
- Employee or retiree only;
- Employee or retiree and spouse;
- Employee or retiree and child(ren);
Employee or retiree, spouse and child(ren).
For employees on an approved leave of absence, their contribution rate will change from the employee contribution rate to the Leave of Absence contribution rate as shown in the table below.
Each class of coverage described in this section has its own contribution rate. Employees contribute to the Dental Plan through monthly deductions from their pay on a pre-tax or after-tax basis. Retirees and survivors receiving monthly benefit checks from ExxonMobil pay by deductions from these checks on an after-tax basis. Other retirees or survivors and participants with continuation coverage pay by check or by monthly draft on their bank account.
No one can be covered more than once in the Dental Plan. You and your spouse cannot both enroll as employees (or retirees) and elect coverage for each other as eligible family members. If you and your spouse work for the company or are both retirees you may both be eligible for coverage. Each of you can be covered as an individual employee (or retiree), or one of you can be covered as the employee (or retiree) and the other can be an eligible family member. Also, if you have children, each child can only be covered by one of you.
In addition a marriage between two ExxonMobil employees does not allow enrollment or cancellation in any of the ExxonMobil health plans if either employee is then making contributions on a pre-tax basis. In order to change your coverage you need to wait until you experience a change in status that allows coverage changes or Annual Enrollment.
How to enroll
As a newly hired employee, if you enroll in the Dental Plan within 30 days of your start date, coverage begins the first day of employment. If you enroll between 31 and 60 days of your date of hire, coverage will be effective the first day of the month following receipt of the forms by Benefits Administration or confirmation of change in EDA.
If you are eligible for the ExxonMobil Pre-Tax Spending Plan, you will be enrolled to pay your monthly contributions on a pre-tax basis unless you annually decline this feature. Your monthly pre-tax contributions and class of coverage must remain in effect for the entire plan year, unless you experience a change in status. (See Annual enrollment and Changing your coverage sections.)
You can enroll eligible family members only if you are enrolled in this Plan. You can enroll in the Plan using Employee Direct Access (EDA) available on the ExxonMobil Me HR Intranet site. Enrollment forms are also available from Benefits Administration for those individuals who do not have access to EDA.
You may be requested to provide documents at some future date to prove that the family members you enrolled were eligible (e.g., marriage certificate, birth certificate). If you fail to provide such requested documents within 90 days of the request, coverage for the family members will be canceled the first of the following month and you may be subject to discipline up to and including termination of employment for falsifying company records.
Under the Children's Health Insurance Program (CHIP) Reauthorization Act of 2009 you may change your Plan election for yourself and any eligible family members within 60 days of either (1) termination of Medicaid or CHIP coverage due to loss of eligibility, or (2) becoming eligible for a state premium assistance program under Medicaid or CHIP coverage. In either case, coverage is effective the first of the month following receipt of the forms by Benefits Administration.
Each year, usually during the fall, ExxonMobil offers an annual enrollment period. During this time, you can switch from your current option to another available option. This is also the time to make changes to coverage by adding or deleting family members. Family members may be added or deleted for any reason but they must be deleted if they are no longer eligible. Changes elected during annual enrollment take effect the first of the following year.
Employees are automatically enrolled in the Pre-Tax Spending Plan to pay monthly contributions on a pre-tax basis unless this feature is declined each time. This choice is only available during the annual enrollment period or with a change in status.
If you pay your monthly contributions on an after-tax basis and would like to continue making contributions on an after-tax basis for the following year, you must elect to do so during each Annual Enrollment and after each change in status. Otherwise, your contributions will be switched to a pre-tax basis beginning the first day of the following year. As a retiree, you will pay your contributions on an after-tax basis via payroll deduction (if eligible), check, or bank draft.
Changing your coverage
An employee may add a family member effective the first day of a month if required contributions are made on a pre-tax basis and adding the family member does not change the coverage level. If you are enrolled on an after-tax basis, you may add an eligible family member to your existing option effective the first of the following month following receipt of your written election by Benefits Administration.
