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Ameren Retiree Medical Plan 1 Revised January 2009 AEE-G38 A Plan Designed to Provide Security for Retirees of Ameren Retiree Medical Plan Administered by: Principal Life Insurance Company and Express Scripts Amended and Restated January 1, 2009 ERISA Summary Plan Description. This document constitutes the Summary Plan Description required by the Employee Retirement Income Security Act of 1974 (“ERISA”) § 102.

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Page 1: Ameren Retiree Medical Plan - IBEW LOCAL · PDF fileAmeren Retiree Medical Plan 3 Revised January 2009 AEE-G38 Your Role in Controlling Healthcare Costs Making choices about Your health

Ameren Retiree Medical Plan 1 Revised January 2009 AEE-G38

A Plan Designed to Provide Security for Retirees of

Ameren Retiree Medical Plan

Administered by: Principal Life Insurance Company

and Express Scripts

Amended and Restated January 1, 2009

ERISA Summary Plan Description. This document constitutes the Summary Plan Description required by the Employee Retirement Income Security Act of 1974 (“ERISA”) § 102.

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Ameren Retiree Medical Plan 2 Revised January 2009 AEE-G38

Purpose

Ameren Corporation (“Ameren”) maintains the Ameren Retiree Medical Plan (“Plan”) to provide health benefits for certain Ameren Retirees and their lawful Spouse or domestic partner, and other eligible Dependents. Ameren Retirees covered under the Plan include only those Retirees defined in the ELIGIBILITY section of this booklet. The Ameren Retiree Medical Plan has been established on a noninsured basis; all liability for payment of benefits is assumed by Ameren. While Principal Life Insurance Company and Express Scripts administer the payment of claims, Principal Life Insurance Company and Express Scripts have no liability for the funding of the benefit Plan. While one of the functions of Principal Life Insurance Company and Express Scripts is to process claims according to the Plan provisions, all claims under the Plan are paid by Ameren and Ameren owns the claim files. Therefore, the final decision on any disputed claim may involve review of these files by Ameren Services. The Plan Administrator has complete discretion to construe or interpret all provisions, to determine eligibility for benefits, and to determine the type and extent of benefits, if any, to be provided. The Plan Administrator’s decisions in such matters shall be controlling, binding, and final. In any action to review any such decision by the Plan Administrator, the Plan Administrator shall be deemed to have exercised its discretion properly unless it is proved duly that the Plan Administrator has acted arbitrarily and capriciously. As a Covered Retiree of the Plan, Your rights and benefits are determined by the provisions of the Plan. This booklet briefly describes those rights and benefits. It outlines what You must do to be covered. It explains how to file claims. DURATION OF THE PLAN. Ameren hopes and expects to continue the Retiree Medical Plan in the years ahead but cannot guarantee to do so. The Company reserves the right to amend, modify, or terminate the Plan with respect to all individuals, including current and future Retirees and their eligible Dependents. PLEASE READ YOUR BOOKLET CAREFULLY. We suggest that You start with a review of the terms listed in the DEFINITIONS Section. The meanings of these terms will help You understand the provisions of Your Plan. Terms defined in the DEFINITIONS Section of this booklet are capitalized in this document. This Summary Plan Description supersedes all prior summary plan descriptions and outlines the provisions and benefits afforded under the Plan as of January 1, 2009. The Company reserves the right to unilaterally amend or terminate the Plan and/or any benefits provided under the Plan at any time. The Plan shall be construed and administered to comply in all respects with applicable federal law. Administered by: PRINCIPAL LIFE and EXPRESS SCRIPTS INSURANCE COMPANY One Express Way Des Moines, IA 50392-0001 St. Louis, MO 63121

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Ameren Retiree Medical Plan 3 Revised January 2009 AEE-G38

Your Role in Controlling Healthcare Costs

Making choices about Your health can sometimes be difficult. When You seek health care, take the same approach You use for buying anything else. Ask questions. Make sure You get the most appropriate care for Your condition. Use the following guidelines to help You be a wise health care consumer: Practice Good Health Habits. Staying healthy is the best way to control Your medical costs.

Eat a balanced diet, exercise regularly, and get enough sleep. Learn how to handle stress. Stop smoking and avoid excessive use of alcohol.

See Your Physician Early. Don't let a minor problem become a major one. This makes

Treatment more difficult and expensive. Make Sure You Need Surgery. If You are unsure about the surgery You face, You may want

to get a Second Opinion. If You need surgery, ask about same day surgery. Many procedures can be performed safely without an overnight Hospital stay. You may be able to have these surgeries as an outpatient or at a place other than a Hospital and go home the same day.

Use Outpatient Services for X-ray or Laboratory Tests. Outpatient preadmission and

diagnostic tests can save costly room and board charges. Compare Prescription Drug Prices. Discuss the use of generic drugs with Your Physician or

pharmacist. Generic drugs are often cheaper than brand name drugs for the same quality. Consider Hospital Stay Alternatives. Home Health Care, Skilled Nursing Facilities, and

Hospice Care Services offer quality care in comfortable surroundings for less cost than staying in the Hospital.

Review Medical Bills Carefully. Make sure You understand all charges and receive bills only

for Services You receive. Keep Your medical records up-to-date. Talk to Your Physician. Discuss the need for Treatment with Your Physician. It's Your body.

To make wise health care decisions, You must understand the Treatment and any risks or complications involved. Ask about Treatment costs too. With today's health care costs, Your Physician will understand Your concern about Your medical expenses.

Be a wise health care consumer. Review Your benefits carefully so You can make informed health care decisions. You can help control health care costs while getting the most Your health care Plan has to offer. In addition to the medical coverage provided under the Plan, Your health plan may also offer programs to help You stay healthy and/or manage disease. Check with them to see what is available. Ameren has chosen Healthways, Inc. as its disease management provider. Healthways, Inc. is only applicable to participants in the HealthLink Standard PPO, HealthLink Health Savings PPO and Basic Plan options. Healthways, Inc. Care Enhancement (Disease Management) programs provide a comprehensive approach to care that supports patients and their Physicians working together to improve health outcomes. This program supports people with specific chronic health conditions, is confidential, and is offered at no additional cost to You and Your eligible Dependents. If You or one of Your Dependents are identified to participate, a Welcome Letter

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Ameren Retiree Medical Plan 4 Revised January 2009 AEE-G38

and a call from a Healthways, Inc. nurse will be received. Both of these will explain the benefits of the program. Your participation is voluntary. Participation in the Healthways, Inc. Care Enhancement Program ends when the Covered Individual becomes eligible for Medicare. Except as provided by applicable law, the Healthways program is not available to you and/or your covered Dependents if this Plan is secondary with respect to you and/or all of those covered Dependents in accordance with the rules set forth in the COORDINATION WITH OTHER

BENEFITS section of this Plan. Five Tips For Improving Your Overall Health and Wellness

Want to become healthier, but don’t know where to start? Check out these five tips for improving your overall health and wellness. 1. Eat right. Better nutrition is about more than knowing which foods are good for you and

which ones are bad. It’s also about eating the right amounts of foods and the right mix of foods from all five food groups (grains, vegetables, fruits, milk, and meat and beans).

2. Get moving. Everyone knows that they should exercise, but actually fitting it into our daily lives is often another story. Nevertheless, exercise is an essential part of creating a healthy lifestyle. The American Academy of Physicians recommends that you exercise 4 – 6 times a week for 30 – 60 minutes.

3. Maintain a healthy weight. Determining if your weight is normal has to do with more than just pounds – it also has to do with your height. You can use a Body Mass Index (BMI) calculator to get a more complete idea of your weight.

4. Reduce stress. Stress is a common part of everyday life and a certain amount of stress is actually good for you. Too much stress can negatively affect your digestive, immune, nervous and cardiovascular systems. Look for your stress triggers and work to change your reaction to them.

5. Know your health status and take steps to improve it. By taking an active role in managing your health, you can help prevent or delay the onset of chronic conditions. Go to the doctor each year for a physical and get all recommended preventive health screenings and tests. Ask your doctor what you can do to improve your cholesterol, blood pressure and other health numbers.

Medical Benefit Information

Principal Life Insurance Company can answer questions about Your benefit program or specific coverage (and Prescription Drug benefits if You are enrolled in the HealthLink Health Savings PPO Plan). The staff provides information on topics such as outpatient surgery, health care alternatives, health care providers, and Treatment costs in Your area. The staff does not prescribe medical Treatment. That is up to Your Physician. But they can help You understand Your benefits and how to use them in the most cost-effective manner. Call the toll-free number below (this number is also shown on Your medical Plan ID card) if You wish to discuss medical benefits with the Principal staff.

866.482.6028

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Ameren Retiree Medical Plan 5 Revised January 2009 AEE-G38

Express Scripts can assist You with questions regarding Your Prescription Drug coverage and benefits (unless You participate in the HealthLink Health Savings PPO Plan). You can reach one of their customer service representatives at 888.256.6131. Ameren Benefits Center

The Ameren Benefits Center is Ameren’s employee benefits customer call center. When You have a question about Your benefits, call the Ameren Benefits Center at 877.7my.Ameren (877.769.2637). The Ameren Benefits Center is available Monday through Friday from 8:00 a.m. to 6:00 p.m., Central Standard Time (CST). myAmeren Benefits Web

Ameren maintains myAmeren Benefits Web at www.myAmeren.com where active and retired Plan participants can enroll, view, or make changes to elected benefit coverage.

myAmeren Benefits Web is generally available 24 hours a day, seven days a week. (Note: There may be short maintenance periods during which benefits information will not be available). In order to maintain confidentiality, a password is required to view Your individual benefit information. If You have forgotten Your password, You can request a new password on the logon screen. Questions about Your benefits should be directed to the Ameren Benefits Center at 877.7my.Ameren (877.769.2637). If You don’t have access to a computer, You can manage Your benefits by calling the Ameren Benefits Center at 877.7my.Ameren (877.769.2637).

