SUPPLEMENT TO THE CONOCOPHILLIPS RETIREE MEDICAL

Transcription

2022RETIREEBENEFITSHANDBOOKEffective January 1, 2022

WelcomeWelcome to the ConocoPhillips Retiree Benefits HandbookiiContactsA-1Retiree Medical – Pre-Age 65 PlanB-1Retiree Medical – Age 65 and Over PlanC-1Houston Onsite Medical Clinic Former Employee PlanD-1Retiree Dental PlanE-1Retiree Life InsuranceF-1Retiree Accidental Death & Dismemberment InsuranceG-1Other Information/ERISAH-1GlossaryI-1Appendix I — Grandfathered Retiree Medical and DentalInsurance Benefit ProvisionsJ-1Appendix II — Grandfathered Retiree Life Insurance BenefitProvisionsK-1This handbook is the Summary Plan Description (SPD) for the ConocoPhillips retiree health andwelfare plans. Additionally, if you are enrolled in a plan that’s insured and provides you an insurancecontract and Certificate of Coverage, that insurance contract and the Certificate of Coverage willbe considered a part of the SPD for that insured plan. When you enroll you will receive informationabout how to access the current cost for most of the plans described in this handbook. Thatinformation and any Summaries of Material Modifications that are issued should be maintainedwith this handbook. If you are enrolled in a plan that’s insured by an insurance contract, sectionsof this handbook that do not apply to you will be indicated. Some retirees are not eligible toparticipate in the plans described in this handbook. Receipt of this handbook does not mean youare eligible to participate in all the plans described. To be eligible to participate in a particular plan,you must meet the eligibility requirements outlined for that plan. This handbook does not describehealth and welfare benefits for current employees. Every effort has been made to ensure theaccuracy of this handbook. If there is any conflict between this handbook and the official plandocuments, the official plan documents will control. If an insurance contract exists, it is part of theofficial plan document and will control. The Appendices of this handbook contains details of certainhistorical official plan provisions. The Company reserves the right to amend or terminate a plan atany time, in its sole discretion, according to the terms of the plan.2022Welcomei

Welcome to the ConocoPhillipsRetiree Benefits HandbookConocoPhillips is committed to your overallhealth and well-being, and we’re pleased to offera quality, competitive retiree benefits packagethat provides valuable health care and financialprotection for you and your family.But remember, it’s your responsibility to makesure you understand your benefits and use themwisely. This easy-to-use handbook, which featuresimportant information about our retiree benefitplans, is designed to help you do just that.iiWelcome2022

Features to Help YouStaying Up to DateWithin the handbook, you’ll find features to help increaseyour understanding of the benefit plan being described.These features include:The benefit information in this handbook will beupdated from time-to-time, as necessary. When thathappens, you’ll receive a notice of what’s changingand when. Be sure to keep any updates with thishandbook for easy access. Examples — We’ve included several examples of yourbenefits at work. As you see your benefits “in action,”you’ll get a working understanding of the mechanics ofyour ConocoPhillips benefit plans and how they mightapply to you.Additional information about your ConocoPhillipsretiree benefits is available on hr.conocophillips.com. Icons — The following icons placed throughout the texthighlights essential information for you:p Refers you to other sections in the handbook thatprovide additional information on the subject.c Highlights information of special importance. Contacts — For easy reference, this chapter, located atthe front of the handbook, provides you with the phonenumbers, addresses, and websites for benefit planresources when you have questions or need contactinformation.cDue to COVID-19, the windows for certain benefitadministration due dates in this handbook weresuspended until the earlier of i) one year from theoriginal due date or ii) 60 days after the announcedend of the National Emergency, i.e., end of theoutbreak period. Contact the Claims Administratorfor further information. Glossary — Some benefit terms used in this handbookhave very specific meanings. These terms are underlinedthroughout this book, and you’ll find their definitions inthe “Glossary” at the end of the handbook.2022Welcomeiii

Welcome2022

ContactsPlan AdministrationA-2COBRA AdministrationA-3Claims and ServicesA-3Retiree Medical – Pre-Age 65Medical and Prescription DrugRetiree Medical – Age 65 and OverMedical BenefitsHouston Onsite Medical Clinic Former Employee PlanRetiree DentalDental BenefitsRetiree Life, AD&D and Disability PlansLife InsuranceAccidental Death & Dismemberment (AD&D) InsuranceDisability BenefitsAA-4A-4A-5A-5A-5A-5A-5A-6A-6A-7A-7 Mobile Accessible2022ContactsA-1

