Phillips 66 2015 ANNUAL BENEFITS ENROLLMENT
2015 ANNUAL BENEFITS ENROLLMENT 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 s right for you when you re fresh out of college may not meet your needs when you re ready to start a family or are beginning to contemplate retirement. 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. This year s Annual Benefits Enrollment period couldn t be easier. Your 2014 elections, except for Flexible Spending Account (FSA) participation, will carry over to the coming year, so no action is needed if you re happy with what you ve got.* If you want to contribute to a Health Care or Dependent Care FSA, however, you ll need to take action. your BENEFITS. your LIFE. Reflecting on your Phillips 66 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. During the year, be sure to take advantage of programs and activities designed to help you feel your best, such as the Wellness Incentive Program and Fitness Reimbursement Program. After all, living well is about making the right choices, not just during the Annual Benefits Enrollment period, but throughout the year. Whether it s eating healthy, exercising regularly, getting a good night s sleep or practicing preventive care, you ve got the power to live well, every day. * If you do not use tobacco, you will be asked to certify that you are a non-tobacco user. Tobacco users will pay higher premiums for supplemental life insurance coverage through Phillips 66 in 2015. 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 coverage changes to the following benefits for 2015: Medical Dental Comprehensive Vision Remember, you must make your tobacco attestation and/or enroll in the FSA Health Care FSA and Dependent Care FSA each year if you wish to participate. 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? 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 each paycheck, or have a lower deductible and copays? Need help? Ask Alex, your virtual benefits advisor, at www.alexforphillips66.com. If you re enrolling in the Consumer Plan, how much should you contribute to your Health Savings Account (HSA)? If you re not enrolling in the Consumer Plan, do you want to enroll in a Health Care FSA? Do you have dependent care needs? If so, would you like to contribute to a Dependent Care FSA? Which vision plan works best for you? Do you need Supplemental Life Insurance or Accidental Death and Dismemberment (AD&D) Insurance? Do you want to elect Dependent Life insurance? Do you want Basic or Enhanced Long-Term Disability (LTD) coverage? Do you need to update your beneficiary designations? Did you complete your Health Assessment, biometrics screening and earn wellness points for the 2015 Wellness Incentive Program? If so, view your total points at https://www.webmdhealth.com/ phillips66/ to help determine your 2015 monthly premium credit. As a reminder, due to the November 30, 2014 deadline, wellness points will not appear in the enrollment system. (Monthly premium credits are only available to employees who enroll in the Consumer Plan or PPO Plan in 2015.) 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): Go to HR Express and click the Enroll Now link. 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. 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. 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. ARE YOU TOBACCO FREE? If you do not use tobacco, you must certify as a non-tobacco user each year during Annual Benefits Enrollment to pay Tobacco Free rates for supplemental life insurance. 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 MEDICAL PLAN 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 CVS 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. EAP offerings will be expanded to include work/life resources to assist in areas such as child care, elder care, education and daily living. EAP will be renamed Resources for Life, reflecting the new services and the fact that it is available to you and your dependents. The HealthNet HMO (California) will be eliminated. 4 PHILLIPS 66 2015 ANNUAL BENEFITS ENROLLMENT
Consumer Plan PPO Plan Network Non-network Network Non-network Your monthly premium (BEFORE Wellness Incentive*) Annual deductible You only: $63.00 You + 1: $102.00 You + 2 or more: $135.00 You only: $1,400 You + 1 or more: $2,800 (Includes prescription drug costs) You only: $131.00 You + 1: $277.00 You + 2 or more: $372.00 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 Health Savings Account (HSA) or Health Care Flexible Spending Account (HCFSA) (Includes prescription drug costs) HSA-eligible Phillips 66 contributes: $500 (you only) $750 (you + 1 or more) You can contribute up to: $2,850 (you only) $5,900 (you + 1 or more) (Age 55 or over, you can make an additional contribution of $1,000) (Includes medical copays and prescription drug costs) HCFSA-eligible Phillips 66 contributes: $0 You can contribute up to: $2,500 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%, after deductible You pay 50%, after deductible $25 copay (primary care) You pay 50%, after deductible $50 copay (specialist) Most other services You pay 20%, after deductible You pay 50%, after deductible You pay 20%, after deductible You pay 50%, after deductible (continued) * If you complete a health assessment, biometric screening and other health activities before the November 30, 2014 deadline, your premium will be reduced by up to $75 per month based on the number of points earned. To view the points you have earned to date, go to HR Express and click on Health and Welfare, then WebMD for single sign on, or log on to WebMD at www.webmdhealth.com/phillips66. PHILLIPS 66 2015 ANNUAL BENEFITS ENROLLMENT 5