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Ameren Retiree Medical Plan 6 Revised January 2009 AEE-G38

Ameren Retiree Medical Plan Table of Contents

PURPOSE ..................................................................................................................... 2 YOUR ROLE IN CONTROLLING HEALTHCARE COSTS ................................................................. 3 FIVE TIPS FOR IMPROVING YOUR OVERALL HEALTH AND WELLNESS............................................ 4 MEDICAL BENEFIT INFORMATION ....................................................................................... 4 AMEREN BENEFITS CENTER............................................................................................... 5 MYAMEREN BENEFITS WEB ............................................................................................... 5 ELIGIBILITY .................................................................................................................. 7 ENROLLMENT PROVISIONS...............................................................................................16 DEFINITIONS ...............................................................................................................23 RETIREE MEDICAL PLAN OPTIONS .....................................................................................33 SCHEDULE OF BENEFITS FOR NON-MEDICARE ELIGIBLE RETIREES .............................................35 SCHEDULE OF BENEFITS FOR MEDICARE ELIGIBLE RETIREES.....................................................45 PLAN PROVISIONS APPLICABLE TO ALL RETIREES ..................................................................49 MEDICAL EXPENSE COVERAGE ..........................................................................................51 UTILIZATION MANAGEMENT REVIEW ..................................................................................65 PRESCRIPTION DRUG CARD PROGRAM ................................................................................71 TERMINATION OF BENEFITS .............................................................................................79 RIGHT TO CERTIFICATE OF CREDITABLE COVERAGE ...............................................................80 CONTINUATION OF BENEFITS FOR SURVIVING DEPENDENTS OF DECEASED RETIREES......................80 CONTINUATION OF BENEFITS FOR CERTAIN SURVIVING DEPENDENTS OF DECEASED ACTIVE EMPLOYEES

WHERE DEPENDENT IS NOW ELIGIBLE FOR MEDICARE............................................................81 COBRA CONTINUATION .................................................................................................82 PRIVACY PRACTICES ......................................................................................................86 COORDINATION WITH OTHER BENEFITS .............................................................................88 SUBROGATION AND REIMBURSEMENT .................................................................................92 CLAIM FILING PROCEDURES .............................................................................................93 MISCELLANEOUS PROVISIONS.........................................................................................102 YOUR RIGHTS UNDER ERISA.........................................................................................103 GENERAL INFORMATION ABOUT THE PLAN .........................................................................104 APPENDIX A...............................................................................................................107

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Ameren Retiree Medical Plan Eligibility

Several factors are considered when determining Your eligibility for coverage under the Ameren Retiree Medical Plan. These factors include:

� Your retirement date

� Your Years of Service at retirement

� The company You retired from

� Your status while an active employee (i.e. union affiliation, management, etc.)

� Your age at retirement

� Your participation or eligibility for participation in the group medical plan while an active employee.

Eligibility for the Ameren Retiree Medical Plan is defined in the following matrixes. Management Retirees1

If You are an Ameren management employee who retires on or after January 1, 2007, You are eligible for coverage under this Plan if You are age 55 or older on the date You retire and You meet the following criteria:

� Immediately prior to Your retirement, You were a regular, full-time employee eligible for active group health plan coverage OR a part-time employee covered under one of the Company’s group health plans; AND

� You accrued at least 10 Years of Service after reaching age 45 as an employee of Ameren.

If You are a management employee who retired prior to January 1, 2007, You are eligible for coverage under this Plan if You are age 55 or older on the date You retire and You meet the eligibility criteria described in the following matrix:

1Regardless of the eligibility requirements outlined in this matrix, you are eligible for coverage under this Plan if: (1) You

were a management employee who retired under the 1998 Special Separation Program and had attained age 50 as of

December 31, 1998; (2) You were a full-time regular management employee of Callaway who retired under the 2005

Voluntary Separation Plan (VSP) and had attained age 50 with at least ten (10) Years of Service on July 15, 2005 and

elected Retiree Medical Plan coverage upon attainment of your earliest eligibility date (age 55); (3) You were a

management employee age 50 or older as of December 31, 1998 and retired as part of the Special Grand Tower

Separation Plan negotiated with Local 148 I.U.O.E. (CIPS) with at least seven (7) Years of Service after age 45 as an

employee of AmerenCIPS; (4) you were a management employee who retired under the 2002 Voluntary Retirement

Program and had attained age 50 and had at least ten (10) years of service as of 12/31/2002; or (5) you were

determined to be eligible under the terms of any other individual special separation agreement.

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Ameren Retiree Medical Plan 8 Revised January 2009 AEE-G38

Company You retired

from

Your Retirement Date Was . . .

Eligibility Rules

AmerenUE Between January 1, 1992 and June 30, 1993

� Immediately prior to Your retirement, You were a regular, full-time employee eligible for active group health plan coverage OR part-time employee covered under one of the Company’s active group health plans.

� OR � You are a Medicare-eligible Dependent of a deceased active Union

Electric (“UE”) management employee who died prior to July 1, 1993.

AmerenUE Between July 1, 1993 and June 30, 1998

� Participant in “UE” benefit plans prior to July 1, 1998; AND � Immediately prior to Your retirement, You were a regular, full-time

employee eligible for active group health plan coverage OR part-time employee covered under one of the Company’s active group health plans; AND

� Accrued at least 10 Years of Service after reaching age 45 as an employee of Ameren Services, AmerenUE or AmerenCIPS; OR

� You are a Medicare-eligible Dependent of a deceased active AmerenUE employee who died between July 1, 1993 and June 30, 1998 and who participated in “UE” benefit plans prior to his/her death.

AmerenUE On or after July 1, 1998

� Immediately prior to Your retirement, You were a regular, full-time employee eligible for active group health plan coverage OR part-time employee covered under one of the Company’s active group health plans; AND

� Accrued at least 10 Years of Service after reaching age 45 as an employee of Ameren.

� OR � You are a Medicare-eligible Dependent of a deceased active

AmerenUE employee who died on or after July 1, 1998.

Ameren Services

Between July 1, 1993 and June 30, 1998

� Participant in “UE” benefit plans prior to July 1, 1998; AND � Immediately prior to retirement, You were a regular, full-time

employee eligible for active group health plan coverage OR part-time employee covered under one of the Company’s active group health plans; AND

� Accrued at least 10 Years of Service after reaching age 45 as an employee of Ameren Services, AmerenUE or AmerenCIPS

� OR � You are a Medicare-eligible Dependent of a deceased active Ameren

Services employee who died between July 1, 1993 and June 30, 1998 and who participated in “UE” benefit plans prior to his/her death.

Ameren Services

On or after July 1, 1998

� Immediately prior to retirement, You were a regular, full-time employee eligible for active group health plan coverage OR part-time employee covered under one of the Company’s active group health plans; AND

� Accrued at least 10 Years of Service after reaching age 45 as an employee of Ameren.

� OR � You are a Medicare-eligible Dependent of a deceased active Ameren

Services employee who died on or after July 1, 1998.

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Ameren Retiree Medical Plan 9 Revised January 2009 AEE-G38

Company You retired

from

Your Retirement Date Was . . .

Eligibility Rules

Central Illinois Public Service Company (CIPS)

Prior to January 1, 1992

� Participated in the CIPS Group Medical Plan for at least 10 years prior to Your retirement date; AND

� Were eligible for an early or normal retirement benefit from the CIPS Retirement Income Plan; AND

� Retired prior to reaching age 60 or Retired at age 60 with less than 25 years of Service (“Full Pay Retiree”).

� OR � You are a Medicare-eligible Dependent of a deceased CIPS Retiree

who met the eligibility requirements described above.

Central Illinois Public Service Company (CIPS)

Between January 1, 1992 and June 30, 1998

� Participant in “CIPS” benefit plans prior to July 1, 1998; AND � Participated in the CIPS Group Medical Plan for at least 10 years prior

to Your retirement date; AND � Were eligible for an early or normal retirement benefit from the CIPS

Retirement Income Plan; AND � OR � You are a Medicare-eligible Dependent of a deceased CIPS Retiree

who met the eligibility requirements described above.

AmerenCIPS Between July 1, 1993 and June 30, 1998

� Participant in “UE” benefit plans prior to July 1, 1998; AND � Immediately prior to retirement, You were a regular, full-time

employee eligible for active group health plan coverage OR part-time employee covered under one of the Company’s active group health plans; AND

� Accrued at least 10 Years of Service after reaching age 45 as an employee of Ameren Services, AmerenUE or AmerenCIPS.

� OR � You are a Medicare-eligible Dependent of a deceased active

AmerenCIPS employee who died between July 1, 1993 and June 30, 1998 and who participated in “UE” benefit plans prior to his/her death.

AmerenCIPS On or after July 1, 1998

� Immediately prior to retirement, You were a regular, full-time employee eligible for active group health plan coverage OR part-time employee covered under one of the Company’s active group health plans; AND

� Accrued at least 10 Years of Service after reaching age 45 as an employee of Ameren.

� OR � You are a Medicare-eligible Dependent of a deceased active

AmerenCIPS employee who died on or after July 1, 1998.

Ameren Energy

Between July 1, 1998 and December 31, 2007

� Immediately prior to retirement, You were a regular, full-time employee eligible for active group health plan coverage OR part-time employee covered under one of the Company’s active group health plans; AND

� Accrued at least 10 Years of Service after reaching age 45 as an employee of AmerenEnergy.

� OR � You are a Medicare-eligible Dependent of a deceased active

AmerenEnergy employee who died between July 1, 1998 and December 31, 2007.

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Ameren Retiree Medical Plan 10 Revised January 2009 AEE-G38

Company You retired

from

Your Retirement Date Was . . .

Eligibility Rules

Ameren Energy Generating Company

On or after July 1, 1998

� Immediately prior to retirement, You were a regular, full-time employee eligible for active group health plan coverage OR part-time employee covered under one of the Company’s active group health plans; AND

� Accrued at least 10 Years of Service after reaching age 45 as an employee of Ameren.

� OR � You are a Medicare-eligible Dependent of a deceased active

AmerenEnergy Generating Company employee who died on or after July 1, 1998.

Ameren Energy Marketing Company

On or after July 1, 1998

� Immediately prior to retirement, You were a regular, full-time employee eligible for active group health plan coverage OR part-time employee covered under one of the Company’s active group health plans; AND

� Accrued at least 10 Years of Service after reaching age 45 as an employee of Ameren.

� OR � You are a Medicare-eligible Dependent of a deceased active

AmerenEnergy Marketing Company employee who died on or after July 1, 1998.

Ameren Energy Fuels & Services Company

On or after July 1, 1998

� Immediately prior to retirement, You were a regular, full-time eligible for active group health plan coverage OR part-time employee covered under one of the Company’s active group health plans; AND

� Accrued at least 10 Years of Service after reaching age 45 as an employee of Ameren.

� OR � You are a Medicare-eligible Dependent of a deceased active

AmerenEnergy Fuels & Services Company employee who died on or after July 1, 1998.

Ameren CILCO

On or after January 1, 2004

� Immediately prior to retirement, You were a regular, full-time employee eligible for active group health plan coverage OR part-time employee covered under one of the Company’s active group health plans; AND

� Accrued at least 10 Years of Service after reaching age 45 as an employee of Ameren.

� OR � You are a Medicare-eligible Dependent of a deceased active

AmerenCILCO employee who died on or after January 1, 2004.

Ameren CILCO InfraServices

On or after January 1, 2004

� Immediately prior to retirement, You were a regular, full-time employee eligible for active group health plan coverage OR part-time employee covered under one of the Company’s active group health plans; AND

� Accrued at least 10 Years of Service after reaching age 45 as an employee of Ameren.

� OR � You are a Medicare-eligible Dependent of a deceased active

AmerenCILCO InfraServices employee who died on or after January 1, 2004

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Ameren Retiree Medical Plan 11 Revised January 2009 AEE-G38

Company You retired from

Your Retirement Date Was . . .