Plan AdministrationFor Information on:Contact/AddressPhone/Operating HoursMedical Benefits(Applies for all retirees eligible forRetiree Medical Pre-Age 65 Plan)Benefits CenterP.O. Box 310512Des Moines, IA 50331-0512(800) 622-5501 or (718) 354-1344 Eligibility criteria to participateWeb:Enrollment, changing coverage Changing personal information(including dependent information)Visit hr.conocophillips.com to see benefitplan information Payment of premiumsVisit http://mybenefits.conocophilllips.comfor personal and benefit plan informationand enrollmentsQualified Medical Child SupportOrders (QMCSO)Medical Benefits(Applies for all retirees eligible forRetiree Medical Age 65 and Over Plan) Web: www.UHCRetiree.com/conocophillips.com(855) 323-1665Enrollment, changing coverage8:00 a.m. to 8:00 p.m. local time,Monday – Friday (calls outside of thesehours will be routed for after-hoursself-service)Changing personal informationTTY/TDD 711Payment of premiumsFax: (888) 836-3985Eligibility criteria to participateDental Benefits(Applies for all retirees eligible for retireemedical insurance) Eligibility criteria to participateUnitedHealthcare DentalAttn: M/S CA 120-0451P.O. Box 6020Cypress, CA 90630-0020Enrollment, changing coverageWeb:www.myuhc.comChanging personal information(including dependent information)Email: SG13001@uhc.com Payment of premiumsLife and Accidental Death &Dismemberment (AD&D) Insurance Eligibility criteria to participate Coverage amountsA-27:00 a.m. to 7:00 p.m. Central time,Monday – FridayEnrollment, changing coverageChanging personal information(including dependent information)Payment of premiumsBenefits CenterP.O. Box 310512Des Moines, IA 50331-0512Web: Visit hr.conocophillips.com to see benefitplan information Visit http://mybenefits.conocophilllips.comfor personal and benefit plan informationand enrollments(800) 996-75637:00 a.m. to 10:00 p.m. Central time,Monday – FridayFax: (844) 608-0601(800) 622-5501 or (718) 354-13447:00 a.m. to 7:00 p.m. Central time,Monday – FridayContacts2022

For Information on:Contact/AddressPhone/Operating HoursContinuing your medical benefitsBenefits CenterP.O. Box 310512Des Moines, IA 50331-0512(800) 622-5501 or (718) 354-1344Web:Fax: (515) 343-2246 Visit hr.conocophillips.com to see benefitplan information Visit http://mybenefits.conocophilllips.comfor personal and benefit plan informationand enrollmentsContactsCOBRA Administration7:00 a.m. to 7:00 p.m. Central time,Monday – FridayClaims and ServicesThe Plans described in this Summary Plan Description (SPD) have a Benefits Committee that has delegated certainresponsibilities to others, which may include the administration of claims. Contact information provided belowidentifies others who have been delegated authority to assist you with your participation in the Plans, includingthe filing of claims. See the “How to File a Claim” section in each of the health and welfare benefit plan chapters for details on filing abenefit claim. See the information in this section for the Claims Administrators and their contact information. See “Claims and Appeals Procedures” for information on how to appeal a denied claim and for the Appeals Administrators’contact information.p “Claims and Appeals Procedures,” page H-20 See “Plan Administration” for descriptions of the Benefits Committee’s rights and responsibilities and its contact information.p “Plan Administration,” page H-42022ContactsA-3

