Effective Jan. 1, 2017, the Devon Energy Corporation Premium Reimbursement Plan was renamed the Devon Energy Corporation Pre-65 Retiree Medical Plan.? A new Devon-insured group plan is now being offered to provide eligible retirees a choice of two arrangements.? Please see below for highlights of each arrangement.?

Eligible retirees who choose Arrangement 1 will enroll in 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, and individual medical needs/preferences.? Upon obtaining a plan through Mercer Marketplace and completing all participation requirements, Devon will establish an unfunded health reimbursement account (HRA) in your name to allow the company to reimburse 80 percent of your monthly premium up to a maximum monthly reimbursement amount (MMRA).

Enrollment Options
Below are highlights of the two arrangements:

Arrangement 1:? Individual Pre-65 Plan with Premium Reimbursement

  • Individual or family plan offered by a third party insurance company
  • You choose the available plan structure that best fits your needs
  • Administered (including enrollment) by Mercer Marketplace; if a plan is not available for your zip code through Mercer, Devon will reimburse for plans purchased on the federal or state exchange
  • You will receive reimbursement of up to 80% of your monthly premium, this is called the “MMRA”

Arrangement 2:? Group Plan with Premium Offset

  • Devon-insured group health coverage
  • High-deductible Health Plan, HSA compatible, utilizing a large PPO network
  • Administered by BlueCross BlueShield of Illinois (BCBS) with enrollment through their affiliate Blue Directions
  • Devon subsidizes this arrangement through an offset of the applicable monthly premium using the same MMRA available for Arrangement 1

Eligibility

Devon Employee

  • Terminated employment at age 55 or older* with 10+ years of continuous service
  • Must have been covered by the active employee medical plan at time of termination
  • Cannot be eligible for Medicare due to age or disability

*If Devon employee is age 65 or older, spouse may still be eligible to participate if all other requirements are met.

Spouse

  • Must be the legal?spouse of a former Devon employee who terminated employment at age 55 or older with 10+ years of continuous service
  • Must have been covered by the active employee medical plan on the Devon employee's employment termination date
  • Cannot be eligible for Medicare due to age or disability

Dependent Children

  • Coverage for dependent children is governed by the terms of the policy or policies for which you enroll. Dependent children do not generate a reimbursement from Devon.

Monthly Maximum Reimbursement Amount (MMRA)

The MMRA is determined by the retiree participant's years of continuous service and age at employment termination. The MMRA for an?eligible spouse is determined by the retiree participant's years of continuous service and the spouse's age on the retiree participant's employment termination date.

Under Arrangement 1, Devon will reimburse 80 percent of your monthly premium for a health insurance plan obtained through Mercer Marketplace up to a maximum Monthly Reimbursement Amount (MMRA).

Under Arrangement 2, Devon subsidizes this arrangement through an offset of the applicable monthly premium using the same MMRA available for Arrangement 1.

Devon has no plans to change the MMRA in the future, but reserves the right to increase, decrease or terminate the MMRA at any time.

Health Reimbursement Account (HRA) - Arrangement 1 only

Once you obtain a health plan through Mercer Marketplace and complete the remaining requirements to participate in the plan, Devon will establish an unfunded, tax-advantaged HRA for you. Please review the following?important details about this account.

Account

  • One account owned by the Retiree Participant until death. At death, eligible surviving spouse becomes owner.
  • Requests for reimbursement must be signed by the Retiree Participant or surviving spouse.
  • Devon will?reimburse your HRA with MMRA funds?as reimbursement requests are received.

Covered Expenses

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

Rollover Rules

  • None. Your HRA is a notional account with no specific funds set aside on your behalf to create a balance in the account. There is 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.

Questions

For questions about the Devon Pre-65 Retiree Medical Plan, 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 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

Medical Flexible Spending Account (FSA)

If you were enrolled in an FSA when you left Devon, 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 877-889-1718 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 800-842-1718.


Wellness

The Well and the Doc

Oklahoma City employees who are retiring from Devon and meet the eligibility requirement can join and use The Well and also receive medical services 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 for Well use. Contact the Doc directly to schedule appointments. 

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.