Eligibility Rules

Ameren Energy Medina Valley Cogen, LLC

On or after January 1, 2004

� Immediately prior to retirement, You were a regular, full-time employee eligible for active group health plan coverage OR part-time employee covered under one of the Company’s active group health plans; AND

� Accrued at least 10 Years of Service after reaching age 45 as an employee of Ameren.

� You are a Medicare-eligible Dependent of a deceased active AmerenEnergy Medina Valley Cogen, LLC employee who died on or after January 1, 2004.

Ameren Energy Resources Generating Company

On or after January 1, 2004

� Immediately prior to retirement, You were a regular, full-time employee eligible for active group health plan coverage OR part-time employee covered under one of the Company’s active group health plans; AND

� Accrued at least 10 Years of Service after reaching age 45 as an employee of Ameren.

� You are a Medicare-eligible Dependent of a deceased active AmerenEnergy Resources Generating Company employee who died on or after January 1, 2004.

Contract Retirees2

To be eligible for benefits under this Plan as a contract Retiree of Ameren, You must be age 55 or older on the date You retire and meet the eligibility criteria described in the following matrix. NOTE: Effective April 1, 2007, if immediately prior to Your retirement, You were not a regular full-time or part-time employee of Ameren due to a layoff, You are eligible to participate in the Plan provided You satisfied all of the eligibility requirements immediately prior to Your layoff and You retire no later than the first day of the month following 180 days after the date of Your layoff.

2Regardless of the eligibility requirements outlined in the eligibility matrix for Contract Employees, you are eligible for coverage under this Plan if, prior to your retirement under the Grand Tower Separation Plan, you were an employee represented by Local 148, I.U.O.E. (CIPS) and had attained age 52 as of June 1, 2001.

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Employees represented by a collective bargaining agreement with

Your Retirement Date was...

Eligibility Rules

AmerenUE and IBEW Local 2 AmerenUE and IUOE Local 148 AmerenUE and IBEW Local 702 Physical AmerenUE and IBEW Local 702 Clerical AmerenUE and IBEW Local 1455 AmerenUE and IBEW Local 1455 Region West AmerenUE and IBEW Local 1439 AmerenUE and IBEW Local 309 AmerenUE and IBEW Local 649 AmerenUE and IBEW Local 1439 South

Between January 1, 1992 and June 30, 1994

� Age 55 or older on the date You retired; AND � Immediately prior to retirement, You were a

regular, full-time employee eligible for active group health plan coverage OR part-time employee covered under one of the Company’s active group health plans.

� OR � You are a Medicare-eligible Dependent of a

deceased active Contract Employee (listed to the left) who died prior to July 1, 1994.

AmerenUE and IBEW Local 2 AmerenUE and IUOE Local 148 AmerenUE and IBEW Local 702 Physical AmerenUE and IBEW Local 702 Clerical AmerenUE and IBEW Local 1455 AmerenUE and IBEW Local 1455 Region West AmerenUE and IBEW Local 1439 AmerenUE and IBEW Local 309 AmerenUE and IBEW Local 649 AmerenUE and IBEW Local 1439 South

Between July 1, 1994 and December 31, 1999

� Immediately prior to retirement, You were a regular, full-time employee eligible for active group health plan coverage OR part-time employee covered under one of the Company’s active group health plans; AND

� Accrued at least 10 Years of Service after reaching age 45 as an employee of Ameren Services, AmerenUE or AmerenCIPS. OR

� You are a Medicare-eligible Dependent of a deceased active Contract Employee (listed to the left) who died between July 1, 1994 and December 31, 1999 and who participated in “UE” benefit plans prior to his/her death.

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Employees represented by a collective bargaining agreement with

Your Retirement Date was...

Eligibility Rules

AmerenUE and IBEW Local 2 AmerenUE and IUOE Local 148 AmerenUE and IBEW Local 702 Physical AmerenUE and IBEW Local 702 Clerical AmerenUE and IBEW Local 1455 AmerenUE and IBEW Local 1455 Region West AmerenUE and IBEW Local 1439 AmerenUE and IBEW Local 309 AmerenUE and IBEW Local 649 AmerenUE and IBEW Local 1439 South AmerenCIPS and IBEW Local 702E – Illini AmerenCIPS and IBEW Local 702S – Shawnee AmerenCIPS and IBEW Local 702W – Great Rivers AmerenEnergy Generating Company and IBEW Local 702 – Newton AmerenEnergy Generating Company and IBEW Local 702 – Newton Clerical AmerenEnergy Generating Company and IUOE Local 148 AmerenEnergy Generating Company and IUOE Local 148 – Coffeen Clerical

On or after January 1, 2000

� Immediately prior to retirement, You were a regular, full-time employee eligible for active group health plan coverage OR part-time employee covered under one of the Company’s active group health plans; AND

� Accrued at least 10 Years of Service after reaching age 45 as an employee of Ameren

OR � You are a Medicare-eligible Dependent of a

deceased active Contract Employee (listed to the left) who died on or after January 1, 2000

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Employees represented by a collective bargaining agreement with

Your Retirement Date was...

Eligibility Rules

AmerenCIPS and IBEW Local 702E - Illini AmerenCIPS and IBEW Local 702S – Shawnee AmerenCIPS and IBEW Local 702W – Great Rivers AmerenEnergy Generating Company and IBEW Local 702 – Newton AmerenEnergy Generating Company and IBEW Local 702 – Newton Clerical AmerenEnergy Generating Company and IUOE Local 148 AmerenEnergy Generating Company and IUOE Local 148 – Coffeen Clerical

Prior to January 1, 1992

� Were eligible for an early or normal retirement benefit from the Central Illinois Public Service Retirement Income Plan; AND

� Participated in the CIPS Group Medical Plan for at least 10 years prior to Your retirement date; AND

� Retired prior to reaching age 60 or Retired at age 60 with less than 25 years of Service (“Full Pay Retiree”).

� OR � You are a Medicare-eligible Dependent of a

deceased IBEW Local 702 (CIPS) Retiree or IUOE Local 148 (CIPS) Retiree who met the eligibility requirements described above.

AmerenCIPS and IBEW Local 702E - Illini AmerenCIPS and IBEW Local 702S – Shawnee AmerenCIPS and IBEW Local 702W – Great Rivers AmerenEnergy Generating Company and IBEW Local 702 – Newton AmerenEnergy Generating Company and IBEW Local 702 – Newton Clerical AmerenEnergy Generating Company and IUOE Local 148 AmerenEnergy Generating Company and IUOE Local 148 – Coffeen Clerical

Between January 1, 1992 and December 31, 1999

� Participant in “CIPS” benefit plans prior to January 1, 2000; AND

� Were eligible for an early or normal retirement benefit from the Central Illinois Public Service Retirement Income Plan; AND

� Participated in the CIPS Group Medical Plan for at least 10 years prior to Your retirement date.

� OR � You are a Medicare-eligible Dependent of a

deceased IBEW Local 702 (CIPS) Retiree or IUOE Local 148 (CIPS) Retiree who met the eligibility requirements described above.

AmerenCILCO and IBEW Local 51

On or after January 1, 2005

� Immediately prior to Your retirement, You were a regular, full-time employee eligible for active group health plan coverage;

� AND � Accrued at least 10 Years of Service after

reaching age 45 as an employee of Ameren.

AmerenEnergy Resources Generating Company and NCF&O Local 8

On or after January 1, 2007

� Immediately prior to retirement, You were a regular, full-time employee eligible for active group health plan coverage OR part-time employee covered under one of the Company’s active group health plans;

� AND � Accrued at least 10 Years of Service after

reaching age 45 as an employee of Ameren.

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Dependents

If You enroll in the Plan, Your Dependents are also eligible for coverage provided that You enroll them according to the appropriate procedures. Eligible Dependents are limited to Your:

� Spouse; however, a Spouse who is covered under another Ameren-sponsored medical plan is not eligible for coverage under this Plan.

� Domestic partner; however, a domestic partner who is covered under another Ameren-sponsored medical plan is not eligible for coverage under this Plan. An individual is your domestic partner for purposes of eligibility under this Plan if he or she meets the following requirements:

a. Is the same sex as You;

b. Is at least 18 years of age and not related to you by blood;

c. Is not married to another person under statutory or common law;

d. Is not in another domestic partnership;

e. Has been in an exclusive, committed relationship with You for at least twelve (12) consecutive months;

f. Has shared the same principal residence as You for at least twelve (12) consecutive months;

g. Is jointly responsible with You for financial obligations and for each other’s common welfare.

However, in order for Your domestic partner to be eligible to participate in the Plan, You must not be married to someone else under statutory or common law.

Important Note: You will be asked to certify that your domestic partner meets the requirements outlined above. If false or misleading information is provided, it may result in any or all of the following actions: a) You will reimburse Ameren for all expenses; b) immediate termination of all coverage under the Plan; c) termination of employment with Ameren; and d) other legal action against You.

� Unmarried Dependent Children who have not reached age 19 and are dependent upon You for more than half of their support.

� Unmarried Dependent Children from their 19th birthday to their 25th birthday who live with You and are dependent upon You for more than half of their support.

� Unmarried Dependent Children over age 25 who were not capable of self-sustaining employment before reaching age 25 due to a Developmental Disability or Physical Handicap and continue to be dependent upon You for more than half of their support. Proof of the disability or handicap must be furnished to the Principal Life Insurance Company within 31 days of the date they would

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otherwise cease to be eligible. A child is considered handicapped if he or she is unable to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected either to result in death or last for a continuous period of not less than 12 months.

A child with a full-time job, generally defined to be 30 or more hours per week, is not considered a Dependent. Temporary absences due to special circumstances, including absences due to illness, education or vacation are not treated as absences for purposes of determining whether the Dependent Child lives with You. A Spouse, domestic partner or child who works for Ameren and who is eligible as an Employee for coverage under an Ameren sponsored Medical Plan cannot be covered as Your Dependent under this Plan. No person can be covered as a Dependent of more than one Employee/Retiree. No person can be covered under more than one Ameren-sponsored medical plan at the same time. The Plan may require that a Retiree furnish proof of continued eligibility of any Spouse, domestic partner and unmarried Dependent Child(ren). Enrollment Provisions

Retirees

In order to elect or decline coverage in the Ameren Retiree Medical Plan, You must make Your elections on-line through myAmeren Benefits Web at www.myAmeren.com or by calling the Ameren Benefits Center at 877.7my.Ameren (877.769.2637). You must choose one of the following coverage categories:

� Decline coverage

� You Only

� You + Spouse (or Domestic Partner)

� You + Child(ren)

� You + Family Upon Your retirement, You must elect one of the above coverage categories no later than 31 days from the date of Your Enrollment Worksheet. The effective date of Your coverage is the date of Your retirement. No medical exam or other proof of good health is required. If You decline coverage, You will not be eligible to enroll in the Plan in the future. If You do nothing, You will be defaulted to the Plan option listed below.

