Phillips 66 2015 ANNUAL BENEFITS ENROLLMENT FOR PRE-65 RETIREES
2015 ANNUAL BENEFITS ENROLLMENT FOR PRE-65 RETIREES October 31 November 21, 2014 your HEALTH.
Living well means different things to different people. Some love to entertain and be surrounded by family and friends. Others prefer having time to themselves to enjoy a little peace and solitude. Some yearn to travel and discover new places. While others would rather stay at home to putter around the garden or pursue a favorite hobby. The same is true for benefits coverage. What was right for you last year, may not meet your needs for the coming year. That s one of the reasons we hold Annual Benefits Enrollment to give you a once-a-year opportunity to take stock of your benefits coverage and make different choices, based on your changing needs. Reflecting on your Phillips 66 retiree benefits coverage is important because having appropriate health care and financial protection are essential to living well. So before November 21, the end of the Annual Benefits Enrollment period, spend some time with your family to review your benefit options and your coverage needs for 2015. your BENEFITS. your LIFE. PHILLIPS 66 2015 ANNUAL BENEFITS ENROLLMENT 1
ANNUAL BENEFITS ENROLLMENT 101: THE BASICS You must enroll online by midnight Central time or by phone 6:00 p.m. Central time on November 21, if you wish to make changes to your retiree medical coverage for 2015. Some things to consider as you prepare for Annual Benefits Enrollment Read this guide and all other enrollment materials carefully. Check out the Annual Benefits Enrollment web page at hr.phillips66.com/annual- Enrollment/2015-Annual-Enrollment.aspx. Has your situation changed since last year s enrollment? Will you or a covered dependent be eligible for Medicare in 2015? Medicare eligibility affects your choices. Compare medical plans to determine which offers the best value. Consider: How much do you normally spend on health care? Would you rather pay less in premiums, or have a lower deductible and copays? Are you a California resident? You may be able to enroll in a Kaiser Permanente plan. Are you a U.S. veteran? You may be able to use your Retiree Medical Account to reimburse yourself for Tricare premiums. 2 PHILLIPS 66 2015 ANNUAL BENEFITS ENROLLMENT
IT S EASY TO ENROLL Once you ve done your homework, you re ready to go. From October 31 November 21, you can enroll online or over the phone and it s easy either way. ONLINE AT YOUR BENEFITS RESOURCES (YBR): From your computer or mobile device, go to http://resources.hewitt.com/phillips66 and enter your YBR user ID and password. Go to Phillips 66 HR Mobile App (available in the App Store or Google Play), select Apps and launch YBR. BY TELEPHONE: Call the Benefits Center at (800) 965-4421, 8:00 a.m. to 6:00 p.m. Central time, Monday through Friday. 2015 ANNUAL BENEFITS ENROLLMENT: OCTOBER 31 NOVEMBER 21 Enroll early! Don t leave enrollment to the last minute. You can change your enrollment elections as often as you want during Annual Benefits Enrollment. Just remember that enrollment ends at midnight Central time (or at 6:00 p.m. Central time if by phone) on November 21, so your elections in the system at that time will be your final elections for January 1, 2015. Forgot your password? If you can t remember your YBR user ID or password, click Forgot User ID or Password at the YBR login. Or, you can call the Benefits Center and say I don t know when prompted to enter your password. NEED ADDITIONAL DETAILS? Health care reform requires Phillips 66 to provide you with a Summary of Benefits and Coverage (SBC), available at http://hr.phillips66.com/annual- Enrollment/2015-Annual-Enrollment. aspx. It s a standardized document that highlights key provisions, limitations and exceptions. PHILLIPS 66 2015 ANNUAL BENEFITS ENROLLMENT 3
YOUR 2015 ANNUAL BENEFITS ENROLLMENT CHOICES YOUR PRE-65 RETIREE MEDICAL PLANS While the basics of how the plan works will not change, there are a few changes for 2015. The plan still covers preventive care, regular checkups and office visits, hospital stays, prescription drugs (retail and mail-order), mental health and substance abuse treatment, and more. Here s a brief overview of how our benefit plans are changing effective January 1, 2015: PPO Plan network and non-network out-of-pocket maximums are increasing. Prescription drug costs under the PPO Plan will count towards the annual out-of-pocket maximum. CVS/caremark will replace Express Scripts as our pharmacy benefit manager. The CVS/caremark pharmacy network includes more than 68,000 independent, chain and retail pharmacies, as well as mail-order and