Administrative and ERISA information

Administrative and ERISA information for the ExxonMobil Life Insurance Program

This section contains technical information about the ExxonMobil Life Insurance Program which includes the Life Insurance Program. 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 sponsor and participating affiliates

The Plan is sponsored by:

Exxon Mobil Corporation
5959 Las Colinas Blvd.
Irving, TX 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.

Basic Plan information

Plan administrator

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

For appeals on eligibility and uninsured death benefits:

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

For service of legal process:

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

Authority of Administrator-Benefits

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

Type of plan

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

Plan numbers

The Plan is identified with government agencies under these numbers: the Employer Identification Number, 13-5409005, and the Plan Number, 624.

Plan year

The Plan year is the calendar year.

Plan funding

Benefits are funded through employee and employer contributions.

Benefit claims

A claim must be filed in writing to the CGLIC Claims Office for Basic Life Insurance and Basic AD&D Insurance, or MetLife for Group Universal Life Insurance and Voluntary AD&D Insurance, or Benefits Administration for any uninsured death benefit. CGLIC, MetLife or Benefits Administration, as appropriate, is responsible for determining entitlement to a benefit and any amount payable under the Plan.

For Basic Life Insurance and Basic AD&D Insurance, 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 Group Universal Life Insurance and Voluntary AD&D Insurance, write to:

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

For Voluntary AD&D, 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 death benefit claim, write to:

ExxonMobil Life Insurance Plan
Benefits Administration
P.O. Box 64111
Spring, TX 77387-4111

All uninsured death benefit claims, basic life insurance and group universal life 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 Basic Life Insurance and Basic AD&D Insurance, with MetLife for Group Universal Life Insurance and Voluntary AD&D Insurance, and with the Administrator-Benefits for any uninsured death 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 death benefit only

If an appeal for an uninsured death 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 Plan 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 Plan 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.

Your rights under ERISA

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.

Prudent actions by plan fiduciaries

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.