Retiree Medical – Pre-Age 65For Information on:Contact/AddressPhone/Operating HoursMedical and Prescription DrugYou should contact the appropriate parties identified below if you have questions about: Network providersCovered and non-covered expensesID cardsClaimsMedical BenefitsHDHP and HDHP Base (Blue ChoicePPO network) OptionsBlue Cross and Blue Shield of TexasMedical Claims AdministratorP.O. Box 660044Dallas, TX 75266-0044Web: hr.conocophillips.com orwww.bcbstx.com(800) 343-47097:00 a.m. to 9:00 p.m. Central time,Monday – Friday (calls outside of thesehours will be routed for after-hoursself-service)Blue Access for Members (BAM)(for self-service)MDLive(for physician telephone medical consultation)Blue Distinction Centers(for transplants, cardiac, orthopedic, bariatric procedures)Well-Being Management*(health-management service on complex conditions tolifelong wellness)Blue365 (access to health & wellness products/services)* Not available to participants on Medicare.2nd MD(for medical second opinions)Web: www.2nd.md.conocophillipsGlobal Core(for traveling outside the U.S.)Web: bcbsglobalcore.com(866) 841-25757:00 a.m. to 7:00 p.m. Central time,Monday – Saturday(800) 810-258324 hours/day, 365 days/yearOutside the U.S.:(804) 673-1177 (call collect)24 hours/day, 365 days/yearPrescription Drug BenefitsCVS CaremarkTMClaims AdministratorP.O. Box 52136Phoenix, AZ 85072-2136Web: hr.conocophillips.com 55) 293-411824 hours/day, 365 days/yearFor Specialty Pharmacy:(800) 237-27676:30 a.m. to 8:00 p.m. Central time,Monday – FridayFor ExtraCare Health Card:(888) 543-59388:00 a.m. to 10:00 p.m. Eastern time,Monday – Friday10:00 a.m. to 6:30 p.m. Eastern time,Saturday – SundayA-4Contacts2022

For Information on:Contact/AddressPhone/Operating HoursRetiree Medical Age 65 and OverFor medical claims: Covered and non-coveredexpenses ID cardsUnitedHealthcare Insurance CompanyP.O. Box 31362Salt Lake City, UT 84131-0362For Members:(855) 323-1665ContactsRetiree Medical – Age 65 and OverMedical Benefits8:00 a.m. to 8:00 p.m. local time,Monday – Friday (calls outside of thesehours will be routed for after-hoursself-service)ClaimsWeb: www.uhcretiree.com/conocophillipsNetwork providersFor prescription drug claims:TTY/TDD 711Telephonic Nurse SupportOptumRxP.O. Box 650287Dallas, TX 75265-0287For Medical Providers:(877) 842-3210Wellness programs8:00 a.m. to 8:00 p.m. local time,Monday – FridayFor Pharmacists:(877) 889-651024 hours/day, 365 days/yearHouston Onsite Medical Clinic Former Employee PlanFor Information on:Contact/AddressPhone/Operating Hours Houston Onsite Medical Clinic925 N. Eldridge PkwySuite E-C4-1-N353Houston, TX 77079(713) 984-6650Clinic servicesAppointmentsCosts7:00 a.m. to 11:45 a.m. Central time,1:00 p.m. to 3:45 p.m. Central time,Monday – FridayWeb: hr.conocophillips.comRetiree DentalFor Information on:Contact/AddressPhone/Operating HoursRetiree Dental(Applies for retirees eligible for retireemedical insurance and enrolled in aUHC dental option)UnitedHealthcare DentalAttn: M/S CA 120-0451P.O. Box 6020Cypress, CA 90630-0020(800) 996-7563 Network providersWeb:Covered and non-covered expensesEmail: SG13001@uhc.comClaimsPremium payment only:Dental Benefitswww.myuhc.com7:00 a.m. to 10:00 p.m. Central time,Monday – FridayFax: (844) 608-0601UnitedHealthcare DentalP.O. Box 887910Los Angeles, CA 90080-79102022ContactsA-5

Retiree Life, AD&D and Disability PlansFor Information on:Contact/AddressPhone/Operating HoursBenefits CenterP.O. Box 310512Des Moines, IA 50331-0512(800) 622-5501 or (718) 354-1344Life InsuranceLife Insurance Plan Claim filingCoverage questionsBeneficiary designationsQuestions after a claim hasbeen paid or deniedConversion coverageadministrationAdditional information for certainheritage Tosco retirees — AppliesONLY to heritage Tosco retirees affectedby the life insurance provisions listed inAppendix IIp“Appendix II,” page K-17:00 a.m. to 7:00 p.m. Central time,Monday – FridayWeb: Visit hr.conocophillips.com to see benefitplan information Visit http://mybenefits.conocophilllips.comfor personal and benefit plan informationand enrollmentsThe HartfordGroup Life Claims AdministratorMaitland Claims OfficeP.O. Box 14299Lexington, KY 40512-4299(888) 563-1124The HartfordPortability and Conversion UnitP.O. Box 248108Cleveland, OH 44124-8108(877) 320-04848:00 a.m. to 8:00 p.m. Eastern time,Monday – FridayFax: (866) 954-26219:00 a.m. to 5:00 p.m. Eastern time,Monday – FridayFax: (440) 646-9339If you are on a waiver of premium due to a disability,there are various life insurance companies insuring thecoverage and they will contact you periodically. Youwill need to keep the insurer’s contact information inyour records for questions or when a claim is to bereported.If you have a life insurance benefit from a pensionplan, you will need to keep the annuity payor’s contactinformation in your records for questions or when aclaim is to be reported.(continued)A-6Contacts2022

