Executive Life Insurance VICTORVILLE, CALIFORNIA

Transcription

1 Executive Life Insurance VICTORVILLE, CALIFORNIA Herman J. Mankiewicz and John Houseman wrote the script for Citizen Kane in Victorville, while residing at the Green Spot motel along Route 66 in 1940.

2 ROUTE 66 AT 34 32'10"N '18"W VICTORVILLE, CALIFORNIA Victorville is located on the southern edge of the Mojave Desert and was once a rest stop for desert travelers. One of the fastest-growing cities in the United States, Victorville is home to the California Route 66 Museum. This Executive Life Insurance booklet when combined with the separate policy you ll receive from MetLife (the insurer) serves as your summary plan description (SPD) for the executive life insurance benefits available under the Phillips 66 Group Life Insurance Plan. It s an overview of certain terms and conditions, rather than a description of every detail of the plan. It s written in clear, everyday language that s designed to help you understand how the plan works. Every effort has been made to ensure the accuracy of the information provided in this SPD. However, if there s any discrepancy or conflict between this SPD and the terms of the official plan document, the official plan document will control. Phillips 66 reserves the right to amend, change or terminate the plan at any time without notice, at its sole discretion. Nothing in this SPD creates an employment contract between the company or its subsidiaries or affiliates and any employee.

3 EXECUTIVE LIFE INSURANCE Executive Life Insurance... 3 The big picture... 4 Eligibility and enrollment... 5 Am I eligible?... 5 Who pays for coverage?... 6 Do I need to enroll?... 6 How do I enroll, and when does coverage begin?... 7 When is EOI required?... 8 What if I take a leave of absence?... 8 Naming a beneficiary... 9 What if I don t name a beneficiary?... 9 How to file a claim What will the Claims Administrator need? How are benefits paid? If you ve assigned your benefits When does coverage end? Is my coverage portable? What about retiree life insurance? Other information Administrative information Plan name Plan identification information Plan Administration Agent for service of legal process Payments to a minor or legally incompetent person If the plan changes or ends Claims and appeals procedures Information and consents required from you If a claim is denied How to file an appeal If an appeal is denied The Appeals Administrator s decision is final Fraudulent claims ERISA plan information Glossary Contacts...20 A couple of technical things The official name of the plan that includes the executive life insurance benefits described here is the Phillips 66 Group Universal Life Insurance Plan. But in this booklet, we ll just call it the Executive Life Insurance Plan or the plan. When we say Phillips 66, the company, we or our, we mean Phillips 66 Company and any other subsidiary or affiliated company that has adopted the plan and is a participating employer. Your ERISA rights Prudent actions by plan fiduciaries Enforce your rights EXECUTIVE LIFE INSURANCE PHILLIPS 66 BENEFITS FOR THE UNEXPECTED 1

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5 EXECUTIVE LIFE INSURANCE Executive Life Insurance The Phillips 66 Executive Life Insurance Plan is designed especially for our employees grades There are many ways to put this valuable benefit to work: Eleanor Eleanor wants to make sure her family is financially secure well into the future. Jonathan Jonathan s coverage is part of his overall estate plan. Brian Brian and his wife are major donors for their alma maters. You pay for this coverage with after-tax dollars. Benefits are provided through a group plan under which individual insurance certificates are issued from MetLife, the Claims Administrator. EXECUTIVE LIFE INSURANCE PHILLIPS 66 BENEFITS FOR THE UNEXPECTED 3