To make a change to your coverage you may also wait until Annual Enrollment or until you experience one of the following Changes in status.
Changes in status
This section explains which events are considered changes in status and what changes you may make as a result. If you have a change in status, you must complete your change within 60 days. If you do not complete your change within 60 days, changes to your coverage may be limited. If you fail to remove an ineligible family member within 60 days of the event that causes the person to be no longer eligible, (e.g., divorce) you must continue to pay the same pre-tax contribution for coverage even though you have removed that ineligible person. The only exception is death of an eligible family member. Your pre-tax contribution for coverage will remain the same until you have another change in status or the first of the plan year following the next annual enrollment period.
Your election made due to a change in status cannot be changed after the form is received by Benefits Administration or the transaction is completed in EDA if it changes your pre-tax elections. If you make a mistake in EDA, call Benefits Administration at 1-800-262-2363 immediately or no later than the same day or first work day following the day on which the mistake was made.
The following is a quick reference guide to the Changes in status discussed in more detail after the table.
Changes during the year - medical/dental/vision (health plans)
The following is a quick reference table that describes events which may allow changes, if the changes are submitted no later than sixty (60) days after the event, as well as the actions you may take. If you have any questions, please call Health Plan Services prior to the expiration of sixty (60) days.
Changes will only be allowed if the medical/dental/vision enrollment form is received within 60 days of the event by the Benefits Administration Office or the change is made in EDA within 60 days. Unless otherwise noted, the effective date will be the first of the month after the forms are received or the transaction is completed in EDA.
Birth, adoption or placement for adoption
If you gain a family member through birth, adoption, or placement for adoption you may add the new eligible family member to your current coverage. You may also enroll yourself, your spouse, and all eligible children. Coverage is effective on the date of birth, adoption or placement for adoption. You must add the new family member within 60 days even if you already have family coverage. See the Changing your coverage section for additional circumstances in which changes can be made.
If you enroll your new family member between 31 and 60 days from the birth or adoption and your coverage level changes, you will pay the cost difference on a post-tax basis until the end of the month in which the forms are received by Benefits Administration. Beginning the first day of the following month your deduction will be on a pre-tax basis.
Sole legal guardianship or sole managing conservatorship
If you (or your spouse, separately or together) become the sole court appointed legal guardian or sole managing conservator of a child and the child meets all other requirements of the definition of an eligible family member, you have 60 days from the date the judgment is signed to enroll the child for coverage. You must provide a copy of the court document signed by a judge appointing you (or your spouse separately or together) guardian or sole managing conservator.
If you are enrolled in the Dental Plan, you can enroll your new spouse and his or her eligible family members (your stepchildren) for coverage. If you are not already enrolled for coverage, you can sign up for dental coverage for yourself, your new spouse, and your stepchildren. If you gain coverage under your spouse's dental plan, you can cancel your coverage. You must make these changes within 60 days following the date of your marriage or wait until Annual enrollment or another change in status.
Death of a spouse
If you lose coverage under your spouse's dental plan, you can sign up for Dental Plan coverage for yourself and your eligible family members. You must make these changes within 60 days following the date you lose coverage or wait until Annual Enrollment or another change in status. If you and your family members are enrolled in the ExxonMobil Dental Plan, any stepchildren will cease to be eligible upon your spouse's death unless you are their court appointed guardian or sole managing conservator.
When a child is no longer eligible
If an enrolled family member is no longer an eligible family member, coverage continues through the end of the month in which they cease to be eligible. In some cases, continuation coverage under COBRA may be available. (See Continuation coverage for more details about COBRA.) You must notify and provide the appropriate forms to Benefits Administration as soon as a family member is no longer eligible. If you fail to notify and provide the appropriate forms to Benefits Administration within 60 days, the family member will not be entitled to elect COBRA. While we have an administrative process to remove dependents reaching the maximum eligibility age, you remain responsible for ensuring that the dependent is removed from coverage. If you fail to ensure that a family member is removed in a timely manner, there may be consequences for falsifying company records.
