Effective Jan. 1, 2016, the Pre-65 Retiree Medical plan was replaced with the Devon Energy Corporation Premium Reimbursement Plan (Devon Pre-65 PRP). This new plan offers more coverage options, increased efficiencies and helps address medical cost inflation for both retirees and the company.

To receive benefits under the new plan, retirees will obtain a medical insurance plan through Mercer Marketplace, a private benefits exchange. Mercer offers a variety of plan options and provides personal assistance to help you choose ideal coverage based on your location, budget, individual medical needs/preferences and more.

Once enrolled in a medical plan through Mercer Marketplace, Devon will establish an unfunded tax-advantaged Health Reimbursement Account (HRA) in which participants will receive up to 80% reimbursement of the monthly premium.

Devon Pre-65 PRP eligibility and participation information for Devon retirees and spouses is provided by the Devon Retirement Service Center via mail or with pension materials. Key factors to remember:

  • Eligible 2015 Pre-65 Retiree Medical plan participants must be enrolled in a new plan for 2016 obtained through Mercer Marketplace by Dec. 15, 2015 to participate in the 2016 Devon Pre-65 PRP.
  • Individuals who become eligible for the plan must enroll in a medical plan obtained through Mercer Marketplace within 60 days following your employment termination date. If you do not, you will no longer be eligible to participate in the Devon Pre-65 PRP.

Coverage under the Devon Pre-65 PRP will end on the date of or within a specific time frame following certain events or actions including, but not limited to:

  • Retiree participant or spouse reaches age 65
  • Retiree participant or spouse becomes eligible for Medicare due to disability (excluding end-stage renal disease)
  • Failure to maintain continuous coverage
  • Spouse has been covered for 10 years

Review the information below to learn more about the HRA and the monthly maximum reimbursement amount.

Health Reimbursement Account (HRA)

Account

  • One account owned by the Retiree Participant until death. At death, surviving spouse becomes owner.
  • Requests for reimbursement must be signed by the Retiree participant or surviving spouse.

Covered Expenses

Up to 80% of premiums for medical insurance plan obtained through Mercer Marketplace (excludes dental and vision)

Rollover Rules

No rollover – no funding until reimbursement.

Reimbursement Requests

Reimbursement requests for covered expenses incurred in a calendar year must be submitted on or before March 31 of the following year.

Monthly Maximum Reimbursement Amount (MMRA)

Retiree participant terminated employment on or after 1/1/2016

MMRA determined by:

  • Years of continuous service at retiree participant employment termination date
    • Minimum continuous service – 10 years
    • Maximum continuous service – 35 years
  • Retiree participant age and/or spouse age at retiree participant employment termination date.
    • Minimum age – 55
    • Maximum age - 64

Questions

For questions about the Devon Pre-65 PRP, contact the Devon Retirement Service Center at retirement@dvn.com or (888) 338-6676.

COBRA (which stands for the Consolidated Omnibus Budget Reconciliation Act of 1985) may allow you to temporarily extend health care benefits in the event you leave the company or otherwise lose coverage. COBRA applies to medical, dental, vision, EAP benefits and, in some circumstances, the medical flexible spending account. You pay the cost of COBRA, and coverage can last up to 18 or 36 months depending on the qualifying event that caused you to lose coverage. The 18-month coverage can be extended to 29 months due to a disability. If you are eligible for COBRA benefits, you will receive complete details and cost information in the mail.

Below are the details on qualifying for COBRA coverage through Devon.

Qualifying Event

Length of Coverage

  • Your employment ends
  • A reduction in your hours worked causes loss of coverage

Up to 18 months

If you or anyone in your family is disabled and you notify the plan administrator
within 60 days of disability determination and before the end of the original
18-month period, you and your dependents may be entitled to receive up to an
additional 11 months of coverage.

Up to 29 months

COBRA allows qualified beneficiaries to elect to continue their health care
coverage because one of the following qualifying events:

  • You divorce or legally separate
  • You become entitled to Medicare (For this purpose, “entitled” means the
    effective date of enrollment in either Medicare Part A or B, whichever
    occurs earlier. It does not mean eligibility to enroll.)
  • Your child is no longer eligible for dependent coverage
  • You die

Be Advised: Removing a dependent from coverage during an open enrollment period
is not a qualifying event and that dependent would not be eligible to receive COBRA.

Up to 36 months

Other options for health care benefits that may be available at a lower cost based on loss of coverage include:

  • If you are married and your spouse’s employer offers coverage, he/she can enroll you and any other eligible dependents.
  • If you are under age 26, a parent can add you to his/her employer plan. Your dependents would not be eligible for coverage on a parent’s plan.
  • You can choose a plan from the government healthcare exchange at www.healthcare.gov


Health Savings Account (HSA)

If you were enrolled in the Choice PPO+ medical plan with an HSA while you were employed at Devon, then this account and all of the money currently in it is still yours to use. Your current health care coverage will determine what you can and cannot do with your HSA funds.