6 EXECUTIVE LIFE INSURANCE The big picture Here s a quick glance at the plan. Plan feature There are two types of coverage from which to choose: Group variable universal life (GVUL); or Group universal life (GUL). Investment feature This feature: May generate tax-deferred income. Gives you access to any cash balance that s built up in your policy. Accelerated benefit option Contact the Claims Administrator for more information or to apply for an accelerated benefit. Account statements What you need to know You can purchase coverage of one to eight times your annual pay, rounded to the next higher $100. The minimum coverage amount is $100,000. The maximum coverage amount is $12 million. You can choose to make additional contributions to the plan. These contributions (called premiums ) are invested as follows: If you have GVUL coverage You choose from 19 variable account options. If you have GUL coverage Premiums are invested in one general, interest-bearing account. Additional premium investment amounts are subject to IRS guidelines. The plan will pay an immediate lump-sum payment if you re terminally ill with a life expectancy of 12 months or less. You can use that money for any purpose. See your individual policy or contact the Claims Administrator to see how the accelerated benefit amount is calculated. You ll receive quarterly (if the cash value is over $25) and annual account statements showing the amount of insurance you have, the value of your investment account and how your investments are performing. This booklet includes only a brief description of the plan s benefits. After your coverage is effective, MetLife will send you a policy certificate explaining your coverage and your rights under the policy. You have 20 days to review your certificate and decline coverage if you choose. MetLife will also provide you with a prospectus, which will contain further information about the plan. Be sure to review that information before purchasing this insurance. Don t miss! The Glossary on page 19 for details about some of the terms used in this booklet. The Contacts section on page 20 for phone numbers, web, mailing addresses and hours of operation for the Benefits Center and the Claims Administrator. 4 PHILLIPS 66 BENEFITS FOR THE UNEXPECTED EXECUTIVE LIFE INSURANCE

7 Eligibility and enrollment AM I ELIGIBLE? You are if you re: A non-store, regular full-time or part-time Phillips 66 employee, scheduled to work an average of at least 20 hours a week; A non-store U.S. citizen or resident alien employee working within or outside the U.S. (or on a personal, disability, military or family medical leave of absence) who is paid on the direct U.S. dollar payroll; Classified in grade 19 through 35; Age 20 and above; and Not enrolled in the supplemental option of the Phillips 66 Group Life Insurance Plan (the Employee Life Insurance Plan). (This plan is described in the separate Employee Life booklet.) If you re eligible, your enrollment materials will show your plan options. If you re enrolled in the plan and your salary grade falls below 19, you won t lose your eligibility. However, if you re not enrolled in the plan at the time of the salary grade reduction below 19, you re no longer eligible to enroll in the plan. You re NOT eligible if Your employee classification isn t described above. For example, temporary employees, independent contractors and commission agents aren t eligible. You re a member of a recognized or certified collective bargaining unit. EXECUTIVE LIFE INSURANCE PHILLIPS 66 BENEFITS FOR THE UNEXPECTED 5

8 EXECUTIVE LIFE INSURANCE WHO PAYS FOR COVERAGE? You pay the entire cost of your coverage as well as any extra premium you ve elected for your investment account with after-tax payroll deductions. To see the costs, go to gvuleservice.metlife.com. Your cost is based on your age (5-year bands) and coverage amount at the time of your enrollment. After your initial enrollment, your cost going forward is based on your age on December 1 and your annual pay as of April 1. If a birthday moved you to a higher-cost age-band rate, the new rate is effective the December 1 coincident with or following your birthday. If your salary increases or decreases during the year, your coverage amount and your cost will change on the April 1 following or coincident with your salary increase/decrease. DO I NEED TO ENROLL? Yes. You must enroll if you want to participate in the plan. When you enroll, you ll: Choose from the plan options available to you; and Authorize any required payroll deductions for the coverage you elect. Your enrollment materials will contain information to help you make your enrollment elections. Contact the Claims Administrator if you need more information. 6 PHILLIPS 66 BENEFITS FOR THE UNEXPECTED EXECUTIVE LIFE INSURANCE