Contact/AddressPhone/Operating HoursContactsFor Information on:Accidental Death & Dismemberment (AD&D) InsuranceAccidental Death & Dismemberment(AD&D) Plan Claim filingCoverage questionsBeneficiary designationsQuestions after a claim hasbeen paid or deniedConversion coverageadministrationBenefits CenterP.O. Box 310512Des Moines, IA 50331-0512Web: Visit hr.conocophillips.com to see benefitplan information Visit http://mybenefits.conocophillips.comfor personal and benefit plan informationand enrollments(800) 622-5501 or (718) 354-13447:00 a.m. to 7:00 p.m. Central time,Monday – FridayThe HartfordGroup AD&D Claims AdministratorMaitland Claims OfficeP.O. Box 14299Lexington, KY 40512-4299(888) 563-1124The HartfordPortability and Conversion UnitP.O. Box 248108Cleveland, OH 44124-8108(877) 320-0484MetLife Disability Claims AdministratorP.O. Box 14590Lexington, KY 40511-4590(800) 638-2242The HartfordP.O. Box 14869Lexington, KY 40512(888) 301-5615Web: www.abilityadvantage.thehartford.comFax: (833) 357-51538:00 a.m. to 8:00 p.m. Eastern time,Monday – FridayFax: (866) 954-26219:00 a.m. to 5:00 p.m. Eastern time,Monday – FridayFax: (440) 646-9339Disability BenefitsLong-Term Disability Plan Questions after a claim has beenapproved (if first day of eliminationperiod is Dec. 31, 2019 or before)Long-Term Disability Plan Questions after a claim has beenapproved (if first day of eliminationperiod is Jan. 1, 2020 or after)Additional information for participantsdisabled prior to Jan. 1, 2003 (or priorto Jan. 1, 2009 if from a BurlingtonResources Inc. company)2022Contacts8:00 a.m. to 11:00 p.m. Eastern time,Monday – Friday8:00 a.m. to 8:00 p.m. Eastern time,Monday – FridayIf your disability benefit payment is not fromMetLife, you will need to keep your insurer’s contactinformation in your records for questions and benefitprovisions.A-7

Contacts2022

Retiree Medical – Pre-Age 65 PlanIntroductionB-4Who Is EligibleB-5Retiree EligibilityIf You Are Rehired/Hired by the CompanyIf Your Eligible Dependent Is Also a Company Employee or RetireeDependent EligibilityDependent Certification RulesIf You or a Dependent Becomes Eligible for MedicareB-7B-8B-9B-9When to Enroll, Change or Cancel CoverageB-10B-11When Coverage BeginsChanging or Cancelling Your CoverageWhat the Plan CostsCost-Sharing Based on the 65-Point RuleHDHP and HDHP Base OptionsHow the 65-Point Rule WorksCompany ContributionsPlan ee Medical Benefit HighlightsB-16Medical OptionsB-22About the High Deductible Health Plan (HDHP) & HDHP Base OptionsNetwork ProvidersNon-Network ProvidersThe HDHP & HDHP Base Options and Health Savings Accounts (HSAs)2022B-5B-6B-6How to Enroll, Change or Cancel CoverageLate EnrollmentRetiree Medical – Pre-Age 65 PlanBB-23B-23B-23B-24B-1