specialty pharmacy services. You will still be required to get your maintenance medications through mail-order. However, you can get your 90-day supply at a CVS/pharmacy through the Maintenance Choice program instead of going through mail-order. The Consumer Plan and PPO Plan will provide: Coverage for one hearing aid device every three years. Coverage for nutritional counseling that is medically necessary for chronic diseases for which dietary adjustment has a therapeutic role. To be covered, nutritional counseling must be prescribed by a physician and provided by an approved, licensed healthcare provider recognized under the plan. Employees and covered dependents are encouraged to get approval from their claims administrator, Aetna or BCBS, prior to obtaining services. Coverage for medically necessary treatments for autism spectrum disorder, including Applied Behavior Analysis (ABA). Specialized care will be coordinated through a dedicated autism care management team at ValueOptions and will include access to a specialty network of qualified autism service professionals and access to additional resources for family members. Note that if you are under age 65 and are eligible for Medicare, you are not eligible for the Consumer Plan. You can select the Medicare-eligible PPO Plan or Medicare-eligible options through Tricare or Kaiser Permanente (if you live in California). Medicare will always be considered primary (meaning it pays first) and the plan you elect will coordinate with Medicare. Family members who are not eligible for Medicare may continue coverage under any of the non-medicare options. Refer to the Retiree Health SPD on hr.phillips66.com for a list of plan provisions. NEW OPTION AVAILABLE Effective January 1, 2015, your premiums for Tricare coverage will be eligible for reimbursement through your Retiree Medical Account (RMA). 4 PHILLIPS 66 2015 ANNUAL BENEFITS ENROLLMENT
Consumer Plan Pre-65 Non-Medicare PPO Plan Pre-65 Non-Medicare and Medicare Network Non-network Network Non-network Annual deductible You only: $1,400 You + 1 or more: $2,800 (Includes prescription drug costs) You only: $600 You + 1 or more: $1,200 You only: $1,000 You + 1 or more: $2,000 (Excludes medical copays and prescription drug costs) Annual out-of-pocket maximum You only: $4,000 You + 1 or more: $8,000 You only: $5,000 You + 1 or more: $10,000 You only: $4,500 You + 1 or more: $9,000 You only: $7,000 You + 1 or more: $14,000 (Includes prescription drug costs) (Includes medical copays and prescription drug costs) Preventive medical care (deductible waived) Covered at 100% $1,500 covered at 100%; 50% thereafter Covered at 100% $1,000 covered at 100%; 50% thereafter Doctor visits You pay 20%, You pay 50%, $25 copay (primary care) You pay 50%, $50 copay (specialist) Most other services You pay 20%, You pay 50%, You pay 20%, You pay 50%, Preventive prescription drugs Deductible waived $1,500 covered at 100% You pay 20% thereafter at network providers and 50% at non-network providers No special provisions for preventive prescription drugs (continued) PHILLIPS 66 2015 ANNUAL BENEFITS ENROLLMENT 5
Consumer Plan Pre-65 Non-Medicare PPO Plan Pre-65 Non-Medicare and Medicare Network Non-network Network Non-network Other network prescription drugs You pay 100% of the negotiated discounted cost until you reach your annual deductible You pay 20% thereafter Retail: Generic: $10 copay Preferred brand: You pay 40% ($30 min./$125 max.) Non-preferred brand: You pay 50% ($60 min./$250 max.) Mail (CVS/caremark): Generic: $20 copay Preferred brand: You pay 40% ($60 min./$250 max.) Non-preferred brand: You pay 50% ($120 min./$500 max.) Keep in mind that you will still be required to get your maintenance medications through mail-order. However, you can get your 90-day supply at a CVS/pharmacy through the Maintenance Choice program instead of going through mail-order. Pre-65 Retiree Medical Monthly Premiums Consumer Plan Non-Medicare PPO Plan Non-Medicare PPO Plan Medicare You or spouse only $ 760 $ 1,310 $ 1,048 You + spouse $ 1,520 $ 2,620 $ 2,096 You + spouse + children $ 1,748 $ 3,013 $ 2,410 You or spouse + children $ 988 $ 1,703 $ 1,362 Children only $ 228 $ 393 $ 1,048 6 PHILLIPS 66 2015 ANNUAL BENEFITS ENROLLMENT