9 HOW DO I ENROLL, AND WHEN DOES COVERAGE BEGIN? You can enroll, cancel or change your coverage elections at any time online or by phone. To do so, go to gvuleservice.metlife.com. Please note that new coverage elections are subject to any Internal Revenue Code limitations. In addition, three big things affect your enrollment or when you can make changes to your coverage: Is evidence of insurability (EOI) required? See page 8 Are you enrolled in supplemental coverage under the Employee Life Insurance Plan? Do you work or live outside the U.S.? If no, coverage begins on the first day of the month coincident with or following your enrollment.* If yes, coverage begins on the first day of the month after the Claims Administrator approves your enrollment.* EOI requires answering questions about your health, and, in some situations, a blood test. The Claims Administrator uses both the EOI questionnaire and blood test results to decide if you qualify for coverage. If yes, you ll need to cancel that coverage before you can enroll in this plan. To do this, go to HR Express and select the Health and Welfare tab > Your Benefits Resources (YBR). No additional password is needed. (You can access YBR from the Internet as well: Go to com/phillips66 and enter your YBR user ID and password.) Or, you can call the Benefits Center at (800) You can exchange your supplemental coverage for coverage under this plan without having to submit EOI if you do so within 60 days of eligibility. You ll at least have coverage up to the guaranteed issue amount even while waiting on approval of any additional coverage applied for in excess of guaranteed issue amounts. If no, you can enroll in the plan, subject to approval of any required EOI. If you work or live outside the U.S., you re eligible for GUL coverage only. If you return to the U.S. for any reason (personal or business) other than to enroll in this plan, you may exchange your GUL certificate for a GVUL certificate. This would give you more investment options. Notes: For all of the above, coverage begins only if you re actively at work on that day. Otherwise, coverage will begin on the first date you are actively at work. Actively at work is defined in the Glossary. You can t be in the hospital on the day you apply for coverage. * If coverage is approved ON the first day of the month, coverage will begin on that day. For example, if coverage is approved on March 1, coverage begins on March 1. If coverage is approved on March 5, coverage begins on April 1. EXECUTIVE LIFE INSURANCE PHILLIPS 66 BENEFITS FOR THE UNEXPECTED 7

10 EXECUTIVE LIFE INSURANCE When is EOI required? You must provide EOI if: You re a new hire and you choose five or more times your annual pay in coverage. You want to increase your coverage amount. Your salary increases more than 20% in a calendar year (unless as a result of a promotion). You terminate your coverage and then re-enroll at a later date. You weren t enrolled in supplemental coverage under the Employee Life Insurance Plan at the time you became eligible for this plan. You were enrolled in supplemental coverage under the Employee Life Insurance Plan, and: You didn t cancel that coverage and enroll in this plan within 60 days of becoming eligible for this plan; or You canceled your supplemental coverage to enroll in this plan, but you re applying for more than $500,000 above the amount of your supplemental coverage.* For example, you had $200,000 in supplemental coverage, but you re applying for $701,000 in Executive Life Insurance coverage. You re newly eligible for Executive Life Insurance coverage and elect the greater of your supplemental coverage under the Employee Life Insurance Plan or more than four times your annual salary. WHAT IF I TAKE A LEAVE OF ABSENCE? Your plan benefits continue during an approved leave of absence. Your cost doesn t change, but you may pay it differently: If you re on a paid leave, your cost will be deducted from your paycheck on an after-tax basis. If you re not on a paid leave, the company will send you a bill, and you ll pay the cost on an after-tax basis. When you return to work, payroll deductions will resume on an after-tax basis. If your coverage ends while you re on your leave you ll need to re-enroll and submit EOI when you return to work if you want coverage. * This provision applies for up to a year after your supplemental coverage was cancelled. 8 PHILLIPS 66 BENEFITS FOR THE UNEXPECTED EXECUTIVE LIFE INSURANCE

