ENROLLMENT PERIOD: OCTOBER 16 30, 2015 It s time for 2016 Annual Enrollment. Read the information in this package carefully before making your decisions, and follow the steps below to make sure your enrollment is successful. 1. REVIEW YOUR PERSONAL REPORT CAREFULLY Check your current coverage levels and dependent information, evaluate your options, and decide if you need to make any changes for 2016. 2. ENROLL ONLINE IF YOU NEED TO MAKE CHANGES FOR 2016 Instructions to enroll online are on the back page of your Personal Report. You can find the HR/Employee Self-Service (ESS) link on KMONLINE > HR/Benefits Quick Links. Enrolling online is easy! 3. ADDING DEPENDENTS FOR 2016 If you are adding a dependent for 2016 that was not covered in 2015, you must certify that they meet the Plan s eligibility requirements and provide the required dependent documentation. Go to page 7 for details. 4. CHECK YOUR CONFIRMATION STATEMENT A confirmation statement will be mailed to your home address in late November. When you receive it, check to make sure your 2016 elections are accurately reflected and keep the statement for your records. Follow the instructions on the statement if you need to make changes. 2016 IS A PASSIVE ENROLLMENT If you do not want to make any changes to your benefits coverage, your current elections will continue for 2016, including your annual HSA and FSA contributions. INSIDE THIS GUIDE Benefits Cost Sheet...1 Benefits Summary...2 Medical and RX...3 Dental and Vision...4 Life and AD&D Insurance...5 Spending Accounts...6 Enrolling Dependents...7 Proof of Eligibility...7 Status Changes...8 Other Programs...8 Contact List...9 To learn more about your health care plans and other benefits, read the Summary Plan Descriptions (SPDs). Go to KMONLINE > HR/Benefits Quick Links > Benefits Online > Plans (SPDs). The SPDs provide details about covered services, eligibility requirements, enrollment, claims and appeals, and contact information. Please review the Important Notices also enclosed with your enrollment materials.
SUMMARY OF MATERIAL MODIFICATIONS (SMM) This guide contains important new information about your benefits coverage and serves as the official Summary of Material Modifications (SMM) to your Summary Plan Description (SPD). It provides information on your benefits under the Kinder Morgan, Inc. Master Employee Welfare Benefits Plan ( Plan ). This new information changes the information in the SPD. Please keep this information with your other Plan references. This SMM is only a summary of the modification to the Kinder Morgan, Inc. Master Employee Welfare Benefits Plan. The official Plan documents and contracts will govern in case of conflict. This is intended to be read in conjunction with the SPD. Kinder Morgan is the Plan sponsor and reserves the right to terminate or amend the Plan provisions described at any time. You can find the Kinder Morgan SPDs on KMONLINE.
BENEFITS COST BELOW ARE THE 2016 PREMIUMS AND RATES: MEDICAL COST - United Healthcare/Kaiser (bi-weekly, pre-tax) Employee Only Employee + One Employee + Family (2 or more) UHC HDHP $ 0.00 $ 34.97 $ 48.66 UHC PPO $54.53 $147.22 $204.80 UHC EPO $77.98 $199.99 $278.23 UHC Out-Of-Area (OOA) $63.56 $171.45 $238.53 KAISER (California) $81.40 $138.97 $206.46 DENTAL COST (bi-weekly, pre-tax) Employee only $6.70 Employee + One $13.73 Employee + Family $20.76 VISION COST (bi-weekly, pre-tax) Employee only $3.86 Employee + One $5.50 Employee + Family $9.86 OPTIONAL EMPLOYEE & SPOUSE LIFE INSURANCE COST (after-tax; monthly rates shown) Age Rate/$1,000 Age Rate/$1,000 Age Rate/$1,000 Age Rate/$1,000 Under 30 $0.060 40-44 $0.105 55-59 $0.450 70-74 $2.060 30-34 $0.080 45-49 $0.160 60-64 $0.690 75 + $3.500 35-39 $0.095 50-54 $0.240 65-69 $1.290 OPTIONAL CHILD LIFE INSURANCE COST (bi-weekly, after-tax): $0.92 VOLUNTARY AD&D INSURANCE COVERAGE AND COST (after-tax; monthly rates shown) Coverage Employee Spouse Children Rate/$1,000 Employee 100% N/A N/A $0.015 Employee & Spouse 100% 50% N/A $0.030 Employee, Spouse & Children 100% 40% 10% $0.030 Employee & Children 100% N/A 10% $0.030 NOTE: To calculate Optional Employee/Spouse life insurance and voluntary AD&D bi-weekly cost: coverage amount divided by $1,000 x monthly rate x 12 months/year = annual amount divided by 26 pay periods = bi-weekly amount. ENROLLMENT PERIOD: OCTOBER 16 30, 2015 1