How the Retiree Medical Plan WorksB-25About Network ProvidersTo Find an HDHP or HDHP Base Network ProviderUsing Network ProvidersTransition of CareSome Basic TermsAnnual DeductibleCoinsuranceAnnual Out-of-Pocket MaximumLifetime Maximum BenefitImportant Plan FeaturesParPlan (PAR) ProvidersMDLiveBlue Access for Members (BAM)2nd MDHealth Advocacy Solutions (HAS)Well-Being ManagementBlue365Pre-AuthorizationPredetermination of BenefitsUtilization Review and Patient ManagementBlue Distinction Centers (BDC)Traveling Outside the United StatesCovered ExpensesDurable Medical EquipmentFoot CareEarsHospices, Hospitals, Home Care and InstitutionsPregnancy or Sexual FunctionPrescription DrugsSurgery, Therapy, Medical and Physician ServicesTransportationNon-Covered ExpensesEars, Eyes, MouthExpenses Payable by OthersFoot CareHospices, Hospitals, Home Care and InstitutionsNot Medically Necessary or ReasonablePregnancy or Sexual FunctionsPrescription DrugsSelf-Inflicted InjuriesWeight LossOther General -38B-39B-39B-39B-39B-39B-40B-40Retiree Medical – Pre-Age 65 Plan2022

Retiree Medical – Pre-Age 65 PlanPrescription Drug CoverageRetail Pharmacy ProgramMail Order/Maintenance Choice ProgramCovered Medications and SuppliesNon-Covered Medications and SuppliesSpecial Rules for Participants Living Outside the United StatesHealth Improvement ProgramsHow to File a ClaimClaim Review and Appeal ProcedureB-48B-49B-49B-50Coordination With MedicareAnnual CertificationB-51In the Event of Your Death2022B-42B-43B-44B-45B-47B-48Coordination of Benefits (COB)When Coverage EndsRetiree Medical – Pre-Age 65 PlanBB-51B-52B-53B-3

IntroductioncpPlease refer to the Glossarybeginning on page I-1for the definitions ofunderlined terms usedthroughout this SPD.“Glossary,” page I-1In this chapter, the term“Company” is used todescribe ConocoPhillips andthe other companies whoseretirees are covered by thisPlan. The term “retiree” isused to describe an eligibleparticipant and does notimply any pension planeligibility or benefit.cThis chapter applies to you only if you’re: An eligible retiree who is under age 65;An eligible retiree’s eligible dependent who is under age 65;A grandfathered participant-2010; orA grandfathered participant-2009.The ConocoPhillips Retiree Medical Pre-Age 65 Plan (the Plan) provides you andyour family with important protection against the financial hardship that oftenaccompanies illness or injury. The Plan has been designed to provide medicalcoverage for you and your family at a competitive cost.Depending on the age of you and your eligible dependents, you may be eligible forthe following medical options: The High Deductible Health Plan (HDHP) option. Note: This option is available onlyto eligible participants who are under age 65 and not eligible for Medicare or whoare a grandfathered participant-2010 or a grandfathered participant-2009; and The High Deductible Health Plan Base (HDHP Base) option. Note: This option isavailable only to eligible participants who are under age 65 and not eligible forMedicare or who are a grandfathered participant-2010 or a grandfatheredparticipant-2009.B-4Retiree Medical – Pre-Age 65 Plan2022