11 Naming a beneficiary You can name or change your beneficiary designation at any time either online at gvuleservice.metlife.com, or by calling MetLife. Your beneficiary receives your plan benefits if you die. You choose (or designate ) your beneficiary. Here s what you need to know: You may name as many beneficiaries as you wish including individual persons, your estate, a trust, or a church or charitable organization. If you name more than one beneficiary and you don t indicate the benefit percentage you want paid to each, benefits will be divided equally among them. You can name one or more contingent beneficiaries. Contingent beneficiaries receive your plan benefits if all of your primary beneficiaries die before you die. When naming your beneficiary(ies), provide as much information as possible, such as each beneficiary(ies) full name, current address, date of birth and other information that may be requested. By law, benefits can t be paid directly to a beneficiary who is under age 18 (a minor) or legally incompetent at the time of your death. Instead, the benefit must be paid to the guardian, conservator or any other person legally responsible for the management of the estate that belongs to the minor or legally incompetent beneficiary. Contact the Claims Administrator for additional details. A divorce does not affect your designation! If you no longer want your ex-spouse as your beneficiary, you need to complete a new beneficiary designation form naming a new beneficiary. Keep your beneficiary designations up-to-date. If a beneficiary moves or dies, be sure to update your beneficiary information. Beneficiary designations take effect on the day the Claims Administrator receives them. WHAT IF I DON T NAME A BENEFICIARY? If you don t name a beneficiary or if all of your named beneficiaries die before you or within 24 hours of your death your benefits will be paid to your estate or to the owner of the policy if you have assigned or transferred ownership. Any payments made by the plan will relieve the Claims Administrator of any liability for plan benefits. EXECUTIVE LIFE INSURANCE PHILLIPS 66 BENEFITS FOR THE UNEXPECTED 9

12 EXECUTIVE LIFE INSURANCE How to file a claim The first step is for your beneficiary to call the Claims Administrator. (See page 20 for the Claims Administrator contact information.) The Claims Administrator will help your beneficiary through the process and will ask for: Your name and Social Security number; The date of your death; and Information regarding your spouse or next of kin: Name; Address; Phone number; and Relationship to you. If a claim is denied, your beneficiary has specific rights and responsibilities for appealing the denial. See Claims and appeals procedures on page 14. WHAT WILL THE CLAIMS ADMINISTRATOR NEED? The Claims Administrator will need a certified copy of the death certificate. In addition, the Claims Administrator may: Ask for additional documents (for example, a copy of trust or estate documents). Require an autopsy (provided it s not against local law) in the event of an appeal. The plan pays for the requested autopsy. HOW ARE BENEFITS PAID? The plan will pay benefits to your designated beneficiary. The benefit may be paid in one of two ways: Increasing Death Benefit This is in effect while you re working. Your beneficiary will receive the amount of life insurance you selected, plus the cash value of your investment account, tax-free. Level Death Benefit After your employment ends, you can change to a Level Death Benefit. Your beneficiary will receive the amount of life insurance you selected. See your insurance policy or contact the Claims Administrator for more information. Restrictions As described on page 12, benefits are paid differently if a beneficiary is under age 18 or is legally incompetent. For example, the benefit may be paid to a guardian or into a trust. The Claims Administrator will provide details. Benefits will not be paid while a beneficiary is under suspicion of murdering the covered person. No payment will be made to a beneficiary convicted of murdering the covered person. The payment that would have gone to the convicted beneficiary will be paid to the other beneficiaries designated by you or if no other designated beneficiaries, then to your estate. Death benefits will not be paid for suicide unless the coverage has been in effect for at least two years. If the person you assigned the policy to (assignee) is convicted of causing your death, neither the assignee nor the beneficiary of the assignee will be paid any death benefits. 10 PHILLIPS 66 BENEFITS FOR THE UNEXPECTED EXECUTIVE LIFE INSURANCE

