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Phillips 66 2015 ANNUAL BENEFITS ENROLLMENT FOR COBRA PARTICIPANTS
2015 ANNUAL BENEFITS ENROLLMENT
FOR COBRA PARTICIPANTSOctober 31 – November 21, 2014
P H I L L I P S 6 6 2 0 1 5 A N N U A L B E N E F I T S E N R O L L M E N T 1
ANNUAL BENEFITS ENROLLMENT 101: THE BASICSYou 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
• Vision
• Resources for Life (formerly EAP)
Even if you’re happy with your current coverage, it’s important for you to realize that 2015 plan changes could affect you in terms of premiums and coverage. If you don’t enroll during Annual Benefits Enrollment, your plan elections will carry over into 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?
✔✔ 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?
✔✔ Which vision plan works best for you?
✔✔ If you’re not already enrolled in Resources for Life (formerly EAP), is that something you’d like to do?
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IT’S EASY TO ENROLLOnce 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.
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.
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.
P H I L L I P S 6 6 2 0 1 5 A N N U A L B E N E F I T S E N R O L L M E N T 3
YOUR 2015 ANNUAL BENEFITS ENROLLMENT CHOICESMEDICAL 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 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.
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Consumer Plan PPO Plan
Network Non-network Network Non-network
Your monthly premium
You only: $430.78
You + 1: $939.93
You + 2 or more: $1,271.43
You only: $629.34
You + 1: $1,370.88
You + 2 or more: $1,855.38
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%, after deductible
You pay 50%, after deductible
$25 copay (primary care)
$50 copay (specialist)
You pay 50%, after deductible
Most other services
You pay 20%, after deductible
You pay 50%, after deductible
You pay 20%, after deductible
You pay 50%, after deductible
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)
P H I L L I P S 6 6 2 0 1 5 A N N U A L B E N E F I T S E N R O L L M E N T 5
Consumer Plan PPO Plan
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.
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 www.kaiserpermanente.org
Phone number
(800) 464-4000
Monthly premium
You only: $638.68
You + 1: $1,341.23
You + 2 or more: $1,788.32
Reminder: HealthNet will no longer be available as of January 1, 2015.
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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: $37.74
You + 1: $76.50
You + 2 or more: $133.62
Annual deductible $50 individual and $150 family
Annual maximum $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.
P H I L L I P S 6 6 2 0 1 5 A N N U A L B E N E F I T S E N R O L L M E N T 7
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 Comprehensive Plan
Monthly premium You only: $0.82
You + 1: $1.47
You + 2 or more: $2.24
You only: $7.75
You + 1: $14.08
You + 2 or more: $21.57
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)
Discounts available Covered in full every year
Lens options — Progressive, anti-reflective
Discounts available Member pays VSP Preferred Pricing
RESOURCES FOR LIFE (FORMERLY EAP)
If you’re currently enrolled in EAP, your coverage will continue in 2015. If you’re not enrolled, you can do so during Annual Benefits Enrollment. Resources for Life provides up to five face-to-face counseling sessions per issue per year. Your monthly cost is $1.73 regardless of how many dependents you cover.
RESOURCESThis 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.
• “COBRA Continuation Coverage” in the Other Information SPD.
• Benefits Center at (800) 965-4421, Monday – Friday, 8:00 a.m. – 6:00 p.m. Central time.
Make sure you understand all your options, so you can make informed choices. Then enroll in your 2015 benefits.
Enroll online before midnight, Central time or by phone before 6:00 p.m., Central time on November 21, 2014.
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YOUR ENROLLMENT CHECKLIST*
Benefit CoverageMy Elections (mark your choices)
Medical
Consumer Plan You only ($430.78/month)
You + 1 ($939.93/month)
You + 2 or more ($1,271.43/month)
PPO Plan You only ($629.34/month)
You + 1 ($1,370.88/month)
You + 2 or more ($1,855.38/month)
Kaiser Permanente HMO (CA only)
You only ($638.68/month)
You + 1 ($1,341.23/month)
You + 2 or more ($1,788.32/month)
No coverage Coverage waived
Dental
Dental Plan You only ($37.74/month)
You + 1 ($76.50/month)
You + 2 or more ($133.62/month)
Vision
Basic Plan You only ($0.82/month)
You + 1 ($1.47/month)
You + 2 or more ($2.24/month)
Comprehensive Plan You only ($7.75/month)
You + 1 ($14.08/month)
You + 2 or more ($21.57/month)
Other
Resources for Life (formerly EAP)
Family coverage ($1.73/month)
* This is for personal use only.
P H I L L I P S 6 6 2 0 1 5 A N N U A L B E N E F I T S E N R O L L M E N T 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-COBGuide-HB-2014-15
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