In the case of divorce, your former spouse and any stepchildren are eligible for coverage only through the end of the month in which the divorce is final. You must notify and provide any requested documents to Benefits Administration as soon as your divorce is final. If you fail to notify and provide the appropriate forms to Benefits Administration within 60 days, the former spouse and family member will not be entitled to elect COBRA. There may also be consequences for falsifying company records. Please see the Continuation coverage section of this SPD.
You may not make a change to your coverage if you and your spouse become legally separated because there is no impact on eligibility.
If you lose coverage under your spouse's dental plan because of divorce, you can sign up for dental coverage for yourself and your eligible family members. You must enroll within 60 days following the date you lose coverage under your spouse's plan or wait until Annual Enrollment or another change in status.
Leave of absence
If you are on an approved leave of absence, you can continue coverage by making required contributions directly to the Dental Plan by check. If you chose not to continue your coverage while on leave, your coverage ends on the last day of the month in which your leave began and you will be required to pay for the entire month's contributions. If you fail to make required contributions while on leave, coverage will end.
If the company should make any payment on your behalf to continue your coverage while you are on leave and you decide not to return to work, you will be required to reimburse the company for required contributions.
If you are on an approved leave of absence and the Leave of Absence contribution rate begins, you may continue your coverage by making your required contribution. See Classes of coverage in the Eligibility and Enrollment section for rate information.
If you were on a leave that meets the requirements of the Family and Medical Leave Act of 1993 (FMLA) or the Uniformed Services Employment and Reemployment Rights Act (USERRA) and your coverage ended, re-enrollment is subject to FMLA or USERRA requirements.
For more information, call Benefits Administration.
Change in coverage costs or significant curtailment
If the cost for coverage charged to you significantly increases or decreases during a plan year, you may be able to make a corresponding prospective change in your election, including the cancellation of your election. This provision also applies to a significant increase in the dental deductible or co-payment.
If the cost of coverage under your spouse's dental plan significantly increases or there is a significant curtailment of coverage that permits revocation of coverage during a plan year and you drop that coverage, you will be able to sign up for dental coverage for yourself and any eligible family members. You must enroll within 60 days following the date you lose coverage under your spouse's plan or wait until Annual Enrollment or another change in status. Coverage due to a change in status will be effective as of the first of the month following your completion of the enrollment, or in the case of Annual Enrollment, the first of the following year.
Addition or improvement of options
If a new plan option is added or if benefits under an existing option are significantly improved during a plan year, you may be able to cancel your current election in order to make an election for coverage under the new or improved option.
Loss of option
If the plan is discontinued, you will be able to elect either to receive coverage under another plan option providing similar coverage or to drop dental coverage altogether if no similar option is available.
IMPORTANT REMINDER: If you pay your contributions on a pre-tax basis and you experience any of the events mentioned previously, or if you are newly eligible as a result of a change or loss of coverage under your spouse's dental plan, it is your responsibility to complete your change within 60 days of experiencing the event. If you miss the 60-day period, you will not be able to make changes until Annual Enrollment or until you experience another Changes in Status.
Other changes that may affect your coverage
If you are a retiree not yet eligible for medicare
If you are a retiree not eligible for Medicare, you and your family members who are not eligible for Medicare can continue to participate in the Plan. When you (as a retiree) or a covered family member become eligible for Medicare, Medicare will become the primary plan and benefits will be coordinated.
If you are an extended part-time employee
If you terminate employment as an extended part-time employee, you are not eligible to continue to participate in the Plan. You may be eligible to elect continuation coverage for yourself and your eligible family members under COBRA provisions. See Continuation coverage for details.