13 If you ve assigned your benefits You may make an absolute assignment of your policy without consideration by using a form provided by the Claims Administrator or available on gvuleservice.metlife.com. If you have assigned or transferred ownership, plan benefits will be paid to the owner of the policy, except as provided by the plan. When does coverage end? Plan coverage ends on the earliest of the following events: The last day of the month in which you stop paying the required costs and there is no cash value remaining to pay insurance costs. You then have a 62-day grace period to pay those costs before coverage is cancelled. The last day of the month of the coverage maturity date (policy anniversary after you reach age 95). The last day of the month in which your coverage is terminated for any reason. The date of your death. IS MY COVERAGE PORTABLE? Yes! When you leave the company you may: Continue coverage and accumulate cash by paying the costs directly to the Claims Administrator. Use all or part of the investment account cash balance to continue your life insurance coverage. Once that balance is used up, you ll need to pay the costs directly to the Claims Administrator. Cancel the policy and receive your cash balance. If you do this, you may not reapply for an individual policy at a later date. Cancellation fees don t apply. WHAT ABOUT RETIREE LIFE INSURANCE? The company will send you an enrollment packet if you re eligible for retiree life insurance. If you want that coverage, you ll need to enroll within 30 days. The enrollment packet will contain details. (Retiree life insurance is described in a separate booklet.) EXECUTIVE LIFE INSURANCE PHILLIPS 66 BENEFITS FOR THE UNEXPECTED 11

14 EXECUTIVE LIFE INSURANCE Other information This section contains important administrative and legal information about the plan. ADMINISTRATIVE INFORMATION Plan name Phillips 66 Group Universal Life Insurance Plan Plan identification information The primary employer (also the plan sponsor) and identification number are: Phillips 66 Company 411 S. Keeler Avenue Bartlesville, OK Employer ID#: Plan Administration The Plan Administrator is: Manager HR Shared Services (HRSS) (or successor) Phillips 66 Company Adams Building 411 S. Keeler Avenue Bartlesville, OK (918) The Plan Administrator is the named fiduciary. As a fiduciary, the Plan Administrator: Has discretionary authority under the plan. Determines all claims and appeals for eligibility to participate in the plan. Has the power to delegate responsibilities and authority (including discretionary authority) under the plan. Agent for service of legal process For disputes arising from the plan, legal process may be served on: General Counsel (or successor) Phillips 66 Company 3010 Briarpark Dr. Houston, TX Service of legal process may also be made upon the Plan Administrator. For disputes arising under or connected with your insurance contract issued by the insurance company, service of legal process may be made upon the Claims Administrator. PAYMENTS TO A MINOR OR LEGALLY INCOMPETENT PERSON The Claims Administrator may authorize payments to a conservator, guardian or other individual who is legally responsible for the management of the estate of a minor or legally incompetent person. If the beneficiary is a minor, the Claims Administrator will pay benefits as directed by the right legal entity working on behalf of the minor. IF THE PLAN CHANGES OR ENDS Phillips 66, acting through action of its Board of Directors or a delegate of the Board of Directors, may amend, modify, suspend or terminate the plan, in part or in whole, at any time and from time to time. Plan changes or terminations apply only to benefits that become payable after the date of the change. For example, if plan benefits were changed on January 1, 2014, that change wouldn t affect a claim that was made on December 31, You ll be entitled to retain your individual insurance contract, and your relationship will be directly with the insurer. 12 PHILLIPS 66 BENEFITS FOR THE UNEXPECTED EXECUTIVE LIFE INSURANCE

