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2017 NEW HIRE BENEFITS

GUIDE

8

If You and Your Spouse Are Both Chevron

Phillips Chemical Employees

If you and your spouse are both Chevron Phillips

Chemical employees and you’re both eligible

for the health and income/survivor protection

plans described in this guide:

You may each be covered as an employee

under the plans, or

One of you may be covered as an employee

and the other may be covered as a dependent.

Only one of you may elect coverage for your

eligible dependent children.

Dependent Verification

The Chevron Phillips Benefits Service Center

will send a request for dependent verification

to your home. It will include a checklist that

requires your signature, which must be returned

with the requested documentation. You

have 60 days from the date your dependent

verification is requested to provide the necessary

documentation. If not provided, benefits

coverage for your unverified dependents

will be terminated.

If you elect benefits coverage for your spouse,

you will need to provide one of the following:

A copy of your marriage certificate, or

A copy of the church record of marriage or

the justice of the peace marriage certificate.

For your dependent children*, the following are

the only acceptable forms of documentation:

A copy of the birth certificate (certified or a

copy of the certified birth certificate, if legal to

make a copy),

Naturalization certificate or consular report of

birth abroad,

Adoption records,

Foster child records,

Court order or papers that indicate you are

the child’s permanent legal guardian, or

Divorce decree, custody agreement, or

Qualified Medical Child Support Order,

naming you as the parent per Chevron Phillips

Chemical’s dependent child* relationship

definition.

* The definition of children includes biological children,

stepchildren, legally adopted children or children legally

placed for adoption, foster children and/or children under

permanent legal guardianship or permanent sole managing

conservatorship.