BENEFITS SUMMARY 2016 BENEFIT ELECTIONS SUMMARY 2016 MEDICAL PLANS High Deductible Health Plan (HDHP) Preferred Provider Organization (PPO) Exclusive Provider Organization (EPO) Out-of-Area (OOA) Kaiser (California only) You can enroll in the following benefits during Annual Enrollment: Medical (includes prescription drug coverage) Dental Cigna Dental is our new carrier for 2016 (replacing MetLife) Vision Life and Accidental Death & Dismemberment (AD&D) Insurance Spending Account contributions: Health Savings Account (HSA) or Flexible Spending Accounts (FSAs) NOTE: Your 2015 elections, including your current HSA or FSA elections, will continue for 2016, so be sure to actively enroll if you want to make changes. MEDICAL & PRESCRIPTION DRUG COVERAGE (RX) Please note that 2016 will be the last year the EPO medical plan will be offered by Kinder Morgan. Now is a good time for you to review our other medical plan options and costs. You will continue to have a choice of medical plan options administered by United Healthcare (UHC). The High Deductible Health Plan (HDHP) is available to all employees, and other options offered to you depend on your home ZIP Code. Review the Medical Benefits chart on the next page for coverage details. If you enroll in any Kinder Morgan medical plan option, prescription drug coverage providing retail and mail services is automatically included. Our prescription drug program is administered by CVS Caremark (except for Kaiser). Details about the program can be found in the SPD on Benefits Online. If you live in California and enroll in the Kaiser Permanente medical plan option, you will be automatically enrolled in the Kaiser prescription drug plan. Kaiser information is included in your enrollment packet if you reside in California. CONTACT LIST For a list of our 2016 providers and other important numbers and links, go to page 9. 2 ID cards: If you change UHC medical plans, or you have a change in dependents, you will receive a new medical ID card with your name and the names of your covered dependents. You will receive a separate CVS Caremark prescription card with only your name, although your dependents will be covered. KMONLINE > HR/BENEFITS QUICK LINKS > BENEFITS ONLINE
MEDICAL AND RX BENEFITS MEDICAL BENEFITS UNITED HEALTHCARE (UHC) HDHP 1 PPO OOA 3 EPO In-network Out-of-network 2 In-network Out-of-network 2 Out-Of-Area Annual Deductible Individual $1,300 $2,600 $500 $1,000 $500 None Family $2,600 $5,200 $1,000 $2,000 $1,000 None Annual Out-Of-Pocket Maximum Individual $4,800 $9,600 $2,500 $5,000 $2,500 $6,850 Family $6,850 $13,700 $5,000 $10,000 $5,000 $13,700 Doctor's Office Visit Primary Care 20%* 40%* $20/visit 40%* 20%* $20/visit Specialist 20%* 40%* $40/visit 40%* 20%* $40/visit Well-Child Care Office Visits & Immunizations $0/visit 40% $0/visit 40% 20%* $0/visit Adult Preventive Care Routine Physicals, GYN exams/ Mammograms, Prostate exams $0/visit 40% $0/visit 40% 20%* $0/visit Emergency Room Care 20%* 20%* 20%* 20%* 20%* 20% You must call Care Coordination within 2 days of admission to avoid penalty Hospital Surgery Outpatient 20%* 40%* 20%* 40%* 20%* $150 copay Inpatient 20%* 40%* 20%* 40%* 20%* $500 Non-notification penalty $250 (The amount you must pay if you or your physician do not call per admission UHC Care Coordination prior to a hospital admission and certain types of outpatient surgical procedures) Mental Health & Substance Abuse Outpatient 20%* 40%* $20/visit 40%* 20%* $20/visit Inpatient 20%* 40%* 20%* 40%* 20%* $500 per admission 1 Annual deductible (which includes RX) must be met before HDHP benefits are paid. 2 Subject to MNRP (110%) when you use a non-network provider. 