Benefits. Comparing Your. Review this guide for more detailed information. other benefits and important terms to know.

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1 Benefits Comparing Your Medical Reference Options Guide Review this guide for more detailed information For about Medicare-Eligible your health and Retirees welfare, life insurance and other benefits and important terms to know.

2 Personal Choice 65 PPO In-Network Annual Deductible N/A $1,000 Annual Out-of-Pocket Maximum $6,700 $1,000 Out-of-Network Lifetime Maximum (per person) N/A N/A Hospital Services Room and Board 100% 70% after deductible Medical Care 100% 70% after deductible Doctor s Visits 100% 70% after deductible Surgeon s Fees 100% 70% after deductible Outpatient Emergency Treatment 100% after $15 copayment Outpatient Services Doctor s Office Visits 100% after $2 copayment; 70% after deductible no copayment at specialist Routine Physical Exams 100% after $2 copayment 70% after deductible Lab Tests, X-rays, Mammograms, etc. 100% 70% after deductible Basic Immunizations 100% after $2 copayment 70% after deductible Allergy Testing and Treatment 100% after $2 copayment; 70% after deductible no copayment at specialist Minor Surgery 100% 70% after deductible Durable Medical Equipment100% 70% after deductible Mental Health Inpatient 100%; 190-day lifetime benefit 70% after deductible maximum for care in a Medicareapproved inpatient facility (including inpatient substance abuse treatment received in a hospital) Outpatient 100% for first two visits; 70% after deductible 100% after $10 copayment per visit for visits 3 10; 100% after $25 copayment per visit for visits 11+ Continued on next page 1 exelonbenefits.com EXELON ( )

3 Continued from previous page Personal Choice 65 PPO In-Network Out-of-Network Substance Abuse Inpatient 100% up to 90-day lifetime benefit 70% after deductible maximum for care in a Medicareapproved residential (non-hospital) substance abuse treatment facility (a combined 190-day lifetime maximum for substance abuse treatment received in a hospital and inpatient mental health care) Outpatient 100% 70% after deductible Prescription Drugs (provided through OptumRx (formerly Catamaran))¹ Retail Generic: $5 copayment Preferred brand: $10 copayment Non-preferred brand: $25 copayment Home Delivery Generic: $10 copayment Preferred brand: $20 copayment Non-preferred brand: $50 copayment 1 If you have questions about your prescription drug coverage, please call OptumRx at Benefits described in this chart apply to covered services only. exelonbenefits.com EXELON ( ) 2

4 Keystone 65 site65.com Your Doctor You choose a participating primary care physician (PCP) Annual Deductible N/A Annual Out-of-Pocket Maximum $6,700 Lifetime Maximum (per person) N/A Hospital Services Room and Board 100% Medical Care 100% Doctor s Visits 100% Surgeon s Fees 100% Outpatient Emergency Treatment 100% after $15 copayment (waived if admitted) Outpatient Services Doctor s Office Visits 100% after $2 copayment at PCP; no copayment at specialist Routine Physical Exams 100% after $2 copayment Lab Tests, X-rays, 100% Mammograms, etc. Basic Immunizations 100% after $2 copayment Allergy Testing and Treatment 100% after $2 copayment at PCP; no copayment at specialist Minor Surgery 100% Durable Medical Equipment100% Mental Health Inpatient 100%; 190-day lifetime benefit maximum for care in a Medicare-approved inpatient facility (including inpatient substance abuse treatment received in a hospital) Outpatient 100% for first two visits; 100% after $10 copayment per visit for visits 3 10; 100% after $25 copayment per visit for visits 11+ Continued on next page 3 exelonbenefits.com EXELON ( )

5 Continued from previous page Keystone 65 site65.com Substance Abuse Inpatient Outpatient 100% Prescription Drugs (provided through OptumRx (formerly Catamaran))¹ 100% up to 90-day lifetime benefit maximum for care in a Medicare-approved residential (non-hospital) substance abuse treatment facility (a combined 190-day lifetime maximum for substance abuse treatment received in a hospital and inpatient mental health care) Retail Generic: $5 copayment Preferred brand: $10 copayment Non-preferred brand: $25 copayment Home Delivery Generic: $10 copayment Preferred brand: $20 copayment Non-preferred brand: $50 copayment 1 If you have questions about your prescription drug coverage, please call OptumRx at or visit mycatamaranrx.com/exelon-medicare. Benefits described in this chart apply to covered services only. exelonbenefits.com EXELON ( ) 4

6 65 Special ibx.com Medicare Medical Plan Major Medical¹ Annual Major Medical Deductible Individual N/A N/A $150 Family N/A N/A $450 Annual Major Medical Out-of-Pocket Maximum Individual N/A N/A $1,000 Family N/A N/A $2,000 Lifetime Maximum N/A N/A N/A (per person) Hospital Stay First 60 days 100% of eligible $1,288² Part A N/A expenses after $1,288² Part A deductible deductible days 100% of eligible expenses over $322² each day $322² each day N/A After 90 days (while using 60 lifetime reserve days) Once lifetime reserve days are used Additional 365 days (non-renewable lifetime maximum) Beyond the additional 365 days 100% of eligible expenses over $644² each day $644² each day N/A $0 100% of eligible days if medically necessary N/A $0 $0 80% after deductible 1 Major Medical covers 80% of the reasonable and customary fee for those medically necessary services that are not covered by Medicare or 65 Special, after payment of the individual or family Major Medical deductible. Major Medical is also subject to a lifetime maximum and certain exclusions. 2 Based on 2016 Medicare deductibles and covered amounts deductibles and covered amounts, if different, will apply. Continued on next page 5 exelonbenefits.com EXELON ( )