15 Your ERISA rights As a participant in the plan, you re entitled to certain rights and protections under the Employee Retirement Income Security Act of 1974 (ERISA), as amended. ERISA provides that all plan participants are entitled to: Receive information about their plan and benefits, as follows: Examine, without charge, at the Plan Administrator s office and at other locations (field offices, plants and selected work sites), all documents governing the plan including insurance contracts and collective bargaining agreements, and a copy of the latest annual report (Form 5500 Series) filed by the plan with the U.S. Department of Labor and available for review at the Public Disclosure Room of the Employee Benefits Security Administration; Obtain, upon written request to the Plan Administrator, copies of documents governing the operation of the plan, including insurance contracts and collective bargaining agreements, and copies of the latest annual report (Form 5500 Series) and updated summary plan description. The Plan Administrator may make a reasonable charge for the copies; and Receive a summary of the plan s annual financial report at no charge (the plan 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 plan participants, ERISA imposes duties upon the people who are responsible for the operation of the plan. The people who operate the plan, called fiduciaries of the plan, have a duty to operate the plan prudently and in the interest of you and other plan participants and beneficiaries. No one, including your employer, your union or any other person, may fire you or discriminate against you in any way to prevent you from obtaining benefits under the plan 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 your rights. For instance, if you request a copy of plan documents or the latest annual report from the plan and don t receive them within 30 days, you may file suit in a federal court. In such a case, the court may require the Plan Administrator 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 Plan Administrator. If you have a claim for benefits that is denied or ignored, in whole or in part, after following the required appeals process, you may file suit in federal court. If the plan fiduciaries misuse the plan s money, or if you re discriminated against for asserting your rights, you may seek assistance from the U.S. Department of Labor, or you may file suit in a federal court. EXECUTIVE LIFE INSURANCE PHILLIPS 66 BENEFITS FOR THE UNEXPECTED 13

16 EXECUTIVE LIFE INSURANCE The court will decide who should pay court costs and legal fees. If you re successful, the court may order the person you have sued to pay these costs and fees. If you lose for example, if the court finds your claim is frivolous the court may order you to pay these costs and fees. Assistance with your questions If you have any questions about the plan, contact the Plan Administrator or the Claims Administrator. If you have any questions about this statement or about your rights under ERISA, or if you need assistance in obtaining documents from the Plan Administrator, 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, DC You may obtain certain publications about your rights and responsibilities under ERISA by calling the publications hotline of the Employee Benefits Security Administration at (866) Claims and appeals procedures The How to file a claim section on page 10 explains what you or your beneficiary needs to do in order to file a claim for plan benefits. In this section, we ll talk about what to do if a claim is denied. We will say you throughout this section, although we mean you, your beneficiary or anyone else duly authorized to work on your behalf. An authorized representative is A person authorized to file claims or appeals on your behalf. For this person to be considered your authorized representative, one of the following requirements must be satisfied: You have given express written consent for the person to represent your interests; or The person is authorized by law to give consent for you (e.g., parent of a minor, legal guardian, foster parent, power of attorney). 14 PHILLIPS 66 BENEFITS FOR THE UNEXPECTED EXECUTIVE LIFE INSURANCE

17 INFORMATION AND CONSENTS REQUIRED FROM YOU When you file a claim or appeal, you and your beneficiaries consent to: The release of any information the Claims Administrator or Appeals Administrator requests to parties who need the information for claims processing purposes; and The release of medical or dental information (in a form that prevents individual identification) to Phillips 66 for use in occupational health activities and financial analysis, as permitted by applicable law. In considering a claim or appeal, the Claims Administrator or Appeals Administrator has the right to: Require examination of you when and as often as required; Have an autopsy performed in the event of death, when permitted by state law; and Review a physician s or dentist s statement of treatment, study models, pre- and posttreatment X-rays and any additional evidence deemed necessary to make a decision. No personnel decisions may be made against you based on the outcomes of the claims and appeals process. IF A CLAIM IS DENIED In general, the Claims Administrator must notify you of its decision on your claim within 90 days after they receive it. Sometimes, the Claims Administrator may need up to 90 more days to decide the claim. If this happens, they ll let you know in writing. They ll also tell you why the extension is needed. If any part of your claim is denied, the Claims Administrator will give you a written or electronic notice that will include (among other things): The specific reason(s) for the denial and the specific provisions on which the denial is based. A description of any additional material or information you must provide in order for your claim to be approved, and an explanation of why that material or information is necessary. If any internal rule, guideline or protocol was used in denying the claim, either that specific rule, guideline or protocol or a statement that such a rule, guideline or protocol was used in denying the claim and that a copy will be provided to you free of charge upon request. A statement that you are entitled, upon request, to see all documents, records and other information relevant to your claim for benefits, and also that you are entitled to get free copies of that information. An explanation of the appeals procedures, including time limits that apply. A statement of your right to file a lawsuit in federal court under ERISA, if your claim is denied on final appeal. EXECUTIVE LIFE INSURANCE PHILLIPS 66 BENEFITS FOR THE UNEXPECTED 15