Enrolled in Medicare

Once you enroll in Medicare, you are no longer eligible to contribute to an HSA. Here is what you can do with your HSA funds:

  • Continue investing for future growth
  • Pay for qualified medical expenses (see IRS Publication 502)
  • Pay for Medicare premiums if you are 65 or older (does not apply to Medicare supplemental policies)
  • Pay for long-term care insurance premiums (subject limits outlined in the instructions for Schedule A of IRS Form 1040)
  • Rollover or transfer HSA assets to another HSA account (at Fidelity or another entity)

If you are disabled or age 65 or older, you can take HSA distributions for non-qualified medical expenses without incurring the additional 20 percent tax. However, these distributions will be subject to income tax.

Enrolled in an Eligible HDHP

Whether or not you are continuing to work (for yourself or another employer) after leaving Devon, if you are enrolled in an eligible high deductible health plan (HDHP) you can:

  • Continue making contributions up to the annual maximum (see IRS Publication 969)
  • Continue investing for future growth
  • Pay for qualified medical expenses (see IRS Publication 502)
  • Rollover or transfer HSA assets to another HSA account (at Fidelity or another entity)

Enrolled in an Ineligible Health Plan

Again, whether or not you continue working after leaving Devon, if you enroll in a health plan that does not meet the deductible requirements for an HSA, you can:

  • Continue investing for future growth
  • Pay for qualified medical expenses (see IRS Publication 502)
  • Rollover or transfer HSA assets to another HSA account (at Fidelity or another entity)

Contacts

HSA administrator

Fidelity Investments

(800) 890-4015

Health Reimbursement Account (HRA)

If you were enrolled in the Choice PPO medical plan when you left Devon and earned the wellness incentive for the HRA, then the money in the account when you left is available to you use until the end of the calendar year in which the HRA was established for claims incurred while you were an active Devon employee. You cannot submit claims for expenses incurred after your employment ended. At the end of the plan year, all remaining HRA funds will be forfeited.

Medical Flexible Spending Account (FSA)

If you were enrolled in the Choice PPO medical plan when you left Devon and contributed to an FSA, you have 90 days from your last day of work to submit your claims for eligible expenses incurred up to your last day of work. You cannot submit claims for expenses incurred after your employment ended. Any FSA funds remaining after the 90 day period ends will be forfeited.

Life and AD&D Insurance

Basic and voluntary insurance coverages stopped on your last day of work. However, you have the option to convert your life insurance coverage to an individual policy within 30 days of your last day of work. Prudential offers two conversion options:

  • Life Conversion: The Life Conversion is a whole life policy with a guaranteed cash value and a guaranteed death benefit for the lifetime of the insured. It is the more costly option, but is a viable alternative if you do not meet the requirements for the Portability option and may have difficulty securing life insurance elsewhere.
  • Portability: The Portability Option is a term life policy with no cash value. You may only elect the Portability option if you had optional life insurance. You are not eligible for this option if you are retiring or disabled.

You must contact Prudential directly at 800-524-0524 to convert your policy.

Long-term Disability

If you left Devon due to disability and have met the eligibility qualifications for long-term disability benefits, your maximum period of payment (as long as you continue to meet the terms outlined in the plan documents) is:

Your Age on Date Disability Begins

Your Maximum Period of Benefits

Under age 61

To your normal retirement age*, but not less than 60 months

Age 61

To your normal retirement age*, but not less than 48 months

Age 62

To your normal retirement age*, but not less than 42 months

Age 63

To your normal retirement age*, but not less than 36 months

Age 64

To your normal retirement age*, but not less than 30 months

Age 65

24 months

Age 66

21 months

Age 67

18 months

Age 68

15 months

Age 69 and over

12 months

*Your normal retirement age is your retirement age under the Social Security Act where retirement age depends on your year of birth.

For questions about long-term disability benefits, please contact Prudential at 866-439-9026.


Wellness

The Well

Oklahoma City employees who are retiring from Devon and meet the eligibility requirement can join and use The Well as an Alumni Member. Review the Retiree Member Terms of Usage and the Terms and Conditions and Release and Waiver of Liability for complete details.

Disclaimer: The information set forth on devonenergy.com is a summary of information regarding benefit plans that Devon currently has in place. In the case of a conflict between the official plan documents and the summary information furnished on devonenergy.com, the official plan documents will govern. Devon reserves the right to terminate, amend or modify plans or any benefits under its various benefit plans, in whole or in part, at any time.