When coverage ends

When coverage ends for the ExxonMobil medical fully-insured HMO Plan

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, retire, or die;
  • You elect not to participate;
  • A family member ceases to be eligible (for example, a child reaches age 26);
  • You are no longer eligible for benefits under this Plan (e.g., employment classification changes from non-represented to represented where you are no longer eligible for this Plan);
  • You terminate employment after being rehired by ExxonMobil as an employee following retirement
  • A Qualified Medical Child Support Order is no longer in effect for a covered family member;

OR

The date:

  • The Medical Plan ends;
  • You do not make any required contribution;
  • 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 Medical Plan coverage, and you may be subject to disciplinary action up to and including termination of employment if you commit fraud against the Medical 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 Medical Plan on your behalf or that you recover from a third party. Your participation may be terminated if you fail to comply with the terms of the Medical 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. This includes failing to provide timely notification of when a covered family member loses eligibility, e.g., spouse loses coverage due to divorce.

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.

Information regarding Continuation of Coverage may be included in information you receive from your HMO or you may contact Member Services directly (See Appendix A)