You are a heritage Burlington Resources Inc.The following groups are not eligible for the retireemedical coverage described in this chapter: Heritage Burlington Resources Copper Range retirees Heritage Tosco retirees under a Senior ExecutiveRetirement Plan Heritage Tosco El Dorado union-represented retirees Ineligible Phillips 66 retirees Retiree EligibilityYou’re eligible to participate in the Plan if you’re underage 65 and not eligible for Original Medicare and: You were a U.S. citizen or U.S. resident alien whenyour employment ended; and:– You were an employee paid on the direct U.S. dollarpayroll1 when your employment ended;– You are an eligible participant who is not subject tothe additional eligibility exclusions described under“Late Enrollment” and in “Appendix I”;p “Late Enrollment,” page B-11; “Appendix I,” page J-1– You met one of the following criteria: You are a terminated ConocoPhillips non-storeemployee and you meet the 65-point rule2,3 forretiree medical eligibility (age plus years of service);or You are a terminated heritage Conoco, heritagePhillips, heritage Tosco individual and you meet theeligibility requirements as outlined in Appendix I; or123retiree, heritage Burlington Resources Post-1986Louisiana Land & Exploration (LL&E) retiree,heritage Burlington Resources Pre-1986 LouisianaLand & Exploration (LL&E) retiree or heritageBurlington Resources Pre-1986 El Paso retiree whoseemployment ended prior to Jan. 1, 2009, and youmeet the eligibility requirements as outlined inAppendix I; orYou are a grandfathered participant-2009(includes age 65 and over) or a grandfatheredparticipant-2010 (includes age 65 and over); orcWhen you or any of your eligible dependents becomeeligible for Medicare due to being age 65 or beingunder age 65 and disabled (excludes grandfatheredparticipants-2010 or grandfathered participants-2009 andtheir eligible dependents), the participant will no longerbe eligible for this Plan. The participant will only be eligiblefor the Retiree Medical Age 65 and Over Plan if enrolled inOriginal Medicare Parts A and B.p“Retiree Medical – Age 65 and Over,” page C-1Direct U.S. dollar payroll means that payroll check is written in U.S. dollars by a U.S. company participating in the Plan and is not converted to another currencybefore being paid to the employee.If you were an employee of COG Operating LLC on Jan. 15, 2021, when COG was acquired by ConocoPhillips, you became a ConocoPhillips employee on Jan. 1,2022; however, you were not eligible for retiree medical insurance. On Jan. 1, 2023, your years of service at COG Operating LLC will be added to the ConocoPhillipsyears of service to determine the points accrued under the 65-point rule for retiree medical insurance eligibility. Note: COG Operating LLC is also known asConcho Resources.If you were a former Shell Enterprises LLC employee who transferred to ConocoPhillips with the Permian assets and had been hired by Shell on or after Jan. 1, 2018,the years of service at Shell will be added to the ConocoPhillips years of service on Dec. 1, 2023 to determine the points accrued under the 65-point rule. If instead,you were the transferred employee who was hired by Shell prior to Jan. 1, 2018, your years of service at Shell will be added to the ConocoPhillips years of serviceupon transfer to ConocoPhillips to determine the points accrued under the 65-point rule for retiree medical insurance eligibility.2022Retiree Medical – Pre-Age 65 PlanB-5Retiree Medical – Pre-Age 65 PlanWho Is Eligible

You terminate employment with the Companyon or after Jan. 1, 2003, and you meet all of thefollowing criteria:– You’re approved for long-term disability (LTD)benefits under the ConocoPhillips Long-TermDisability Insurance Plan (LTD Plan);– Your disability started prior to your employmentend date;– You received approval for LTD benefits within12 months of your employment end date or theend of the elimination period defined by the LTDPlan; and– You continue to be eligible for LTD benefits; orSee “Late Enrollment” and “Appendix I” foradditional eligibility provisions.p “Late Enrollment,” page B-11; “Appendix I,” page J-1 You are a surviving spouse/eligible dependent child ofan employee eligible for the Employee Medical Plan ora retiree eligible for this Plan. See “What the Plan Costs”for cost sharing provisions. Additional exclusions apply;see “Late Enrollment” and “Appendix I” for information; orp “Late Enrollment,” page B-11; “What the Plan Costs,”page B-14; “Appendix I,” page J-1 You are a surviving domestic partner of an employee/retiree who was eligible for this Plan, provided you wereenrolled in employee or retiree medical coverage on thedate of the employee’s/retiree’s death. Surviving childrenof a domestic partner are not eligible. See “What the PlanCosts” for cost sharing provisions. Additional exclusionsapply; see “Late Enrollment” and “Appendix I” forinformation.p “Late Enrollment,” page B-11; “What the Plan Costs,”page B-14; “Appendix I,” page J-1Note: Special rules apply if your spouse/domesticpartner is also a Company employee or retiree.p“If Your Eligible Dependent Is Also a Company Employeeor Retiree,” at rightIf You Are Rehired/Hired by the CompanyYour retiree coverage (as a retiree, as a survivingspouse/domestic partner or as a surviving dependent)will end effective on the date the coverage you electas an eligible active employee begins. When yousubsequently end your employment, you can elect theretiree medical insurance coverage provisions availableto you based on your age at the time of re-enrollment.If you are considered an ineligible Phillips 66 retiree whenhired by ConocoPhillips and later become eligible forConocoPhillips retiree benefits, you will no longer beconsidered an ineligible Phillips 66 retiree.If Your Eligible Dependent Is Also a CompanyEmployee or RetireecReview the rules used in determining dependent eligibilityunder the Plan.p“Dependent Eligibility,” page B-7If you have an eligible dependent (spouse/domesticpartner, dependent child) who is also employedby ConocoPhillips, a pre-age-65 retiree ofConocoPhillips or a grandfathered participant-2010or a grandfathered participant-2009, neither younor any eligible dependent can be covered by morethan one Company medical plan, including COBRA.Dual coverage is prohibited even if the other medicalcoverage is union-sponsored medical coverage.If both you and your spouse/domestic partner are retiredfrom ConocoPhillips, your election is considered to be aseparate election from your spouse’s/domestic partner’selection and cannot be changed during the calendaryear unless a change in status occurs (e.g., you getdivorced, gain or lose a dependent, change in jobstatus, etc.).pB-6“Changing or Cancelling Your Coverage,” page B-13Retiree Medical – Pre-Age 65 Plan2022