3 Subject to Reasonable & Customary (R&C) limits when you use a non-network provider. *after the deductible is met you pay this amount. This is not a complete list of covered services. Please see your Summary Plan Description (SPD) for the complete list. PRESCRIPTION DRUG COVERAGE - CVS CAREMARK Retail (up to a 31-day supply) Mail Order (up to a 90-day supply) Generic $10 copay Generic $20 copay Brand Formulary 1 25% coinsurance ($20 min) Brand Formulary 1 25% coinsurance ($40 min) Brand Non-Formulary 1 25% coinsurance ($40 min) Brand Non-Formulary 1 25% coinsurance ($80 min) Specialty RX N/A Specialty RX 2 $150 (30-day supply) 1 Your cost will be higher if you receive a name brand drug when a generic is available. 2 Limited to 30 day supply. PENALTY: All maintenance drugs taken on a regular long-term basis (30 days or more) must be filled with a 90 day prescription through the CVS Caremark mail service or a local CVS pharmacy (90 day supply), or effective with the 3rd fill of maintenance prescriptions at a retail pharmacy, you will pay a double copay or 25% coinsurance plus $20 for formulary or $40 for non-formulary. ENROLLMENT PERIOD: OCTOBER 16 30, 2015 3
DENTAL ::: VISION DENTAL PROGRAM Kinder Morgan dental benefits will be administered by Cigna Dental beginning January 1, 2016. You may obtain dental treatment from a dentist in Cigna s Dental Preferred Provider Organization (DPPO) or from any dentist you choose. You will have lower out-of-pocket costs if you use a DPPO network provider since participating dentists have agreed to accept negotiated fees as payment in full for covered services. Your dental benefits and services will remain the same in 2016. Please refer to the Cigna guide included with your enrollment materials to find out more about the Cigna DPPO and website customer tools. Search for a dentist by going to www.cigna.com to find a dentist or call your current dentist to see if he or she participates in the Cigna DPPO. If you enroll for dental coverage, you will receive a Cigna Dental ID card in the mail. The card will have the group plan number and only your name, although your dependents will be covered. You should also register on the www.mycigna.com website to learn more about your dental coverage. Learn more about the features and advantages of the Cigna DPPO by calling the Cigna pre-enrollment line available October 16, through December 31, 2015. Effective January 1, 2016, contact Cigna at (800) 244-6224. VISION PROGRAM Kinder Morgan s vision program is administered by VSP. The vision plan covers an annual eye exam, prescription glasses, contact lenses, and provides extra savings and discounts on other vision services such as laser vision correction surgery and retinal screenings. When you use a VSP network provider, you ll pay less out of your pocket and claims for benefits will be filed for you by the VSP provider. If you use a non-network provider for vision services, you will be required to pay for services at the time you receive them and then submit a claim reimbursement form to VSP. Let your vision provider know you re covered by VSP. Coverage for yourself and your family members can be verified by VSP with your Social Security Number and group number 12055862. Review the Vision SPD and register on the VSP website at www.vsp.com for coverage details. 4 KMONLINE > HR/BENEFITS QUICK LINKS > BENEFITS ONLINE