Consumer Plan PPO Plan Network Non-network Network Non-network Preventive prescription drugs Other network prescription drugs Deductible waived $1,500 covered at 100% You pay 20% thereafter at network providers and 50% at non-network providers You pay 100% of the negotiated discounted cost until you reach your annual deductible You pay 20% thereafter No special provisions for preventive prescription drugs 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. Health Maintenance Organization (HMO) If you live within a Kaiser Permanente service area in California, you can choose to enroll in the Kaiser HMO. For coverage details, contact Kaiser. Kaiser Permanente Website Phone number Monthly premium www.kaiserpermanente.org (800) 464-4000 You only: $132.16 You + 1: $262.93 You + 2 or more: $350.25 Reminder: HealthNet will no longer be available as of January 1, 2015. 6 PHILLIPS 66 2015 ANNUAL BENEFITS ENROLLMENT
FLEXIBLE SPENDING ACCOUNTS (FSAs) FSAs let you set aside money from your pay before taxes are calculated and use it to pay for eligible health care and dependent care expenses. Phillips 66 offers the Health Care FSA and Dependent Care FSA. Contributions are limited by the Internal Revenue Service (IRS) and you must use the money before the end of the year or you ll forfeit it (use it or lose it). The Phillips 66 FSA Plan is administered by WageWorks. When you enroll in an FSA for the first time, WageWorks will provide a health care debit card you can use to pay for eligible health care expenses. FSA cards from WageWorks expire every three years. ABOUT THE HEALTH SAVINGS ACCOUNT (HSA) You must be enrolled in the Consumer Plan (HSA-eligible) to contribute to an HSA or receive Phillips 66 HSA contributions. Your HSA is owned by you, the funds carry over from year to year, and you can take it with you even if you leave the company. If you enroll in the Consumer Plan (HSA-eligible), your contributions can be deducted from your paycheck on a before-tax basis and company contributions will be automatically credited to your account. For more information on the HSA, go to www.jpmorgan.com/phillips66hsa. For questions, call (866) 566-7101. You must enroll to participate in an FSA in 2015. For the Health Care FSA, you can contribute any amount from $120 up to $2,500. It s important to consider your anticipated needs because you will forfeit any FSA funds that aren t used to pay qualified expenses incurred during the year. For the Dependent Care FSA, you can contribute any amount from $120 up to $5,000. This helps you pay for qualified child care services (for example, day care) for children under the age of 13, or care for a disabled spouse or dependent of any age, which allows you (or, if you re married, you and your spouse) to work. For information on eligible health care and dependent care expenses, go to https://www.wageworks.com/employee/ eligible-expenses/ or http://www.irs.gov. PHILLIPS 66 2015 ANNUAL BENEFITS ENROLLMENT 7
DENTAL PLAN The Dental Plan provides coverage for regular checkups, basic, restorative, and major services and orthodontia. Network Non-network Your monthly premium You only: $7.00 You + 1: $15.00 You + 2 or more: $26.00 Annual deductible Annual maximum $50 individual and $150 family $2,000 per person Preventive 100% covered 80% covered Basic services 80% covered 50% covered Major services 50% covered 50% covered Orthodontia 50% covered $2,000 lifetime per person Before seeing your dentist, always check that he or she is still in the MetLife network. To do so, or to find a network dental provider if you don t already have one, go to www.metlife.com/mybenefits. Enter Phillips 66 Company in the box for company, and fill in your ZIP code. 8 PHILLIPS 66 2015 ANNUAL BENEFITS ENROLLMENT
VISION PLANS Phillips 66 has two vision plans administered by VSP, one of the nation s largest vision benefit and service carriers. The following chart shows benefits when you receive services from VSP network providers. For information on non-network coverage, see the Vision Highlights information on hr.phillips66.com. Provision Basic Plan (Company-Provided) Comprehensive Plan (Optional) Monthly premium Company-paid You only: $7.60 You + 1: $13.80 You + 2 or more: $21.15 Exam Covered in full Covered under Basic Plan Frames or contact lenses Discounts available $150 allowance every year Contact lens fitting Discounts available Covered in full Lenses Single vision, bifocal, trifocal, lenticular, polycarbonate (under age 19) Lens options Progressive, anti-reflective Discounts available Discounts available Covered in full every year Member pays VSP Preferred Pricing PHILLIPS 66 2015 ANNUAL BENEFITS ENROLLMENT 9