Health Maintenance Organization (HMO) If you live in California and within a Kaiser Permanente service area, you can choose to enroll in the Kaiser HMO. For coverage details, contact Kaiser. Kaiser Permanente Website Phone number Pre-65 non- Medicare monthly premium* www.kaiserpermanente.org (800) 464-4000 You or spouse only: $879.70 You + spouse: $1,935.32 You + spouse + children: $2,639.08 You or spouse + children: $1,759.38 Children only: $879.70 * Contact Kaiser if you or a covered dependent are eligible for Medicare. TURNING AGE 65 IN 2015? Medicare coverage for eligible participants begins on the first day of the month of their 65th birthday (or the first day of the prior month if their birthday is on the first day of the month). If you are eligible for Medicare, pre-65 retiree medical coverage for an enrolled participant will end on the last day of the month before turning 65. (For example, if your birthday is October 15, you will have pre-65 coverage through September 30 and Medicare coverage will begin October 1.) If you or your eligible dependent elects Medicare supplemental coverage through Tricare, UnitedHealthcare or Kaiser Permanente (if you live in California), any remaining credits in your Retiree Medical Account (RMA) may be used to reimburse the monthly premiums you pay for coverage for yourself or your eligible dependents. Enrollment information is generally mailed approximately 60 days before a 65th birthday. For more information on post-65 retiree medical coverage, please refer to hr.phillips66.com. PHILLIPS 66 2015 ANNUAL BENEFITS ENROLLMENT 7
RESOURCES This Annual Benefits Enrollment Guide covers highlights of what you need to know to enroll in your 2015 benefits. If you want more information on a specific plan eligibility, coverage details, how it works you have several resources: Annual Benefits Enrollment website: hr.phillips66.com/annual-enrollment/2015- Annual-Enrollment.aspx. View the Summary Plan Descriptions (SPDs) at hr.phillips66.com. Benefits Center at (800) 965-4421, Monday Friday, 8:00 a.m. 6:00 p.m. Central time. Enroll online before midnight, Central time or by phone before 6:00 p.m., Central time on November 21, 2014. Make sure you understand all your options, so you can make informed choices. Then enroll in your 2015 benefits. 8 PHILLIPS 66 2015 ANNUAL BENEFITS ENROLLMENT
YOUR ENROLLMENT CHECKLIST* Benefit Medical Consumer Plan (Non-Medicare) PPO Plan Non-Medicare PPO Plan Medicare Kaiser Permanente HMO (CA only) No coverage * This is for personal use only. Coverage You or spouse only ($760.00/month) You + spouse ($1,520.00/month) You + spouse + children ($1,748.00/month) You or spouse + children ($988.00/month) Children only ($228.00/month) You or spouse only ($1,310.00/month) You + spouse ($2,620.00/month) You + spouse + children ($3,013.00/month) You or spouse + children ($1,703.00/month) Children only ($393.00/month) You or spouse only ($1,048.00/month) You + spouse ($2,096.00/month) You + spouse + children ($2,410.00/month) You or spouse + children ($1,362.00/month) Children only ($1,048.00/month) You or spouse only ($879.70/month) You + spouse ($1,935.32/month) You + spouse + children ($2,639.08/month) You or spouse + children ($1,759.38/month) Children only ($879.70/month) Coverage waived My Elections (mark your choices) PHILLIPS 66 2015 ANNUAL BENEFITS ENROLLMENT 9
This guide contains information you need to enroll in your 2015 benefits, which become effective January 1, 2015. Visit Your Benefits Resources (YBR) for tools, details and your monthly premiums. Expatriates: See hr.phillips66.com regarding your medical, prescription drug and dental coverage (offered through CIGNA International). This communication is an overview of certain terms and conditions of the health and welfare benefits and is for information purposes only. Receipt of the information provided in this communication does not guarantee eligibility for any associated plan or benefit. Eligibility is governed by the specific terms and conditions of the official plan documents and any underlying insurance contracts. This communication is intended for U.S.-paid active employees, other than store employees and recurring seasonal employees. It is not intended for employees covered by a collective bargaining agreement, unless the terms of the collective bargaining agreement specifically provide for participation. If there is any discrepancy or conflict between this overview and the terms of the official plan documents and any underlying insurance contracts, if applicable, the official plan documents and insurance contracts, as applicable, will control. Nothing in this overview creates an employment contract between Phillips 66, its subsidiaries or affiliates and any employee. Phillips 66 reserves the right to amend, change or terminate the plans, any underlying contract or any other program, at any time without notice, at its sole discretion, according to the terms of the plan. Your Benefits Resources is a trademark of Hewitt Associates LLC. HR-USB-Pre65Guide-HB-2014-16