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Chevron is legally required to provide certain notices to plan participants. These notices are also posted here for your reference. Questions should be directed to the Human Resources Service Center.

state-specific notices

Illinois Essential Health Benefit (EHB) Listing (Public Act 102-0630)

New Jersey Earned Sick Leave – Notice of Employee Rights
New Jersey State and Federal Labor Laws Poster English | Spanish

The New York City Department of Consumer and Worker Protection provides a comprehensive resource guide for workers within New York to understand their employment rights.

Pennsylvania Residency Certification Form
Pennsylvania State and Federal Labor Laws Poster English | Spanish
Texas Worker’s Compensation Notice
Texas State and Federal Labor Laws Poster English | Spanish 

employment notices

benefit notices

This legally-required notice describes how medical information about you may be used and disclosed and how you can get access to this information.

The Americans with Disabilities Act (ADA) requires employers, like Chevron, who offer wellness programs that collect employee health information to provide a notice to employees informing them what information will be collected, how it will be used, who will receive it, and what will be done to keep it confidential.

Notice regarding Chevron’s Wellness Programs
Notice regarding Chevron’s Wellness Programs (Expatriates in the U.S.)
Notice regarding Chevron’s Wellness Programs (COBRA)

The Patient Protection and Affordable Care Act, which is the law that’s known simply as “Health Care Reform,” generally requires all U.S. citizens and resident aliens to have medical coverage beginning January 1, 2014, or pay a penalty. To make affordable coverage available to everyone, the government created the public Health Insurance Marketplace. The Marketplace offers one-stop shopping to find and compare private health insurance options.

The Marketplace is designed to serve those who cannot get medical coverage through their employer or a public program. Chevron currently plans to continue to offer comprehensive, quality medical plans as part of your overall benefits package. In addition, Chevron’s health benefits meet the minimum essential coverage standard set by the Affordable Care Act. This means you can certainly shop around in the Marketplace, but keep the following in mind:

  • If you are eligible for Chevron’s health benefits, you aren’t required to go to the Marketplace to shop for health coverage. You can still buy private medical insurance through the Marketplace, but if you do, you won’t qualify for a discount (subsidy) on your monthly premium. This means you’ll have to pay for that coverage on an after-tax basis, and Chevron will not contribute to the cost of the coverage you purchase. Call the HR Service Center if you have questions about your eligibility for Chevron health coverage.
  • If you aren’t eligible for Chevron’s health benefits, you may qualify to save money and lower your monthly premium by shopping for coverage on the Marketplace. The possible savings on your premium depends on if you have other employer coverage available, your household income and your family size. If you decide to apply for medical coverage through the Marketplace, you must submit an application during the government’s Open Enrollment period. Applications are available on www.healthcare.gov. Use the information on the notice below to fill out the Employer section on the application. Call the HR Service Center if you have questions about your eligibility for Chevron health coverage.

Note that there is a separate open enrollment period for the Marketplace. The Marketplace enrollment period has no connection to Chevron’s open enrollment. 

Notice of Health Insurance Marketplace

The Patient Protection and Affordable Care Act (ACA) requires that almost everyone in the U.S. have health coverage that qualifies as minimum essential coverage. U.S. taxpayers must be able to provide proof of such coverage for themselves and their dependents. Form 1095 is required to report information about offers of health coverage and enrollment in health coverage for federal tax purposes. Depending on the source of your health care coverage, you may receive a Form 1095-B, a Form 1095-C, or even both. Learn more about Form 1095.
Family and Medical Leave Act – Your Rights and Responsibilities
Women’s Health and Cancer Rights

This document provides information about the Surprise Billing provision of the No Surprises Act, a consumer protection law that helps curb the practice known as surprise billing for medical care. This information is provided for your awareness only; your action is not required. This legislation applies to all covered participants in all Chevron-sponsored medical, prescription drug, mental health and substance use disorder plans. If you have questions about this information, contact your health plan directly for assistance.

This document provides information about the Continuity of Care provision of the No Surprises Act, a consumer protection law that applies when a provider ceases to be a network provider during an ongoing course of treatment. This information is provided for your awareness only; your action is not required. This legislation applies to all covered participants in all Chevron sponsored medical, prescription drug, mental health and substance use disorder plans. If you have questions about this information, contact your health plan directly for assistance.

If you or your children are eligible for Medicaid or CHIP and you’re eligible for health coverage from your employer, your state may have a premium assistance program that can help pay for coverage, using funds from their Medicaid or CHIP programs.