Category Default Plan Option (if You don’t make an election)

Non-Medicare Eligible Retirees (& non-Medicare eligible dependents) who were participating in the Ameren Group Medical Plan for Management, IBEW Local 51, NCF&O Local 8, IBEW Local 1455 or 1455 Region West (as an active employee)

Same plan You were participating in the day before Your retirement date.

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Category Default Plan Option (if You don’t make an election)

Medicare Eligible Retirees and/or any Medicare-eligible dependents who were participating in the Ameren Group Medical Plan for Management, IBEW Local 51, NCF&O Local 8, IBEW Local 1455 or 1455 Region West (as an active employee)

Medicare Supplement with the same PRESCRIPTION DRUG option You were participating in the day before Your retirement date. (If one person is not Medicare eligible, he or she will be enrolled in the Standard PPO Plan, while the other person is enrolled in the Medicare Supplement Plan).

Non-Medicare Eligible Retirees (& non-Medicare eligible dependents) who were enrolled in the Open Access III Plan (as an active employee)

Standard PPO or Basic Plan (depending on home zip code) with 3-tier prescription drug coverage

Medicare Eligible Retirees and/or any Medicare eligible dependents who were enrolled in the Open Access III Plan (as an active employee)

Medicare Supplement Plan with three-tier prescription drug coverage. (If one person is not Medicare eligible, he or she will be enrolled in the Standard PPO Plan, while the other person is enrolled in the Medicare Supplement Plan).

Dependents

Unless You elect otherwise, Coverage for Your Eligible Dependents who had Dependent coverage under one of the Company’s group health plans on the day before You retired, will be automatically enrolled in this Plan as of the same date You are enrolled in the Plan. You will have 31 days from the date of Your Enrollment Worksheet to enroll any Eligible Dependents in the Plan who were not covered under one of the Company’s group health plans as a Dependent on the day before Your retirement. If You fail to enroll any such Eligible Dependent within the 31 day time period, such Dependent cannot be enrolled in the Plan in the future except under the circumstances described under “Adding Dependents After Retirement” below. Adding Dependents After Retirement

If You were an AmerenUE management employee who retired on or after January 1, 1992, but prior to July 1, 1993 or an AmerenUE Contract Employee who retired on or after January 1, 1992, but prior to July 1, 1994, You may enroll any eligible Dependents in the future as long as You are covered under the Plan. Coverage will begin on the date You enroll the dependents for coverage under the Plan. You can enroll a dependent by calling the Ameren Benefits Center at 877.7my.Ameren (877.769.2637) or by using myAmeren Benefits Web. The following rules apply for all other Retirees eligible for coverage under this Plan: If, at the time of retirement, You elected not to provide coverage under the Plan for an eligible Dependent (including Your Spouse or domestic partner) because he or she was eligible for other healthcare coverage, You may enroll the Dependent in this Plan in the future (provided he or she qualifies as a eligible Dependent) if he or she is no longer eligible for, or enrolled in, the other coverage, provided that You:

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� Are covered under the Plan.

� Request enrollment of the Dependent within 31 days after the other coverage ends (either on myAmeren Benefits Web or by calling the Ameren Benefits Center at 877.7my.Ameren (877.769.2637).

� Certify that Your Dependent is not eligible for coverage under another employer’s plan. (The Company may request that Your Dependent provide a statement from his/her present or previous employer regarding eligibility for coverage.)

Example: At the time of retirement, You did not enroll Your Spouse or domestic partner in the Ameren Retiree Medical Plan since he/she was employed and had medical coverage through his/her employer. At the time of Your Spouse or domestic partner’s termination of employment,

� Your Spouse or domestic partner is not eligible for any medical coverage through that employer, therefore, You may add Your Spouse or domestic partner to the Plan.

� If however, Your Spouse or domestic partner has medical coverage available through that employer (regardless of the cost of coverage or the benefits provided under that plan), You may NOT add Your Spouse or domestic partner to the Plan.

Coverage will be effective as of the date the other coverage was lost. If You acquire a new Dependent through marriage, domestic partnership, birth, adoption or Placement for Adoption after You retire and while You are covered under the Plan, You may enroll the newly acquired Dependent within 31 days of the marriage, domestic partnership, birth, adoption or Placement for Adoption (provided he/she qualifies as an eligible Dependent). In the case of the birth, adoption or Placement for Adoption of a child, Your Spouse or domestic partner may also be enrolled as a Dependent if he/she is otherwise eligible for coverage. To enroll a new Dependent, You must:

� Request enrollment of the Dependent within 31 days of the event (either on myAmeren Benefits Web or by calling the Ameren Benefits Center at 877.7my.Ameren (877.769.2637).

� If enrolling a new Spouse, You may be asked to provide a copy of the marriage certificate.

� If enrolling a new Domestic Partner, You will be asked to certify that the domestic partner meets the requirements outlined in the ELIGIBILITY section.

� If enrolling a new child, You may be asked to provide a copy of the birth certificate or adoption papers.

Coverage will be effective as of the date of marriage, domestic partnership, birth, adoption or Placement for Adoption. Any dependent who is covered under this Plan and is subsequently dropped from coverage for any reason may not be re-enrolled for coverage at any time in the future, except as outlined below under SPECIAL ENROLLMENT RIGHTS UNDER THE CHILDREN’S HEALTH INSURANCE PROGRAM

REAUTHORIZATION ACT OF 2009.

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Qualified Medical Child Support Orders

This Plan will also extend benefits to a covered individual’s non-custodial child, as required by any Qualified Medical Child Support Order (QMCSO), as defined by ERISA § 609 (a). The Plan has detailed procedures for determining whether an order qualifies as a QMCSO. Participants can obtain, without charge, a copy of such procedures by calling the Ameren Benefits Center at 877.7my.Ameren (877.769.2637). Annual Enrollment Period

Each November, during the annual enrollment period, You will be given the opportunity to change Your medical Plan elections. For example, if You are enrolled in the HealthLink Standard PPO Plan, You could enroll in the HealthLink Health Savings PPO or one of the other HMO options available to non-Medicare eligible Retirees. Medicare-eligible Retirees could elect to move from the Conventional Plan into the Medicare Supplement Plan, or vice versa. This would also be the time that You could evaluate and change Your prescription drug coverage. Changes in elections made during annual enrollment will be effective January 1 of the following year and will be in effect for the full year. Any changes You may need to make to Your Dependent coverage will be governed by the provisions described above in ‘Adding Dependents After Retirement’. If coverage under the Plan is declined, You are not eligible to participate in the Plan in the future. Cost of Coverage for Retirees

If You retired from Central Illinois Public Service Company prior to January 1, 1992 and You are a “full pay” Retiree who is eligible for this Plan, the Company currently pays 75% of the cost of this coverage for You and 50% of the cost for Your Covered Dependents. You pay the remainder of the cost for this coverage through billing statements or direct debit from Your bank account.

Special Enrollment Rights under the Children’s Health Insurance Program Reauthorization Act of 2009

Effective April 1, 2009, if you decline coverage for yourself, Spouse or eligible dependents because of other health coverage under Medicaid or a state Children’s Health Insurance Program (“CHIP”), you may be able to enroll yourself and your eligible dependents (including your Spouse) in this Plan if you, your Spouse or eligible dependent lose eligibility for such coverage. You must request enrollment in the Plan within 60 days after the Medicaid or CHIP coverage ends. Coverage under the Plan will be effective as of the date the Medicaid or CHIP coverage was lost.

You, your Spouse and/or eligible dependents may be also entitled to a special enrollment right upon becoming eligible for premium assistance, with respect to coverage under the Plan, under either Medicaid or CHIP. You must request enrollment in the Plan within 60 days after becoming eligible for the premium assistance.

If you, your Spouse and/or eligible dependents do not request enrollment within the 60-day Special Enrollment Period permitted above, enrollment is not permitted until the next Annual Enrollment Period.

A request for special enrollment can be made on-line through myAmeren Benefits Web at www.myAmeren.com or by calling the Ameren Benefits Center at 877.7my.Ameren (877.769.2637).

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If You retired on or after January 1, 1992 (except for employees represented by a collective bargaining agreement with AmerenCILCO IBEW Local 51 and employees represented by a collective bargaining agreement with AmerenEnergy Generating Company NCF&O Local 8 – see below), the Company currently pays a portion of the cost of this coverage for You and Your Covered Dependents. You pay the remainder of the cost for this coverage through billing statements or direct debit from Your bank account. See APPENDIX A for the current contribution schedule. If you are an employee who was represented by a collective bargaining agreement with AmerenCILCO IBEW Local 51 who retired between January 1, 2005 and December 31, 2007, the Company currently pays the full cost for this Coverage. If you are an employee who was represented by a collective bargaining agreement with AmerenCILCO IBEW Local 51 who retired on or after January 1, 2008, currently you and the Company will share in the cost for this Coverage. You pay for your portion of the cost of this Coverage through billing statements or direct debit from your bank account. See APPENDIX A for the current contribution schedule. If you are an employee who was represented by a collective bargaining agreement with AmerenEnergy Resources Generating Company NCF&O Local 8 who retired on or after January 1, 2007, the Company currently pays a portion of the cost of this Coverage for you and your Covered Dependents. You pay the remainder of the cost for this Coverage through billing statements or direct debit from your bank account. See APPENDIX A for the current contribution schedule. Your cost for this coverage is subject to change. Is Your Dependent Child a ‘Qualified Tax Dependent’?

The definition of a Dependent Child for purposes of eligibility under the Ameren Retiree Medical Plan is different than the definition of a tax-qualified dependent under the Internal Revenue Code. If You are covering a Dependent that does not meet the IRS definition of a qualified tax dependent (i.e.- You cannot claim them on Your tax return), the fair market value of the health coverage for the non-qualified dependent child(ren) is considered to be ‘imputed income’ and is therefore subject to income tax withholding and employment taxes. You are responsible for determining whether Your Dependent Child is eligible for employer-provided coverage on a tax-free basis. The following matrix outlines the IRS definition of a qualified tax dependent:

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Qualifying Child Qualifying Relative

Must meet all of the following requirements:

Your natural child; a stepchild, legally adopted child, foster child or a child placed for adoption AND Lives with You for more than one half of the year (except for temporary absences due to illness, education, business, vacation, or military service) AND � Is under age 19 at the end of the year, or

� Is a full-time student under age 24 at the end of the year, or

� Is permanently and totally disabled at any time during the year – regardless of age

AND Does not provide more than one-half of his/her own support for the year.

Must meet all of the following requirements:

Your natural child, stepchild, legally adopted child, foster child or child placed for adoption OR Your domestic partner’s child who lives with You (except for temporary absences due to illness, education, business, vacation or military service) and is a member of Your household for the entire year AND Receives over one-half of his/her support from You AND Is not a Qualifying Child for You or any other taxpayer. (NOTE: The IRS definition of a qualifying relative also includes family members who are not eligible for Ameren healthcare coverage as a dependent, such as nieces, nephews, aunts, uncles and others.)