LIFE AND DISABILITY Now let s take a look at benefits that protect you and your family from the unexpected. Phillips 66 provides you with both basic life insurance at 1 times your annual pay and Occupational Accidental Death (OAD) insurance of $500,000. You pay nothing for this protection. You also have the option to purchase additional insurance for yourself and for your dependents. Employee Supplemental Life Insurance: You can purchase up to 8 times your annual pay in supplemental life insurance for yourself. Remember, if you do not use tobacco, you will be asked to attest that you are a non-tobacco user. Tobacco users will pay higher premiums for supplemental life insurance coverage through Phillips 66. Non-Tobacco User IMPORTANT REMINDER: Evidence of Insurability (EOI) will be required any time you increase your coverage. Tobacco User Age Monthly Premium (per $1,000) Age Monthly Premium (per $1,000) <30 $0.038 <30 $0.050 30 34 $0.052 30 34 $0.086 35 39 $0.058 35 39 $0.115 40 44 $0.064 40 44 $0.151 45 49 $0.092 45 49 $0.234 50 54 $0.138 50 54 $0.389 55 59 $0.250 55 59 $0.772 60 64 $0.438 60 64 $1.140 65 69 $0.859 65 69 $2.692 70+ $1.207 70+ $3.405 Remember, a tobacco user isn t necessarily a smoker it s anyone who uses tobacco. Phillips 66 will follow the federal definition of tobacco products, which includes cigars, cigarettes, smokeless tobacco (snuff or chewing tobacco), pipe tobacco or roll-your-own tobacco. You will be considered a non-tobacco user if you have not used tobacco more than four times in the prior six months. 10 PHILLIPS 66 2015 ANNUAL BENEFITS ENROLLMENT
Dependent Life Insurance: If you wish to purchase life insurance for your family, you have two options: High option: $75,000 for your spouse/ $25,000 for each dependent child. Low option: $40,000 for your spouse/ $15,000 for each dependent child. You can only increase your dependent coverage by one level during Annual Benefits Enrollment. For example, you can change from no coverage to the low option or from the low option to the high option. You can cancel coverage at any time. Dependent Life Insurance Monthly Premium High option $14.63 Low option $8.78 Long-Term Disability (LTD): Phillips 66 pays for short-term disability coverage, but if you wish to purchase additional income protection in the event you experience a disability that exceeds 52 weeks, you need to enroll in one of two LTD options: Basic coverage, which pays 50% of your pre-disability earnings; or Enhanced coverage, which pays 60% of your pre-disability earnings. The maximum benefit cannot exceed $20,000 per month. Long-Term Disability (LTD) Basic LTD Enhanced LTD Monthly Premium $0.402 per $100 of monthly pay $0.522 per $100 of monthly pay Employee Accidental Death and Dismemberment (AD&D): You can purchase from $20,000 to $1 million of AD&D coverage (in increments of $10,000), but the amount cannot exceed 12 times your pay. Dependent AD&D: If you have AD&D insurance, you can purchase from $20,000 to $500,000 of AD&D coverage for your spouse, and from $10,000 to $50,000 for each of your eligible children. However, an individual dependent s coverage cannot exceed your employee AD&D coverage. AD&D Insurance Monthly Premium Employee AD&D (no age limit) Spouse AD&D (ends at age 70) $0.014 per $1,000 of coverage Child AD&D (ends at age 25) PHILLIPS 66 2015 ANNUAL BENEFITS ENROLLMENT 11
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. Ask Alex at www.alexforphillips66.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. 12 PHILLIPS 66 2015 ANNUAL BENEFITS ENROLLMENT
YOUR ENROLLMENT CHECKLIST* Benefit Coverage My Elections (mark your choices) Medical Consumer Plan You only ($63.00/month) You + 1 ($102.00/month) You + 2 or more ($135.00/month) PPO Plan You only ($131.00/month) You + 1 ($277.00/month) You + 2 or more ($372.00/month) Kaiser Permanente HMO (CA only) You only ($132.16/month) You + 1 ($262.93/month) You + 2 or more ($350.25/month) No coverage Coverage waived Health Savings Account HSA (Consumer Plan only) You only: Up to $2,850 Amount: You + 1 or more: Up to $5,900 Can add $1,000 if over age 55 Flexible Spending Accounts Health Care FSA Up to $2,500 Amount: Dependent Care FSA Up to $5,000 Amount: Dental Dental Plan You only ($7.00/month) You + 1 ($15.00/month) You + 2 or more ($26.00/month) Vision Basic Plan Family Coverage X Comprehensive Plan (includes basic coverage) You only ($7.60/month) You + 1 ($13.80/month) You + 2 or more ($21.15/month) Life and Disability OAD $500,000 X Basic Life 1x your annual pay X Employee Supplemental Life Up to 8x your annual pay Amount: Dependent Life High option ($75,000 spouse; $25,000 each child) Low option ($40,000 spouse; $15,000 each child) Employee AD&D $20,000 to $1 million Amount: Spouse AD&D $20,000 to $500,000 Amount: Child AD&D $10,000 to $50,000 Amount: Short-Term Disability Varies based on years of service X Basic LTD 50% pre-disability pay Enhanced LTD 60% pre-disability pay Other Resources for Life (formerly EAP) Family coverage X * This is for personal use only. PHILLIPS 66 2015 ANNUAL BENEFITS ENROLLMENT 13
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-ACTGuide-HB-2014-14