LIFE AND AD&D INSURANCE LIFE AND ACCIDENTAL DEATH & DISMEMBERMENT (AD&D) INSURANCE Kinder Morgan s Basic Life and Basic AD&D, and Optional Life and Voluntary AD&D insurance are insured through PrudentiaI. Basic Life and Basic AD&D coverage are provided to you at no cost. The amount of coverage for each of these company-provided benefits is 2x your annual base salary not to exceed $800,000. Optional Life Insurance: To provide you and your family with additional financial protection, you may want to purchase extra Life and AD&D insurance to supplement the basic coverage provided by Kinder Morgan. You pay the premiums for this coverage. Rates are unchanged for 2016 (see page 1). EVIDENCE OF INSURABILITY (EOI): Additional amounts of life insurance coverage may be subject to Evidence of Insurability. EOI is proof of good health that may be required by the insurance company. If EOI is required for your Optional Employee or Spouse life election, you will receive a letter from Prudential at your home address in January 2016. Please respond within 60 days to start the EOI review process or your request for higher coverage will be closed. Optional Employee Life: Coverage can be elected in multiples of $10,000 up to 5x your annual base pay rounded down to the nearest $10,000 increment. Maximum coverage is the lesser of 5x your annual base pay or $2 million. If you are currently not enrolled, or if you increase your current coverage by more than $10,000, EOI will be required. Any increase in coverage greater than $240,000 is also subject to EOI. Optional Spouse Life: Coverage can be elected in multiples of $5,000. Maximum coverage is the lesser of 50% of the approved employee optional life coverage or $250,000, rounded down to the nearest $5,000 increment. You must be enrolled in Optional Employee Life in order to enroll for Optional Spouse Life. EOI will be required if you newly enroll, or if you increase your current spousal coverage by more than $5,000. Any increase in coverage greater than $50,000 is also subject to EOI. UPDATE YOUR BENEFICIARIES Protect your loved ones and update your beneficiary designations online today for Life and AD&D insurance, and for your Retirement and Savings Plan. It s important! Follow the directions at KMOnline > HR/Benefits Quick Links > Benefits Online > Forms > Beneficiary Designation To learn more about your life insurance and estate planning needs, visit the KM Prudential website at: www.prudential.com/kindermorgan Optional Child Life: Eligible children from live birth to age 25 are covered at $10,000 each. You must be enrolled in Optional Employee Life in order to enroll for Optional Child Life. Voluntary Accidental Death & Dismemberment (AD&D): You may elect Voluntary AD&D coverage for just yourself, or for you and your family. Coverage is elected in multiples of salary up to 5x your annual base pay. Maximum coverage is the lesser of 5x annual base pay or $2 million, rounded up to the next $1,000. ENROLLMENT PERIOD: OCTOBER 16 30, 2015 5
SPENDING ACCOUNTS PRE-TAX SPENDING ACCOUNTS You can elect to contribute pre-tax dollars to a spending account to help pay for eligible healthcare expenses. Your annual Health Savings Account (HSA) or Flexible Spending Account (FSA) election will be divided by the applicable pay periods and an equal amount will be deducted pre-tax from each of your paychecks throughout 2016. Read about the options available to you and review the SPD s for more details. HSA AND FSA CONTRIBUTIONS HSA 1 Health Care FSA Limited Purpose FSA (LFSA) 2 Dependent Care FSA Eligible if Enrolled in HDHP Yes No Yes Yes Eligible if NOT Enrolled in HDHP No Yes No Yes Annual Pre-Tax Contribution Limits $3,350/ $6,750 $2,550 $2,550 $5,000 Eligible Expenses 3 Healthcare Healthcare Dental & Vision Dependent Care Unused Contributions Rollover Yes No No No Administrator Optum Bank Payflex Payflex Payflex 1 An employee age 55 or older can make an additional $1,000 in catch-up contributions to a Health Savings Account (HSA). $3,350 for employee only coverage and $6,750 for family. Unused HSA contributions are not forfeited, and rollover year to year. 2 LFSA may be used to pay for eligible dental and vision expenses; eligible medical and prescription expenses can be submitted after you meet your annual medical deductible (proof required). 