Under a special rule for children of divorced and separated parents, even if the Dependent Child does not live with You for more than half of the year, he or she can still satisfy the residence and support requirements to be Your Qualifying Child under the following circumstances:

� You are divorced, legally separated or living apart during the last six months of the calendar year from the child’s other parent;

� The child receives over half of his or her support during the year from You, the other parent or both; and

� The child is in the custody of You, the other parent or both for more than half of the calendar year.

Your domestic partner’s child will usually not be Your Qualifying Relative since he or she is likely to be a Qualifying Child of Your domestic partner. Note; however, that if Your domestic partner is not required to file a federal income tax return and either does not file such a return or does so solely to obtain a refund of withheld income taxes, Your domestic partner’s child will not be considered a Qualifying Child of Your domestic partner. If Your Covered Dependent Child does not meet the IRS definition of a qualified tax dependent, You can maintain the coverage, but You must inform the Ameren Benefits Center of the non-qualified tax status of the Dependent by calling 877.7my.Ameren (877.769.2637).

You are strongly encouraged to consult your tax advisor for questions about this matter. Is Your Domestic Partner Eligible for Federal Tax-Free Health Benefits?

In order for the coverage for Your domestic partner to be tax-free, You must be able to claim your domestic partner as a dependent for federal income tax purposes OR he or she must meet all of the following requirements:

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1. Lives with You for the entire calendar year.

2. Is a member of Your household for the entire calendar year.

3. Receives more than half of his/her support from You for the calendar year.

4. Cannot be claimed as anyone else’s qualifying child dependent.

5. Is a U.S. resident, U.S. citizen, U.S. national, or a resident of Canada or Mexico. In order for Your domestic partner to be a member of Your household, You must both maintain and occupy the household and the relationship between You and Your domestic partner must not violate local law. If Your domestic partner DOES meet the necessary requirements outlined above and therefore coverage under the Plan qualifies for tax-favorable treatment, You must inform the Ameren Benefits Center of the qualified tax-free status by calling 877.7my.Ameren (877.769.2637). If You do not notify the Ameren Benefits Center of the tax dependent status of Your domestic partner, premiums deducted for coverage for Your domestic partner will be subject to imputed income, which means You will be required to pay income tax withholding and employment taxes. You are strongly advised to consult your tax advisor for questions about this matter. Cost of Coverage for Surviving Dependents of Deceased Retirees

For surviving dependents of deceased Ameren Retirees (excluding employees represented by a collective bargaining agreement with AmerenCILCO and IBEW Local 51 and employees represented by a collective bargaining agreement with AmerenEnergy Resources Generating Company and NCF&O Local 8) who retire on or after January 1, 1992 and for surviving dependents of deceased Central Illinois Public Service (CIPS) employees who retired from CIPS prior to January 1, 1992: The Company currently pays a portion of the cost of this coverage for Your surviving Dependents. The remainder of the cost of this coverage is collected through billing statements or a direct debit from Your bank account. Information about the cost of this coverage is outlined in Appendix A. For Surviving Dependents of Deceased employees who were represented by a collective bargaining agreement with AmerenCILCO and IBEW Local 51 who retired between January 1, 2005 and December 31, 2007: The Company currently pays the full cost of this Coverage for Your surviving dependents. For Surviving Dependents of Deceased employees who were represented by a collective bargaining agreement with AmerenCILCO and IBEW Local 51 who retire on or after January 1, 2008: The Company currently pays a portion of the cost of this Coverage for Your surviving dependents. The remainder of the cost of this coverage is collected through billing statements or direct debit from Your bank account. Information about the cost of this coverage is outlined in APPENDIX A.

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Surviving Dependents of Deceased employees who were represented by a collective bargaining agreement with AmerenEnergy Resources Generating Company and NCF&O Local 8 who retire on or after January 1, 2007: The Company currently pays a portion of the cost of this Coverage for Your surviving Dependents. The remainder of the cost of this coverage is collected through billing statements or direct debit from Your bank account. Information about the cost of this coverage is outlined in APPENDIX A. Contribution rates may be adjusted from time to time by the Company for each of the groups stated above. Coverage Identification Card

Once You are enrolled in the Plan, You will be issued identification cards which provide information about Your medical and prescription drug coverage. You should carry the cards with You at all times, and show them to Your providers when You go to the Physician, Hospital, or Pharmacy. Definitions

Several words and phrases used to describe Your Plan are capitalized whenever they are used in this booklet. These words and phrases have special meanings as explained in this section. Adverse Benefit Determination means a denial of a request for Service or failure to provide or make payment (in whole or in part) for a Covered Expense. Adverse Benefit Determination also includes any reduction or termination of a covered Service. Ambulatory Surgery Center means a facility designed to provide surgical care which does not require Hospital confinement but is at a level above what is available in a Physician’s office or clinic. An Ambulatory Surgery Center:

� is licensed by the proper authority of the state in which it is located, has an organized Physician staff, and has permanent facilities that are equipped and operated primarily for the purpose of performing surgical procedures; and

� provides Physician Services and full-time skilled nursing Services directed by a licensed registered nurse (R.N.) whenever a patient is in the facility; and

� does not provide the Services or other accommodations for Hospital confinement; and

� is not a facility used as an office or clinic for the private practice of a Physician or other professional providers.

Ameren means Ameren Corporation and includes only the following subsidiaries: Ameren Services, AmerenUE, AmerenCIPS, AmerenEnergy Generating Company, AmerenEnergy Resources Generating Company, AmerenEnergy Fuels and Services Company, AmerenEnergy, AmerenEnergy Marketing Company, AmerenCILCO, AmerenCILCO InfraServices, AmerenEnergy Medina Valley Cogen, LLC, and AmerenIP. Appropriate means that the type, level, and length of Service, and setting are needed to provide safe and adequate care and Treatment.

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Average Semi-Private Charge means:

� the Hospital's standard charge for semi-private room and board accommodations (if the Hospital has more than one charge, use the average of these charges); or

� 80% of the Hospital's lowest charge for single-bed room and board accommodations where the Hospital does not provide any semi-private accommodations.

Average Wholesale Price (AWP) means the published cost of a drug product to the wholesaler. Birthing Center means a freestanding facility that is licensed by the proper authority of the state in which it is located and that:

� provides prenatal care, delivery, and immediate postpartum care; and

� operates under the direction of a Physician who is a Specialist in obstetrics and gynecology; and

� has a Physician or certified nurse midwife present at all births and during the immediate postpartum period; and

� provides, during labor, delivery and the immediate postpartum period, full-time skilled nursing Services directed by a licensed registered nurse (R.N.) or certified nurse midwife; and

� has a written agreement with a Hospital in the area for emergency transfer of a patient or a newborn child, with written procedures for such transfer being displayed and staff members being aware of such procedures.

Claims Administrator means any entity authorized by the Plan Administrator to process claims for benefits under this Plan. Coinsurance means the percentage of covered health care costs either paid by the Plan or paid by You (for example, under the Basic Plan, the Plan pays 80% of covered charges and You pay the remaining 20% after You satisfy the Deductible). Company means Ameren Services Company, as agent for Ameren Corporation and its subsidiaries. Concurrent Review means a Utilization Management Review conducted during a patient's Hospital stay or course of Treatment. Continued Stay Review means a review by the Cost Containment Administrator of a Physician's report of the need for continued Hospital confinement to determine if the continued stay is for Medically Necessary Care. Contract Employee means an employee covered by a collective bargaining agreement. Co-payment; Co-pay means a specified dollar amount that must be paid by You or one of Your Covered Dependents each time certain or specified Services are rendered.

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Cosmetic Treatment and Services mean Treatment or Service to change:

� the texture or appearance of the skin; or

� the relative size or position of any part of the body; when such Treatment or Service is performed primarily for psychological purposes or is not needed to correct or improve a bodily function. Cosmetic Treatment and Services include, but are not limited to, surgery, pharmacological regimens, and all related charges. Cost Containment Administrator means the organizations designated by the Plan Administrator to perform certain procedures described in the UTILIZATION REVIEW Section. Covered Dependent means a Dependent who meets the Plan’s eligibility requirements set forth in this Summary Plan Description and who has been enrolled hereunder. Covered Domestic Partner means a domestic partner who meets the Plan’s eligibility requirements set forth in this Summary Plan Description and has been enrolled hereunder and whose coverage under the Plan is in effect. Covered Expenses mean charges for the types of Treatment or Service listed under Covered Expenses to the extent the charges do not exceed Reasonable and Customary Charges. The Treatment or Service must be required for the Treatment of a sickness, injury, or certain routine care and must be considered by the Claims Administrator to be Medically Necessary Care. Covered Retiree means a Retired Employee who meets the Plan’s eligibility requirements set forth in this Summary Plan Description and who has enrolled hereunder. Creditable Coverage means the length of time You or Your Dependent(s) have health coverage, such as coverage under a group health plan (including COBRA continuation coverage), HMO, individual health insurance policy, Medicaid or Medicare. Days in a waiting period in which You or Your Dependent(s) have no other coverage are not Creditable Coverage and are not taken into account when determining a significant break in coverage (generally 63 days or more). Custodial Care means assistance with meeting personal needs or the Activities of Daily Living. For this purpose, "Activities of Daily Living" means activities that do not require the Services of a Physician, registered nurse (R.N.) licensed practical nurse (L.P.N.), or other health care professional including, but not limited to, bathing, dressing, getting in and out of bed, feeding, walking, elimination, and taking medications. Deductible; Deductible Amount for purposes of medical plan coverage means a specified dollar amount of medical Covered Expenses (and covered prescription drug expenses if enrolled in the HealthLink Health Savings PPO Plan) that must be incurred by You or one of Your Covered Dependents before benefits will be payable under this Plan for all or part of the remaining Covered Expenses during the calendar year. For purposes of the prescription drug program means the dollar amount for each calendar year that a Participant is responsible for paying under the Coinsurance option before any prescription drug benefits are payable. The Plan will subtract the Deductible Amount from Covered Expenses and will then pay the Covered Expenses as stated in the Schedule of Prescription Drug Benefits. You pay one individual

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Deductible Amount each calendar year. For satisfaction of the family Deductible Amount, no more than one individual Deductible Amount will apply for any one person. The Deductible Amount under the Coinsurance Option of the Prescription Drug Plan is separate from any medical Deductible that may apply. Dependent means Your lawful Spouse, domestic partner or Dependent Child, if that Spouse, domestic partner or child is not in the Armed Forces of any country and is not covered under this Plan as an Employee. Dependent Child means: Your natural child; Your stepchild who resides with You; children of Your domestic partner; an adopted child; a child who has been placed with You for adoption; a child for whom You have been appointed legal guardian or custodian by a court order; a child who is recognized under a qualified medical child support order (QMCSO) as having a right to enrollment under the Plan. In all cases the child must depend upon You for more than half of his or her support. However, when a court recognizes a child as a QMCSO-child, the child will be considered Your eligible Dependent regardless of whether or not the child is living with You or receiving more than half of his or her support from You. When a court or administrative order determines paternity and establishes upon You a duty to support Your natural child, the child will be considered Your eligible Dependent regardless of whether or not the child is living with You or receiving his or her main support and care from You. Developmental Disability means a Dependent Child's substantial handicap, as determined by the Plan Administrator, which:

� results from mental retardation, cerebral palsy, epilepsy, or other neurological disorder; and

� is diagnosed by a Physician as a permanent or long term continuing condition. Durable Medical Equipment means equipment that:

� can withstand repeated use; and

� is primarily and customarily used to serve a medical purpose; and

� is generally not useful to a person who is not sick or injured, or used by other family members; and

� is Appropriate for home use; and

� improves bodily function caused by sickness or injury, or prevents further deterioration of the medical condition.