If you work beyond when you become eligible for medicare
If you continue to work for ExxonMobil, although you are eligible for Medicare, your ExxonMobil coverage remains in effect for you and eligible family members and the Plan is your primary plan.
If you or your covered family members become medicare eligible for any reason
When a retiree or a covered eligible family member become eligible for Medicare, benefits will be coordinated with Medicare.
If you die
If you die while enrolled, your covered eligible family members can continue coverage. Their eligibility continues with the company contributions for a specified amount of time:
- If you have 15 or more years of benefit service at the time of your death, eligibility continues until your spouse remarries or dies.
- If you have less than 15 years of benefit service, eligibility continues for twice your length of Benefit Service or until the spouse remarries or dies, whichever occurs first.
Children of deceased employees or retirees may continue participation as long as they are an eligible family member. If your surviving spouse remarries, eligibility for your children also ends. Special rules may apply to family members of individuals who become retirees due to disability. (See Continuation coverage for suspended retirees).
Eligible family members of deceased extended part-time employees are not eligible to continue to participate in the Plan. These family members may be eligible to elect continuation coverage under COBRA provisions. (See Continuation coverage for details).
If you become a suspended retiree
If you are a retiree and you would otherwise lose coverage because you have become a suspended retiree under the ExxonMobil Disability Plan, you may continue coverage for yourself and your family members who were eligible for plan participation before you became a suspended retiree for either 12 or 18 months.
Coverage continues for 12 months from the date coverage would otherwise end if you received transition benefits under the ExxonMobil Disability Plan. However, if you did not receive transition benefits under the ExxonMobil Disability Plan, coverage continues for 18 months from the date coverage would otherwise end. The cost of this continued coverage is 102% of the combined participant and company contributions.
When coverage ends
Coverage for you and/or your family members ends on the earliest of the following dates:
- The last day of the month in which:
- You terminate employment (except as a retiree or due to disability);
- You elect not to participate;
- A family member ceases to be eligible (for example, a child reaches age 26); or
- A retiree becomes a suspended retiree (see Suspend retiree under Eligible Family Members).
- You are no longer eligible for benefits under this Plan (e.g., employment classification changes from "regular employee" to "non-regular employee" or from non-represented to represented where you are no longer eligible for this Plan);
- You do not make your required contribution;
- A Qualified Medical Child Support Order is no longer in effect for a covered family member;
- The date:
- You die;
- The Plan ends;
- Your employer discontinues participation in the Plan;
- You enrolled an ineligible family member and in the opinion of the Administrator-Benefits, the enrollment was a result of fraud or a misrepresentation of a material fact.
You are responsible for ending coverage with Benefits Administration when your enrolled spouse or family member is no longer eligible for coverage. If you do not complete your change within 60 days, any contributions you make for ineligible family members will not be refunded.
Loss of eligibility
Everyone in your family may lose eligibility for plan coverage, and you may be subject to disciplinary action up to and including termination of employment if you commit fraud against the Plan, for instance, by filing claims for benefits to which you are not entitled. Coverage may also be terminated if you refuse to repay amounts erroneously paid by the Plan on your behalf or which you recover from a third party. Your participation may be terminated if you fail to comply with the terms of the Plan and its administrative requirements. You may also lose eligibility if you enroll persons who are not eligible, for instance, by covering children who do not meet the eligibility requirements or do not cancel coverage for family members at the time they are no longer eligible, e.g. divorced spouse.
Extended benefits at termination
You are entitled to extended coverage for as much as a year if you are terminated due to disability with fewer than 15 years of service. This coverage is provided at no cost to you. This is considered a portion of the COBRA continuation period. In order to assure coverage beyond this extension period, you must elect COBRA upon termination of employment.
Several conditions must be met:
- The disability must exist when your employment terminates.
- The extension lasts only as long as the disability continues, but no longer than 12 months.
This extension applies only to the employee who is terminated because of a disability. Continuation coverage for eligible family members may be available through COBRA.