States that may offer premium assistance
The Mental Health and Substance Use Disorder Plan (MHSUD) is a grandfathered health plan under the Patient Protection and Affordable Care Act. Chevron Corporation believes the Chevron Corporation Mental Health and Substance Use Disorder Plan (the MHSUD Plan) is a grandfathered health plan under the Patient Protection and Affordable Care Act (the Affordable Care Act). As permitted by the Affordable Care Act, a grandfathered health plan can preserve certain basic health coverage that was already in effect when that law was enacted. Being a grandfathered health plan means that your plan may not include certain consumer protections of the Affordable Care Act that apply to other plans, for example, the requirement for the provision of preventive health services without any cost sharing. However, grandfathered health plans must comply with certain other consumer protections in the Affordable Care Act, for example, the elimination of lifetime limits on benefits. Questions regarding which protections apply and which protections do not apply to a grandfathered health plan and what might cause a plan to change from grandfathered health plan status can be directed to the plan administrator at 1-888-825-5247. You may also contact the Employee Benefits Security Administration, U.S. Department of Labor at 1-866-444-3272 or www.dol.gov/ebsa/healthreform. This website has a table summarizing which protections do and do not apply to grandfathered health plans.
Mercer Privacy Statement Regarding Your Personal Information
Aflac Group Certification Statements

The Employee Retirement Income Security Act of 1974 (ERISA) requires companies to file an annual report for each benefit plan with the Employee Benefits Security Administration. ERISA also requires that participants be given an annual summary of these financial reports within 60 days after the annual report is filed. This summary is called the Summary Annual Report (SAR). The publications listed below contain the SARs for the benefit plans shown. You can also get a copy of the full report without charge from the internet at: http://www.efast.dol.gov. Click Form 5500/5500-SF Search in the upper left corner. Questions should be directed to the HR Service Center. 

Chevron Corporation, which covers the following plans:

  • Chevron Employee Savings Investment Plan 
  • Supplemental Life Insurance Plan 
  • On-the-Job Accident Insurance Plan 
  • Basic Life Insurance Plan 
  • Chevron Omnibus Health Care Plan
  • Dependent Life Insurance Plan 
  • Long-Term Disability Plan 
  • Chevron Long-Term Disability Restoration Plan 
  • Chevron Business Travel Accident Insurance Plan 
  • Chevron Voluntary Group Accident Insurance Plan 
  • Chevron Long-Term Care Plan 
  • Term Life Insurance Plan of Texaco Inc. 
  • Retired Participants in the Gulf Group Life Insurance Plan 
  • Unocal Life Insurance Plan

Chevron Stations Inc. Thrift Plan

Chevron is required to mail an Annual Funding Notice to retirement plan participants once every year. The Annual Funding Notice provides information about your Plan's funded status, the value of its assets and liabilities, a description of how the assets are invested, and an explanation of the benefits that are guaranteed by the Pension Benefit Guaranty Corporation (PBGC), a federal agency. Questions should be directed to the HR Service Center.

Chevron Retirement Plan
Chevron - MEBA Marine Pension Plan
Chevron - SUP Marine Pension Plan
Chevron Mining - UMWA Employees Pension Plan
Pasadena Refining System, Inc. Retirement Plan
Star Enterprise Retirement Plan

price transparency: machine readable files

The Consolidated Appropriations Act of 2021 (CAA) and the Transparency in Coverage Rule (TIC Rule) both contain numerous health care provisions establishing new standards for price transparency and patient protections against certain surprise medical bills. Group health plans are required to post publicly available machine-readable files (MRFs), updated monthly, that include certain information, including network negotiated payment rates, historical out-of-network reimbursement rates, and more. A machine-readable file is a digital representation of data or information in a file that can be imported or read by a computer system for further processing without human intervention. These files are not meant for a participant-friendly search of rates, benefits, or cost sharing; you should continue to login to your Anthem account for that information.

MRFs for the Medical PPO, HDHP and HDHP Basic can be accessed according to the instructions below. For Medical HMO Plans, contact the claims administrator directly for information about accessing the plans' MRFs.

The Consolidated Appropriations Act of 2021 (CAA) and the Transparency in Coverage Rule (TIC Rule) both contain numerous health care provisions establishing new standards for price transparency and patient protections against certain surprise medical bills. Group health plans are required to post publicly available machine-readable files (MRFs), updated monthly, that include certain information, including network negotiated payment rates, historical out-of-network reimbursement rates, and more. A machine-readable file is a digital representation of data or information in a file that can be imported or read by a computer system for further processing without human intervention. These files are not meant for a participant-friendly search of rates, benefits, or cost sharing; you should continue to contact Beacon Health Options for that information.

MRFs for the Mental Health and Substance Use Disorder (MHSUD) Plan can be accessed below.

state and federal labor law posters

The state and federal labor law poster for each state is listed below for your reference at any time. You can also view the printed version of your state’s poster on display at your work site. Reference this document to locate the state-specific contact and other information that applies to your state’s poster.

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