3 Healthcare can include qualifying medical, dental, or vision expenses Health Savings Account (HSA) If you elect the HDHP medical plan option, you may elect to contribute to a Health Savings Account. You can use your HSA dollars to pay for qualified health care expenses such as copayments, coinsurance and deductibles now or in the future, and your HSA balance rolls over from year to year with no forfeiting of contributions. If you are contributing to an HSA for the first time, Kinder Morgan will help you open your Health Savings Account with our HSA trustee, Optum Bank (a division of United Healthcare). Your pre-tax dollars will be deposited by the Company into your HSA once your account is established. You will also receive a Welcome Kit, and a MasterCard and PIN at your home address from Optum Bank. Flexible Spending Accounts (FSA) Two types of FSAs are available to you, the Health Care FSA and the Dependent Care FSA. Limited Purpose Health Care FSA (LFSA) for Dental/Vision Expenses If you are enrolled in the HDHP, you may elect an LFSA in addition to (or in lieu of) an HSA. The LFSA can be used to pay for qualified out-of-pocket dental and vision expenses for you and your eligible dependents. The LFSA can also be used for medical and prescription expenses only after satisfying your annual medical deductible (proof required). 6 KMONLINE > HR/BENEFITS QUICK LINKS > BENEFITS ONLINE
ENROLLING DEPENDENTS ::: PROOF OF ELIGIBILITY ENROLLING YOUR ELIGIBLE DEPENDENTS If you are adding a dependent for benefits in 2016, you will need to provide proof of eligibility by Friday, October 30, 2015. Valid dependent documentation is required even if you have covered that dependent in past years, but you are not currently covering them in 2015. For more information on proof that is required, please refer to the Summary of Required Documents on our intranet website under Annual Enrollment (KMONLINE > HR/Benefits Quick Links > Benefits Online > Annual Enrollment). Please review the eligibility chart below for examples of dependents that can be covered and the documentation required. PROOF OF ELIGIBILITY DEPENDENT CRITERIA REQUIRED DOCUMENTATION Spouse Legally married more than 12 Months Front page of prior year s tax return showing married status and both names, OR Marriage Certificate AND current household bill or statement showing both names Legally married less than 12 Months Marriage Certificate Children Biological, adopted or foster children, stepchildren, children of Domestic Partner, and children covered by Qualified Medical Child Support Order For Medical/Dental/Vision coverage Child s Birth Certificate showing names of both parents For stepchildren and children of a Domestic Partner, in addition to above requirements, proof of residency with employee required Proof of Residency Front page of prior year s income tax return showing dependent child s name, OR school or emergency record showing employee s home address Domestic Partner Affidavit of Domestic Partnership criteria found on Benefits Online > Forms IMPORTANT: Please review the Summary of Required Documents and the Summary Plan Descriptions for more eligibility details DEPENDENT DOCUMENTATION DEADLINE: FRIDAY, OCTOBER 30, 2015 Write your name and employee ID on the email Subject line and on your documents Scan and email required documentation to: annualenrollment@kindermorgan.com Medical coverage for dependents reaching age 26 will end as of the last day of the birth month. Medical coverage may be extended if the child is mentally or physically disabled and dependent upon you for care and support, and lives in your home (certification required). Dental and Vision coverage for eligible dependents reaching age 25 will end as of the last day of the birth month. Dependents age 19 to 25 must be full-time students or solely supported by you to be eligible for Dental and Vision coverage. ENROLLMENT PERIOD: OCTOBER 16 30, 2015 7