18 EXECUTIVE LIFE INSURANCE HOW TO FILE AN APPEAL Appeals must be filed within 60 days. If you miss this deadline, you CANNOT appeal. If any part of your claim is denied, you can appeal that denial. The goal of the appeals process is to ensure you have a full and fair review of your appeal. Your appeal must be made in writing within 60 days after you receive the denial and must be sent to the Appeals Administrator at the address found in the Contacts section on page 20. In your appeal, you may: Include written comments, documents, records and other information relating to your claim, whether or not those materials were submitted with your initial claim. Request to see and get free copies of all documents, records and other information relevant to your claim. If an appeal is denied If any part of your claim is denied on appeal, you ll be given a written or electronic notice that will include: The specific reason(s) for the denial. References to each of the specific provision(s) of the plan on which the denial is based. A statement that you are entitled, upon request, to see all documents, records and other information relevant to your claim for benefits, and also that you are entitled to get free copies of that information. A statement describing any further appeal procedures, including any applicable deadlines, and your right to obtain further information about such procedures. A statement of your right to file a lawsuit in federal court under ERISA. The Appeals Administrator must notify you of its decision within 60 days after it receives your appeal. Sometimes, the Appeals Administrator may need up to 60 more days to decide the appeal. If this happens, you ll be informed in writing. You ll also be told why the extension is needed. 16 PHILLIPS 66 BENEFITS FOR THE UNEXPECTED EXECUTIVE LIFE INSURANCE

19 The Appeals Administrator s decision is final The Appeals Administrator that makes the final appeals decision acts as fiduciary under ERISA and has the full discretion and authority to: Make final determinations of all questions relating to eligibility for any plan benefit and to interpret the plan for that purpose; and Make final and binding grants or denials of benefits under the plan. Benefits under the plan will be paid only if the Appeals Administrator decides in its sole discretion that the applicant is entitled to them. The determination of the Appeals Administrator on appeal will be final and binding. However, if you ve gone through the appeals process and still believe you re entitled to a plan benefit, you may file a civil action under Section 502(a) of the Employee Retirement Income Security Act of 1974, as amended ( ERISA ). You cannot sue in federal court before 60 days after proof of loss was submitted. Your suit must be filed within three years* from when proof of loss was required. FRAUDULENT CLAIMS If the plan finds that you or someone on your behalf has submitted a fraudulent claim to the plan, the plan has the right to recover any amounts paid by the plan with respect to fraudulent claims or expenses and may take legal action against you. Upon determining that a fraudulent claim has been submitted, the plan has the right to permanently terminate your coverage under the plan, and the Plan Administrator has the authority to take any actions he or she deems appropriate to remedy such violations, including pursuing legal action or equitable remedies to recover any payments made by the plan to any party, regardless of when the fraudulent claim was discovered. Such action will not preclude the company from taking other appropriate action. You will have the right to appeal the decision by going through the appeals process that applies to the specific benefit being terminated. * If the law of the state in which you live makes the three-year limit void, the action must begin within the shortest time period permitted by law. EXECUTIVE LIFE INSURANCE PHILLIPS 66 BENEFITS FOR THE UNEXPECTED 17

20 EXECUTIVE LIFE INSURANCE ERISA plan information The plan is governed by a federal law the Employee Retirement Income Security Act of 1974 (ERISA), as amended and is subject to its provisions. Phillips 66 Group Universal Life Insurance Plan (Commonly referred to as the Employee Executive Life Insurance Plan) Type of plan Plan number 505 Plan year and fiscal records Plan funding and sources of contributions Group numbers Welfare benefit plan providing group universal life or group variable life insurance. Benefits under the plan are provided under the terms and conditions of the plan, and the insurance contract as determined by the Claims Administrator. January 1 December 31 Benefits are funded through insurance contracts. The costs are paid entirely by participating employees. Group variable universal life (GVUL) GU Group universal life (GUL) GMM PHILLIPS 66 BENEFITS FOR THE UNEXPECTED EXECUTIVE LIFE INSURANCE