cIf an eligible dependent has other medical coverage (inaddition to coverage under this Plan) or is eligible forMedicare, refer to this Plan’s coordination of benefits(COB) provisions.p“If You or a Dependent Become Eligible for Medicare,”page B-9; “Coordination of Benefits (COB),” page B-50If you enroll in the Plan, your eligible dependents mayalso be enrolled for coverage. Eligible dependentsinclude your: Spouse (including your state-recognized common-lawspouse1; excluding a spouse after a divorce or separationby a legal separation agreement2) or your domesticpartner; and Child, as follows:– Your biological, legally adopted (includes foreignadoptions) or placed for adoption child;– Your domestic partner’s biological or legally adoptedchild (includes foreign adoptions), provided the childreceives over 50% of his or her support from you andhas the same principal place of abode as you for thetax year; or– Your stepchild, provided the parent is your spouseand you and your spouse either remain married andreside in the same household or your spouse diedwhile married to you.You can cover the child/stepchild/domestic partner’schild if he or she is:– Under age 263; or– Age 26 or older, provided the child was disabled priorto age 26 and coverage is approved by the Plan within30 calendar days of his or her reaching age 26 or initialeligibility after age 264.1234The common-law marriage must be consummated in a state thatrecognizes common-law marriage, and all state requirements must havebeen met.The Plan will recognize a decree of legal separation or court-approved legalwritten separation agreement of any kind — including a court-approvedseparate maintenance agreement.Your child is considered an eligible dependent up to age 26 regardless ofstudent status, marital status, employment status and/or IRS dependentrequirements.A disabled dependent over age 26 who is disabled prior to age 26 may enrollin the Plan (i) during annual enrollment or (ii) if such disabled dependentexperiences a qualified change in status.2022Retiree Medical – Pre-Age 65 PlanNote: A dependent is not eligible if he or she: Is on active duty in any military service of any country(excluding weekend duty or summer encampments); Is not a U.S. citizen, resident alien or resident of Canadaor Mexico; Is already covered under a Company medical planas an employee, retiree or as a dependent of either(including COBRA participants and excluding the RetireeMedical Age 65 and Over Plan); Is covered under the Phillips 66 retiree medical plan; Is the child of a domestic partner and has been claimedas a dependent on your domestic partner’s or onanybody else’s federal tax return for the year of coverage; Is the child of a domestic partner and the domesticpartnership between you and your domestic partner hasended, even if your domestic partner’s child continues toreside with you; Is the child of a surrogate mother (is not consideredthe child of the egg donor) and does not qualify as adependent otherwise; Is no longer your stepchild due to divorce, legalseparation or annulment; Is a grandchild not legally adopted by you; Is placed in your home as a foster child or under a legalguardianship agreement; or Is in a relationship with you that violates local law.In addition, retirees age 65 and over who are eligiblefor and regardless of whether they enroll or not in theRetiree Medical Age 65 and Over Plan can enroll theireligible dependents who are under age 65 and noteligible for Original Medicare in this Plan. (Thosedependents aren’t eligible for the Retiree MedicalAge 65 and Over Plan.)p“Retiree Medical – A

This supplement is a legally required Summary of Material Modifications (SMM) to the ConocoPhillips Retiree Medical – Pre-Age 65 Plan (“Pre-Age 65 Plan”), a component plan of the ConocoPhillips Retiree Medical and Dental Plan. When combined with the Retiree Ben