Emergency Medical Condition means a condition manifesting itself by acute symptoms of sufficient severity (including pain). This condition may be as a result of an injury, sickness, or mental illness, which occurs suddenly and is such that a prudent layperson, with an average knowledge of health and medicine, could reasonably expect the absence of immediate medical attention to result in:

� serious jeopardy to the health of the individual (or unborn child);

� serious impairment to bodily functions; and

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� serious dysfunction of any bodily organ or part.

Episode of Hospice Care means the period of time:

� beginning on the date a Hospice Care Program is established for a dying individual; and

� ending on the earlier of the date six months after the date the Hospice Care Program is established, the date the attending Physician withdraws approval of the Hospice Care Program, the date the individual recovers or the date the individual dies.

Two or more Episodes of Hospice Care for the same individual will be considered one Episode of Hospice Care, unless separated by a period of at least three months during which no Hospice Care Program is in effect for the individual. Experimental or Investigational Measures mean any Treatment or Service, regardless of any claimed therapeutic value, not Generally Accepted by Specialists in that particular field of medicine or dentistry, as determined by the Plan Administrator or it’s delegate. Formulary means the list of FDA-approved prescription drugs and supplies developed by Express Scripts' Pharmacy and Therapeutics Committee and/or customized by the Plan Sponsor which represents the current clinical judgment of practicing health care practitioners based on a review of current data, medical journals, and research information. In Your pharmacy benefit plan, the Formulary drug list is used as a guide for determining Your Co-pay amount for each prescription, with drugs listed on the Formulary typically available to You at a lower Co-pay amount. The Formulary may change from time to time. To obtain information about prescription drugs on Express Scripts’ Formulary, You may call toll-free 888.256.6131 or visit Express Scripts’ website: www.express-scripts.com. Generally Accepted means that the Treatment or Service for the particular sickness or injury which is the subject of the claim that:

� has been accepted as the standard of practice according to the prevailing opinion among experts as shown by (or in) articles published in authoritative, peer-reviewed medical and scientific literature; and

� is in general use in the relevant medical or dental community; and

� is not under continued scientific testing or research. Generic Prescription Drug means a drug that has the same active ingredients and is subject to the same rigorous FDA standards for quality, strength, and purity as its brand name equivalent. The brand name drug is the product name under which it is advertised and sold. Generic drugs are usually sold under unfamiliar names although they have the same effectiveness and are as medically equivalent as the brand name drug. Health Care Extender means an allied health practitioner (including any health practitioner approved by Magellan Behavioral Health) who is delivering medical Services under the direction and supervision of a Physician.

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Direction and supervision means the Physician co-signs any progress notes written by the Health Care Extender; or there is a legal agreement that places overall responsibility for the Health Care Extender's Services on the Physician. Health Professional means an individual who:

� has undergone formal training in a health care field;

� holds an associate or higher degree in a health care field, or holds a state license or state certificate in a health care field; and

� has professional experience in providing direct patient care. Home Health Aide means a person, other than a licensed registered nurse (R.N.), who provides medical or therapeutic care under the supervision of a Home Health Care Agency. Home Health Care Agency means a Hospital, agency, or other Service that is certified by the proper authority of the state in which it is located to provide home health care. Home Health Care Plan means a program of home care that:

� is required as the result of a sickness or injury; and

� prevents, delays, or shortens a Hospital Inpatient Confinement or Skilled Nursing Facility confinement; and

� is documented in a written plan of care; and

� is reviewed and certified by a Physician to be necessary. Hospice means a facility, agency, or Service that:

� is licensed, accredited, or approved by the proper regulatory authority to establish and manage Hospice Care Programs; and

� arranges, coordinates, and/or provides Hospice Care Services for dying individuals and their families; and

� maintains records of Hospice Care Services provided and bills for such Services on a consolidated basis.

Hospice Care Program means a program:

� managed by a Hospice; and

� established jointly by a Hospice, a Hospice Care Team, and an attending Physician; to meet the special physical, psychological, and spiritual needs of dying individuals and their families. Hospice Care Team means a group that provides coordinated Hospice Care Services and normally includes:

� a Physician;

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� a patient care coordinator (Physician or nurse who serves as an intermediary between the program and the attending Physician);

� a nurse;

� a mental health Specialist;

� a social worker;

� a chaplain; and

� lay volunteers. Hospital means an institution that is licensed as a Hospital by the proper authority of the state in which it is located, but not including any institution, or part thereof, that is used primarily as a clinic, Skilled Nursing Facility, convalescent home, rest home, home for the aged, nursing home, Custodial Care facility, or training center. Hospital shall also include an Inpatient or Residential Alcohol or Drug Abuse Treatment Facility approved by Magellan Behavioral Health. Hospital Admission Review means a review by the Cost Containment Administrator of a Physician's report of the need for Hospital confinement (scheduled or emergency) to determine if the confinement is for Medically Necessary Care. Hospital Confinement Charges mean Covered Charges by a Hospital for room, board, and other usual Services while a person is confined in a Hospital. The charges must be incurred while the person is confined for a period of at least 23 consecutive hours (for any cause). Hospital Room Daily Limit means Covered Expenses by a Hospital for room and board while confined in a private room will be based on the Average Semi-Private Room Charge as defined in this section. There is no limit for charges incurred for a semi-private room, ward, or Intensive Care Accommodations. Immediate Family means a covered individual's husband or wife, natural or adoptive parent, child or sibling, stepparent, stepchild, stepbrother or stepsister, father-in-law, mother-in-law, son-in-law, daughter-in-law, brother-in-law, sister-in-law, grandparent, grandchild, or Spouse of grandparent or grandchild. Initial Clinical Review(er) means a Clinical review conducted by Appropriate licensed or certified Health Professionals. Initial Clinical Review staff may approve requests for admissions, procedures, and Services that meet clinical review criteria, but must refer requests that do not meet clinical review criteria to a Peer Clinical Reviewer for certification or Non-certification. Intensive Care Accommodation means a Hospital facility exclusively reserved for critically and seriously ill or injured patients who require constant audio-visual monitoring as ordered by the attending Physician. Such accommodation provides room and board, specialized nursing care, and immediately available supplies and special equipment. Medically Necessary Care means as determined by the Claims Administrator (or Magellan for mental health or substance abuse Treatment), any Treatment or Service that is:

� prescribed by a Physician and required for the screening, diagnosis or Treatment of a medical condition; and

� consistent with the diagnosis or symptoms; and

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� not excessive in scope, duration, intensity or quantity; and

� the most Appropriate level of Services or supplies that can safely be provided; and

� determined by the Plan Administrator or it’s delegate to be Generally Accepted. Network Provider/In-Network Provider means a Hospital, Physician, or other provider who has agreed to participate in HealthLink’s Preferred Provider Organization (PPO) network program. Network Service Area means a geographic area within which Network Provider Services are available to covered individuals. Non-certification means a decision by the Cost Containment Administrator that an admission, continued stay, or other health care Service has been reviewed and, based upon the information provided, does not meet the Cost Containment Administrator's requirements for Medically Necessary Care, Appropriateness, health care setting level of care or effectiveness, and the request is therefore denied, reduced, or terminated. Non-Network/Out-of-Network Provider means a Hospital, Physician, pharmacy, or other provider who has not agreed to participate in the respective network identified by the Claims Administrator for Your Plan option. Non-Preferred Brand Name Prescription Drug means a brand-name drug that is not listed on Your Formulary. These drugs are typically more expensive alternatives to preferred drugs, providing the same Treatment at a higher cost. (Also known as “non-preferred medication” or “non-Formulary brand.") Notification of Utilization Management Review Services means receipt of necessary information to initiate review of a request for Utilization Management Review Services to include the patient’s name and Your name (if different from patient’s name), attending Physician’s name, treating facility’s name, diagnosis, and date of Service. Ordering Provider means the Physician or other provider who specifically prescribes the health care Service being reviewed. Out-of-Pocket Expenses for purposes of medical coverage means Covered Expenses for Treatment or Service, and for covered prescription drug expenses if enrolled in the HealthLink Health Savings PPO Plan, for which no benefits are payable because of Deductible, Co-payment, and Coinsurance features. For purposes of the Coinsurance Prescription Drug Option under the Prescription Drug Card Program, Out-of-Pocket Expenses means covered prescription drug expenses for which no benefits are payable because of Deductible and Coinsurance features. Peer Clinical Review(er) means a Clinical review conducted by a Physician or other Health Professional when a request for an admission, procedure, or Service was not approved during the Initial Clinical Review. In the case of an appeal review, the Peer Clinical Reviewer is a Physician or other Health Professional who holds an unrestricted license and is in the same or similar specialty as typically manages the medical condition, procedures, or Treatment under review. Generally, as a peer in a similar specialty, the individual must be in the same profession, i.e., the same licensure category as the Ordering Provider.

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Physical Handicap means a Dependent Child's substantial physical or mental impairment, as determined by the Plan Administrator, which:

� results from injury, accident, congenital defect, or sickness; and

� is diagnosed by a Physician as a permanent or long term dysfunction or malformation of the body.