7 Continued from previous page 65 Special ibx.com Medicare Medical Plan Major Medical¹ Skilled Nursing Facility Care First 20 days 100% of eligible $0 N/A expenses days 100% of eligible Up to $161² each day N/A expenses over $161² each day After 100 days $0 OPTION: 365 lifetime days can be used in hospital or skilled nursing facility 80% after deductible Durable Medical Equipment 80% after annual $161 Part B deductible², ³ 20% after annual $161 Part B deductible², ³ Blood First three pints $0 Three pints N/A Additional amounts 100% of eligible $0 N/A expenses Medical Expenses Medicare-allowed amount Charges above Medicare-allowed amount 80% after annual $161 Part B deductible², ³ 20% after annual $161 Part B deductible², ³ Charges in excess of Medicare-allowed amount up to the Blue Cross and Blue Shield reasonable and customary amount, at 80% after deductible $161 Part B deductible² $0 $0 Charges in excess of Medicare-allowed amount up to the Blue Cross and Blue Shield reasonable and customary amount, at 80% after deductible 1 Major Medical covers 80% of the reasonable and customary fee for those medically necessary services that are not covered by Medicare or 65 Special, after payment of the individual or family Major Medical deductible. Major Medical is also subject to a lifetime maximum and certain exclusions. 2 Based on 2016 Medicare deductibles and covered amounts deductibles and covered amounts, if different, will apply. 3 If you use one of Medicare's participating providers. Continued on next page exelonbenefits.com EXELON ( ) 6

8 Continued from previous page 65 Special ibx.com Home Health Care Medically necessary skilled care, services and medical supplies (see page 6 for durable medical equipment benefits) Medicare Medical Plan Major Medical¹ 100% of eligible expenses $0 Outpatient private duty nursing (RN or LPN) up to 240 hours per year at 80% after deductible Prescription Drugs (provided through OptumRx (formerly Catamaran)) $0 See chart on page 8 N/A 1 Major Medical covers 80% of the reasonable and customary fee for those medically necessary services that are not covered by Medicare or 65 Special, after payment of the individual or family Major Medical deductible. Major Medical is also subject to a lifetime maximum and certain exclusions. 2 Based on 2016 Medicare deductibles and covered amounts deductibles and Benefits described in this chart apply to covered services only. covered amounts, if different, will apply. 7 exelonbenefits.com EXELON ( )

9 65 Special ibx.com Participants in 65 Special pay coinsurance, or a percentage of each prescription s total cost. The percentage of the cost depends on whether each prescription is a generic, preferred brand, non-preferred brand, lifestyle drug or non-sedating antihistamine. There are minimum and maximum payments for three of these medication categories. And, if you reach $1,500 in out-of-pocket prescription drug costs for a covered individual in a year, Exelon will pay 100% of the prescription drug costs for that individual for the rest of the year. 65 Special Prescription Drug Coverage Type of Medication Plan Pays You Pay Retail (up to 31-day Supply) Home Delivery (up to 90-day Supply) Retail (up to 90-day Supply) Minimum Maximum Minimum Maximum Minimum Maximum Generic 90% 10% $5 $15 $10 $25 $15 $45 Preferred 80% 20% $15 $30 $25 $50 $45 $90 Brand Non-Preferred Brand 70% 30% $30 $50 $50 $85 $90 $150 Lifestyle Drugs 50% 50% N/A N/A N/A There is a $1,500 annual prescription drug out-of-pocket limit for each covered individual. If you have questions about your prescription drug coverage, call OptumRx at or visit mycatamaranrx.com/exelon-medicare. exelonbenefits.com EXELON ( ) 8

10 Health Care Plan Privacy Notice Available Under the privacy rules of the Health Insurance Portability and Accountability Act ( HIPAA ), Exelon Corporation s group health care plans must give participants a notice describing their rights and the legal duty of the plans with respect to certain health information that may identify you ( protected health information ). The notice also includes information regarding the manner in which the plan may use and disclose personal health information. A copy of this notice is maintained on our benefits website, exelonbenefits.com. In addition, if you would like a paper copy of this notice, you may request a copy directly from the Vice President, Health & Benefits or submit your request in writing to: Privacy Officer Request for Privacy Notice, Vice President, Health & Benefits, Exelon Corporation, 10 S. Dearborn St., 50th Floor, Chicago, IL Note: For all medical programs, the following procedures are covered when done in connection with a mastectomy: reconstruction of the breast on which the mastectomy was performed; surgery and reconstruction of the other breast to produce a symmetrical appearance; and prostheses and treatment of physical complications of all stages of mastectomy, including lymphedemas. This comparison chart contains information about Exelon s medical plan, but it does not give all the details. If there are any differences between the information contained here and the official plan documents, the official plan documents will govern. ENB GF Post-65 9/ Printed on Mohawk Via, 100% PC Cool White, which contains 100% postconsumer waste and process-chlorine-free fiber and is manufactured with wind power.