STATUS CHANGES ::: OTHER PROGRAMS QUALIFIED STATUS CHANGES ADVOCATE4ME PROGRAM United Healthcare (UHC) Managing your health, and your health plan benefits, isn t always easy. With Advocate4Me, you now have a dedicated team of people ready to answer your questions, help you understand your treatment options, estimate costs ahead of time, and more. Refer to the enclosed UHC flyer. This service is provided at no cost to you and is automatically included when you are enrolled in a United Healthcare plan. It s just one more way UHC is helping make things simpler for you. Email Advocate4Me@uhc.com or call the number on your UHC health plan ID card. Advocate4Me is available by phone, Monday through Friday, 8 a.m. 8 p.m. CT. Take the time to think carefully about your 2016 benefit choices. Remember, you can only change your elections in 2016 if you have a qualified change in status such as marriage, birth or adoption of a child, divorce or legal separation, death of a covered dependent, or a change in your spouse s or domestic partner s employment status. Changes due to a qualified change in status during the year must be made within 30 calendar days of the event. The date of the event is considered day one. To report your qualifying event, complete an Employee Benefits Change Request (EBCR) form, available at KMONLINE > HR/Benefits Quick Links > Benefits Online > Forms, along with the supporting documentation. Include your name and Employee ID on all documents and in the email Subject line. EMPLOYEE ASSISTANCE PROGRAM (EAP) You and your family have a free voluntary assessment and referral service available through your EAP. Your EAP is designed to provide confidential support for those everyday challenges or more serious problems, and it s available 24 hours a day, 7 days a week. To receive counseling services, financial and legal advice, help with relationships and more, call the Optum EAP at (866) 248-4094 at any time, or go online at www.liveandworkwell.com to access helpful tools and resources (access code: kinder). UHC NURSELINE The UHC NurseLine service is available 24 hours every day for you and your family to help answer your health-related questions. Call (800) 237-4936 toll-free to reach a nurse who can provide you with information. TTY/TDD (Hearing impaired) (800) 855-2880. Register on our provider websites listed on the next page to take advantage of the many tools and resources available to you. You ll find lots of helpful information. 8 KMONLINE > HR/BENEFITS QUICK LINKS > BENEFITS ONLINE
CONTACT LIST PROVIDER TELEPHONE SERVICE/GROUP ID WEBSITE KM Benefits Department (866) 775-5790 option 3 Benefits KMONLINE > HR/Benefits Quick Links > Benefits Online During Annual Enrollment only, scan and email documentation to this email address: annualenrollment@kindermorgan.com Scan and email documentation due to status changes (or New Hires) to this email address: benefits@kindermorgan.com Fax documentation to this number: (713) 495-7416 Mail documentation to this address: KM Benefits Department 1001 Louisiana St., Suite 1000 Houston, TX 77002-5089 United Healthcare (UHC) (877) 561-2829 Medical (700639) www.myuhc.com Kaiser (HMO) - California (800) 464-4000 Medical (138050-0000) www.kaiserpermanente.org CVS Caremark (800) 840-0357 Prescription - Rx (5101) www.caremark.com Cigna (800) 244-6224 Dental (3339023) www.mycigna.com Vision Service Plan (800) 877-7195 Vision (12055862) www.vsp.com Optum EAP (866) 248-4094 Employee Assistance Program (EAP) www.liveandworkwell.com Access Code: kinder UHC - Nurseline (866) 232-1626 Optum NurseLine Available 24/7 Optum Bank (800) 791-9361 Health Savings Account www.optumhealthbank.com PayFlex (Health Hub) (800) 284-4885 Flexible Spending Accounts www.healthhub.com Prudential (800) 778-3827 Life & AD&D Insurance (51297) www.prudential.com/kindermorgan KM Benefits Service Center (866) 301-2359 Retirement (Pension) Plan www.ibenefitcenter.com/kindermorgan Empower Retirement (800) 345-2345 Savings Plan - 401(k) www.retireonline.com AXA Assistance (800) 565-9320 Travel Assistance Program www.axa-assistance.us Computershare (800) 633-9394 ESPP www-us.computershare.com/employee ENROLLMENT PERIOD: OCTOBER 16 30, 2015 9