Physician means Doctor of Medicine (MD); Doctor of Osteopathy (DO); Audiologist; Certified Registered Nurse Anesthetist (CRNA); Chiropractor; Dentist; Certified Midwife; Occupational Therapist; Optometrist; Physician Assistant; Physical Therapist; Podiatrist (DPM); Psychologist; Speech Pathologist; and/or any provider approved by Magellan Behavioral Health. Physician Visit means a face-to-face meeting between a Physician or Physician’s staff and a patient for the purpose of medical Treatment or Service. Physician Visit Charges means Covered Expenses for Treatment or Service furnished at a Physician's clinic or office or by a Physician at Your or Your Covered Dependent's home. Such Services include charges for: dressings; supplies; equipment; injections; anesthesia; take-home drugs; blood; blood plasma; x-ray and laboratory examinations (including professional components that are billed by a pathologist in connection with the laboratory testing); x-ray, radium, and radioactive isotope therapy; and routine physical examinations. Placement for Adoption; Placement means the assumption and retention by a person of a legal obligation for total or partial support of a child in anticipation of adopting the child. The child's Placement with the person terminates upon the termination of such legal obligation. Plan means Ameren Retiree Medical Plan. Plan Administrator means Ameren Services Company. Preferred Brand Name Prescription Drug means a brand-name drug that is listed on Your Formulary. (Also referred to as a "Formulary brand drug.) These drugs are brand name because they are patented and can only be made by one manufacturer or its licensees. “Preferred” means that Express Scripts has approved them based on their safety, effectiveness and cost as compared to similar drugs. Prospective Review means a Utilization Management Review conducted prior to a patient's stay in a Hospital or other health care facility or course of Treatment, including any required preauthorization or pre-certification. Reasonable and Customary Charges means:

� For medical care received from Network Providers, the negotiated fee between the Network Provider and HealthLink.

� For medical care received from Non-Network Providers, the amount, as determined by the Claims Administrator, that most health care providers within a geographic cost area charge for a Treatment or Service.

� For this Plan, an actual charge for a Treatment or Service will be in excess of Reasonable and Customary Charges only if, as determined by the Claims Administrator,

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90% or more of all other charges reported to the Claims Administrator for the same (or a similar) Treatment or Service provided within the same (or a comparable) cost area are lower in amount than the actual charge.

� For medical care received from a provider in the Transplant Network, the amount will be based on the negotiated fee.

Retired Employee/Retiree means any such person who is retired, if such person was age 55 or older on the date of retirement and belongs to a group described in the ELIGIBILITY section of this booklet. NOTE: See footnotes in the ELIGIBILITY section for circumstances where certain employees were eligible for retirement prior to reaching age 55. Retrospective Review means a Utilization Management Review conducted after the patient is discharged from a Hospital or other health care facility or has completed a course of Treatment. Skilled Nursing Facility means an institution (including one providing sub-acute care), or distinct part thereof that is licensed to provide skilled nursing care for persons recovering from sickness or injury and that:

� is supervised on a full-time basis by a Doctor of Medicine (M.D.), Doctor of Osteopathy (D.O.), or a licensed registered nurse (R.N.); and

� has transfer arrangements with one or more Hospitals, a utilization review plan, and operating policies developed and monitored by a professional group that includes at least one M.D. or D.O.; and

� has a contract for the Services of an M.D. or D.O., maintains daily records on each patient and is equipped to dispense and administer drugs; and

� provides 24-hour nursing care and other medical Treatment. Not included are rest homes, homes for the aged, nursing homes, or places for Treatment of mental disease, drug addiction, or alcoholism. Specialist/Specialty Provider means any Physician other than a Primary Care Physician who is classified as a Specialist by the American Boards of Medical Specialties. Spouse means a person of the opposite sex to whom You are currently married by a marriage procedure which was solemnized by a person authorized by law to solemnize marriages. Spouse does not include common-law Spouses (even if Your state recognizes common-law marriages), ex-Spouses, domestic partners or anyone else to whom You are not currently married. Transplant Network means any network of providers that the Plan determines to be an Appropriate transplant provider and that has contracted to provide Transplant Services subject to a negotiated fee schedule. Treatment or Service means confinement, Treatment, Service, substance, material, or device. Urgent Review means a Utilization Management Review that must be completed sooner than a Prospective Review in order to prevent serious jeopardy to Your or the patient’s life or health or the ability to regain maximum function, or in the opinion of a Physician with knowledge of

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Your or the patient’s medical condition, would subject You or the patient to severe pain that cannot be adequately managed without Treatment. Whether or not there is a need for an Urgent Review is based upon the Cost Containment Administrator's decision using the judgment of a prudent layperson that possesses an average knowledge of health and medicine. Utilization Management Review means a set of formal techniques designed to monitor the use of or evaluate the clinical necessity, Appropriateness, efficacy or efficiency of health care Services, procedures, providers, or facilities. Year of Service for purpose of determining eligibility for a Retiree means a calendar year in which You worked at least 1000 hours. Year of Service for purposes of determining eligibility for a surviving dependent of an active employee means the length of time from date of hire to date of death of the employee. For purpose of determining premiums for retirees and eligible surviving dependents, Years of Service means the length of time which is used in the calculation to determine Your benefit under the Ameren Retirement Plan. Years of Pension Service accrued before January 1, 2003 as an employee of AmerenEnergy or AmerenEnergy Marketing Company do not count toward Service when determining eligibility for the Ameren Retiree Medical Plan. You/Your means a Retiree or Dependent of a Retiree who is eligible to participate in the health benefit Plan offered by the Company as set forth in this Summary Plan Description and who has enrolled hereunder, unless the context clearly dictates otherwise. Retiree Medical Plan Options

The Ameren Retiree Medical Plan offers several choices for Retirees and their Dependents who are not eligible for Medicare:

� HealthLink Standard PPO,

� HealthLink Health Savings PPO with Prescription Drug Coverage included, and

� Basic Medical

Note: Retirees who are not Medicare-eligible also have the option of electing coverage under an HMO, rather than electing coverage under one of the Plan options listed above. Details regarding the HMO options are available in the Group Health Plan HMO, Personal Care HMO or United Healthcare of the River Valley HMO summary plan descriptions. In addition, there are two medical Plan options offered to Retirees and their Dependents who are eligible for Medicare:

� Conventional Plan

� Medicare Supplement Retirees and their eligible Dependents also participate in the Prescription Drug Card Program (unless You enroll in the HealthLink Health Savings PPO which already includes prescription drug coverage). The appropriate medical Plan option, plus the Prescription Drug Card benefits comprise Your current Plan benefits.

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Important Note: Retirees who are Medicare Eligible may elect to participate in one of the medical plan options, but not participate in the Prescription Drug Card Program. This option is only available if all covered family members are Medicare Eligible. Medicare Part A and Part B

It is very important that You enroll in Parts A and B of Medicare as soon as You become eligible for Medicare benefits3. If You are eligible for Medicare but don’t enroll, You will still be covered under either the Conventional Plan or Medicare Supplement Option just as though You were enrolled in Medicare. This means the Plan will determine and subtract the benefits Medicare would have paid and then pay benefits on the balance of the claim in accordance with Plan provisions. This provision also applies to Your Dependents who become eligible for Medicare. For additional information, refer to the “COORDINATION WITH OTHER BENEFITS” section of this booklet. Medicare Part D

Medicare Part D is the prescription drug benefit available to all Medicare participants. It requires enrollment in a Medicare prescription drug plan and payment of a monthly premium. If You elect Ameren’s 3-Tier or Coinsurance Prescription drug coverage, You are not required to enroll in Medicare Part D. The Prescription drug coverage in these plans is Creditable Coverage. For these purposes, Creditable Coverage means that the benefits provided under Ameren’s prescription drug plan are at least equal to the benefits provided under Medicare Part D. If You also enroll in a Medicare Part D plan, Medicare will be primary and this Plan will pay secondary. Important Note: If You enroll in Medicare Part D, You may want to consider one of the Ameren Medical Only options with no prescription drug coverage. This option is only available if all covered family members are Medicare Eligible. The medical only option may be attractive to participants who wish to reduce the prescription drug expenses that apply to the lifetime maximum benefit under the Plan.

3 Effective January 1, 2006, Reimbursement of a portion of Medicare Part B premiums may be available for a grandfathered group

of “regular pay” retirees who retired from AmerenCIPS on or after January 1, 1992 and before July 1, 1998 (for management

retirees) and December 31, 1999 (for contract retirees). Such retirees must have retired either at their normal retirement date or at

an early retirement date, but with at least 25 years of service. Surviving Dependents of these grandfathered retirees are not

eligible for Medicare Part B premium reimbursement. Each year, generally in January, the Company will request the information

required from the retiree to receive such reimbursement.

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Schedule of Benefits for Non-Medicare Eligible Retirees

HealthLink Standard PPO – Schedule of Benefits

HEALTHLINK STANDARD PPO PLAN Available to Non-Medicare Eligible Participants only

PLAN FEATURE IN-NETWORK OUT-OF-NETWORK

Lifetime Maximum Benefit

$750,000

Calendar Year Deductible (annual amount You have to pay before the Plan begins paying benefits)

$400 per person $800 per family

$600 per person $1,200 per family

Amounts paid as an In-Network Deductible also apply towards satisfying Out-of-Network

Deductible and vice versa

Out-of-Pocket Limit (maximum out-of-pocket amount of Covered Expenses You could have to pay in a single year, including Deductibles)

$2,500 per person $5,000 per family

$ 5,000 per person $10,000 per family

Amounts paid In-Network are included in determining whether You have reached the Out-of-Network out-of-pocket limit

and vice versa

Charges for mental health, alcohol, and substance abuse Treatment not approved by Magellan Behavioral Health, and Utilization Management Review Penalties do not apply to the

Out-of-Pocket Expense Maximums.

Inpatient Hospital (pre-certification required)

You pay Deductible, then the Plan pays 90%

You pay Deductible, then the Plan pays 70% of Reasonable and Customary

Charges

Outpatient Facility

You pay Deductible, then the Plan pays 90%

You pay Deductible, then the Plan pays 70% of Reasonable and Customary

Charges

Emergency Room Services You pay $50 Co-pay per visit if true emergency, then the Plan pays 100% (the Co-pay will be waived if

admitted) If not true emergency, $50 Co-pay, Calendar Year Deductible and applicable Coinsurance will apply

Ambulance

The Plan pays 100%, if true emergency If not true emergency, Calendar Year Deductible and applicable Coinsurance will apply

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HEALTHLINK STANDARD PPO PLAN (continued) Available to Non-Medicare Eligible Participants only

PLAN FEATURE IN-NETWORK OUT-OF-NETWORK

Office Visits (Including covered diagnostic Services performed in the Physician’s office)

You pay Deductible, then the Plan pays 90%

You pay Deductible, then the Plan pays 70% of Reasonable and Customary

Charges

Maternity Care Office Visits/Prenatal & Postnatal, In-Hospital delivery, and Newborn nursery Services

You pay Deductible, then the Plan pays 90%

You pay Deductible, then the Plan pays 70% of Reasonable and Customary

Charges

Allergy Injections and Serum

You pay Deductible, then the Plan pays 90%

You pay Deductible, then the Plan pays 70% of Reasonable and Customary

Charges

Chiropractic Services Limited to 10 visits per year and must be Medically Necessary. Pre-certification is required for additional visits.

You pay Deductible, then the Plan pays 90%

You pay Deductible, then the Plan pays 70% of Reasonable and Customary

Charges

Physical Therapy Limited to 20 visits per year. Pre-certification is required for additional visits.