21 Glossary Absolute assignment Active employee Actively at work Annual pay Appeals Administrator Beneficiary, beneficiary(ies) Claims Administrator ERISA EOI, evidence of insurability Family medical leave of absence (FMLA) Leave of absence Non-store The irrevocable transfer of all rights, title, interest and incidents of ownership, both present and future, of the assigned benefit to an individual or trustee. An employee who s on the direct U.S. dollar payroll. Performing all of the usual and customary duties of your job at a place required by the employer. Your base salary. An entity that processes appeals regarding benefit claims. The person(s) or entity(ies) you designate to receive specific benefits in the event of your death. You must name your beneficiary(ies) on the form provided by the Claims Administrator or online at com/phillips66 or gvuleservice.metlife.com. The entity responsible for processing benefit claims and for any other functions as explained in this summary plan description (SPD). Employee Retirement Income Security Act of 1974, as amended from time to time. A statement providing your medical history. The Claims Administrator will use this statement to determine your insurability under the applicable plan. The statement and any required physical exam will be paid by the Claims Administrator. FMLA leave is family or medical leave taken under the terms of the Family and Medical Leave Act of 1993 (as amended). A direct U.S. dollar payroll status that may allow an employee to continue participation for a limited period of time in certain benefit programs for which he or she was participating as an active employee prior to going on leave of absence status. For leaves, refer to the appropriate leave policy for a complete definition. For a leave of absence-labor Dispute, the company places an active employee on this leave for the time when he or she is not working due to a Labor Dispute. Generally, benefits are not available during the leave. Employee jobs that are not classified in the personnel systems of the employer as retail marketing. Plan year The calendar year (January 1 December 31). Resident alien Terminally ill You are a resident alien as of the first date you are or may be treated as a resident alien as defined by the IRS. Generally, you must satisfy either the green card test or the substantial presence test to be treated as a resident alien. For more information, see IRS Publication 519 U.S. Tax Guide for Aliens. Certified by a physician as having a life expectancy, due to illness, of 12 months or less. EXECUTIVE LIFE INSURANCE PHILLIPS 66 BENEFITS FOR THE UNEXPECTED 19

22 EXECUTIVE LIFE INSURANCE Contacts For information on: Contact/address Phone/operating hours Group Universal Life/ Group Variable Universal Life Eligibility criteria Changing personal information (including dependent information) To view coverage Eligibility appeals To enroll Questions about coverage or rates Coverage or beneficiary changes To report a claim Questions after a claim has been paid or denied Benefits Center 7201 Hewitt Associates Center P.O. Box Charlotte, NC Web: Visit hr.phillips66.com to see benefit plan information Visit Your Benefits Resources (YBR) through HR Express (for active employees only), or at for plan information and enrollments Phillips 66 Plan Administrator Manager HR Shared Services (HRSS) 411 S. Keeler Avenue Bartlesville, OK MetLife GUL/GVUL Claims and Appeals Administrator Tesson Ferry St. Louis, MO Web: gvuleservice.metlife.com; or hr.phillips66.com MetLife is the Claims Administrator and Appeals Administrator. (800) or (646) :00 a.m. to 6:00 p.m. Central time, Monday Friday, except U.S. company holidays Note: You change your address or phone number online through HR Express. (918) MetLife (800) (if enrolled) 7:00 a.m. to 7:00 p.m. Central time, Monday Friday (800) (if not enrolled) 8:00 a.m. to 5:00 p.m. Central time, Monday Friday 20 PHILLIPS 66 BENEFITS FOR THE UNEXPECTED EXECUTIVE LIFE INSURANCE