You pay Deductible, then the Plan pays 90%

You pay Deductible, then the Plan pays 70% of Reasonable and Customary

Charges

Speech/Occupational Therapy Limited to 20 visits per year. Pre-certification is required for additional visits.

You pay Deductible, then the Plan pays 90%

You pay Deductible, then the Plan pays 70% of Reasonable and Customary

Charges

Wellness and Preventive Care Services as recommended (except colonoscopies) Limited to $750 per person per calendar year

The Plan pays 90% (Deductible does not apply)

The Plan pays 70% of Reasonable and Customary

Charges (Deductible does not apply)

Colonoscopies You pay Deductible, then the Plan pays 90%

You pay Deductible, then the Plan pays 70% of Reasonable and Customary

Charges

Home Health Care

You pay Deductible, then the Plan pays 90%

You pay Deductible, then the Plan pays 70% of Reasonable and Customary

Charges

Hospice Care

You pay Deductible, then the Plan pays 90%

You pay Deductible, then the Plan pays 70% of Reasonable and Customary

Charges

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HEALTHLINK STANDARD PPO PLAN (continued) Available to Non-Medicare Eligible Participants only

PLAN FEATURE IN-NETWORK OUT-OF-NETWORK Skilled Nursing Facility

You pay Deductible, then the Plan pays 90%

You pay Deductible, then the Plan pays 70% of Reasonable and Customary

Charges X-Ray and Laboratory Services - Performed in a Hospital or other independent outpatient facility

You pay Deductible, then the Plan pays 90%

You pay Deductible, then the Plan pays 70% of Reasonable and Customary

Charges Durable Medical Equipment

You pay Deductible, then the Plan pays 90%

You pay Deductible, then the Plan pays 70% of Reasonable and Customary

Charges All other Covered Expenses

You pay Deductible, then the Plan pays 90%

You pay Deductible, then the Plan pays 70% of Reasonable and Customary

Charges

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HealthLink Health Savings PPO Plan – Schedule of Benefits

HEALTHLINK HEALTH SAVINGS PPO PLAN Available to Non-Medicare Eligible Participants Only

PLAN FEATURE IN-NETWORK OUT-OF-NETWORK

Lifetime Maximum Benefit

$750,000

Calendar Year Deductible (the annual amount You have to pay out-of-pocket before the Plan begins paying benefits) • You Only Coverage

• You & Spouse (or domestic partner), You & Child(ren), or You & Family Coverage

$1,200

$2,400

IMPORTANT NOTE: The $1,200 deductible applies ONLY if You have elected Retiree Only coverage. If You have elected to cover any family members under the HealthLink Health Savings PPO, the Plan will not pay benefits until Your Calendar Year Deductible of $2,400 has been met, whether by one or more covered individuals.

Amounts paid as an In-network Deductible also apply towards satisfying the Out-of-Network Deductible and vice-versa

Out-of-Pocket Expense Maximum (the maximum out-of-pocket amount of Covered Expenses You have to pay in a single year, including Deductibles)

$3,000 for single coverage $6,000 if Retiree and any family member is covered

$ 5,000 for single coverage

$10,000 if Retiree and any family member is covered

Amounts paid In-Network are included in determining whether You have reached the Out-of-Network out-of-pocket limit

and vice versa

Charges for mental health, alcohol, and substance abuse Treatment not approved by Magellan Behavioral Health, and Utilization Management Review Penalties do not apply to the Out-of-Pocket

Expense Maximums.

Inpatient Hospital (pre-certification required)

You pay Deductible, then the Plan pays 80%

You pay Deductible, then the Plan pays 60% of Reasonable

and Customary Charges

Outpatient Facility

You pay Deductible, then the Plan pays 80%

You pay Deductible, then the Plan pays 60% of Reasonable

and Customary Charges

Emergency Room Services You pay the Deductible, then the Plan pays 100%, if true emergency4

4 If not a true emergency, as defined by the Plan, the Calendar Year Deductible and applicable Coinsurance will apply.

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HEALTHLINK HEALTH SAVINGS PPO PLAN (continued) Available to Non-Medicare Eligible Participants Only

PLAN FEATURE IN-NETWORK OUT-OF-NETWORK

Ambulance

You pay the Deductible, then the Plan pays 100%, if true

emergency5

Office Visits (Including covered diagnostic Services performed in the Physician’s office)

You pay Deductible, then the Plan pays 80%

You pay Deductible, then the Plan pays 60% of Reasonable

and Customary Charges

Maternity Care Office Visits/Prenatal & Postnatal, In-Hospital delivery, and Newborn nursery Services

You pay Deductible, then the Plan pays 80%

You pay Deductible, then the Plan pays 60% of Reasonable

and Customary Charges

Allergy Injections and Serum

You pay Deductible, then the Plan pays 80%

You pay Deductible, then the Plan pays 60% of Reasonable

and Customary Charges

Chiropractic Services-Limited to 10 visits per year and must be Medically Necessary. Pre-certification is required for additional visits.

You pay Deductible, then the Plan pays 80%

You pay Deductible, then the Plan pays 60% of Reasonable and Customary

Charges

Physical Therapy - Limited to 20 visits per year. Pre-certification is required for additional visits.

You pay Deductible, then the Plan pays 80%

You pay Deductible, then the Plan pays 60% of Reasonable and Customary

Charges

Speech/Occupational Therapy - Limited to 20 visits per year. Pre-certification is required for additional visits.

You pay Deductible, then the Plan pays 80%

You pay Deductible, then the Plan pays 60% of Reasonable and Customary

Charges

Home Health Care You pay Deductible, then the Plan pays 80%

You pay Deductible, then the Plan pays 60% of Reasonable and Customary

Charges

Hospice Care You pay Deductible, then the Plan pays 80%

You pay Deductible, then the Plan pays 60% of Reasonable and Customary

Charges

5 *If not a true emergency, as defined by the Plan, the Calendar Year Deductible and applicable Coinsurance will apply.

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HEALTHLINK HEALTH SAVINGS PPO PLAN (continued) Available to Non-Medicare Eligible Participants Only

PLAN FEATURE IN-NETWORK OUT-OF-NETWORK

Skilled Nursing Facility You pay Deductible, then the Plan pays 80%

You pay Deductible, then the Plan pays 60% of Reasonable and Customary

Charges

X-Ray and Laboratory Services - Performed in a Hospital or other independent outpatient facility

You pay Deductible, then the Plan pays 80%

You pay Deductible, then the Plan pays 60% of Reasonable and Customary

Charges

Wellness and Preventive Care Services as recommended (except colonoscopies) Limited to $750 per person per calendar year

The Plan pays 90% (Deductible does not apply)

The Plan pays 70% of Reasonable and Customary

Charges (Deductible does not apply)

Colonoscopies You pay Deductible, then the Plan pays 90%

You pay Deductible, then the Plan pays 70% of Reasonable and Customary

Charges

Durable Medical Equipment

You pay Deductible, then the Plan pays 80%

You pay Deductible, then the Plan pays 60% of Reasonable and Customary

Charges

Prescription Drugs (Managed Indemnity Plan)

You pay Deductible, then the Plan pays 80% (You pay 20% of Caremark’s discounted price)

Up to a maximum supply of 34 days for each prescription for

Retail Drugs and up to 90 days for each prescription for Mail Order Drugs

All other Covered Expenses

You pay Deductible, then the Plan pays 80%

You pay Deductible, then the Plan pays 60%

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Basic Plan – Schedule of Benefits

BASIC PLAN For Non-Medicare Eligible Participants who live outside the HealthLink Network

(Covered Expenses are based on Reasonable and Customary Charges)

PLAN FEATURE PROVIDER OF CHOICE

Lifetime Maximum Benefit $750,000

Calendar Year Deductible (the annual amount You have to pay before the Plan begins paying benefits)

$150 per person $250 per family

Out-of-Pocket Expense Maximums (the maximum out-of-pocket amount of Covered Expenses You have to pay in a single year, including Deductibles)

$1,700 per person $2,650 per person

Charges for mental health, alcohol, and substance abuse Treatment not approved by Magellan Behavioral Health and Utilization Management Review Penalties do not apply to the Out-of-Pocket Expense Maximums.

Inpatient Hospital - (pre-certification required)

You pay the Deductible, then the Plan pays 80% of Reasonable and Customary Charges

Outpatient Facility You pay the Deductible, then the Plan pays 80% of Reasonable and Customary Charges

Emergency Room Services

You pay the Deductible, then the Plan pays 80% of Reasonable and Customary Charges

Ambulance You pay the Deductible, then the Plan pays 80% of Reasonable and Customary Charges

Preadmission Testing Charges

You pay the Deductible, then the Plan pays 80% of Reasonable and Customary Charges

Office Visits (Including covered diagnostic Services performed in the Physician’s office)

You pay the Deductible, then the Plan pays 80% of Reasonable and Customary Charges

Maternity Care Office Visits/Prenatal & Postnatal, In-Hospital delivery, and Newborn nursery Services

You pay the Deductible, then the Plan pays 80% of Reasonable and Customary Charges

X-Ray and Laboratory Services - Performed in a Hospital or other independent outpatient facility

You pay the Deductible, then the Plan pays 80% of Reasonable and Customary Charges

Chiropractic Services – Limited to 10 visits per year and must be Medically Necessary. Pre-certification is required for additional visits.

You pay the Deductible, then the Plan pays 80% of Reasonable and Customary Charges

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BASIC PLAN (continued) For Non-Medicare Eligible Participants who live outside the HealthLink Network

(Covered Expenses are based on Reasonable and Customary Charges)

PLAN FEATURE PROVIDER OF CHOICE

Physical Therapy - Limited to 20 visits per year. Pre-certification is required for additional visits.

You pay the Deductible, then the Plan pays 80% of Reasonable and Customary Charges

Speech/Occupational Therapy - Limited to 20 visits per year. Pre-certification is required for additional visits.

You pay the Deductible, then the Plan pays 80% of Reasonable and Customary Charges

Home Health Care You pay the Deductible, then the Plan pays 80% of Reasonable and Customary Charges

Hospice Care You pay the Deductible, then the Plan pays 80% of Reasonable and Customary Charges

Skilled Nursing Facility You pay the Deductible, then the Plan pays 80% of Reasonable and Customary Charges

Wellness and Preventive Care Services as recommended (except colonoscopies) – Limited to $750 per person per calendar year

The Plan pays 80% of Reasonable and Customary Charges (Deductible does not apply)

Colonoscopies You pay the Deductible, then the Plan pays 80% of Reasonable and Customary Charges

Durable Medical Equipment

You pay the Deductible, then the Plan pays 80% of Reasonable and Customary Charges

All other Covered Expenses

You pay the Deductible, then the Plan pays 80% of Reasonable and Customary Charges

HealthLink Network Programs

The HealthLink PPO Plans are designed to help you reduce healthcare expenses whenever you use a Physician or Hospital that is a member of the HealthLink Network of healthcare providers. HealthLink is able to reduce healthcare costs because, due to the number of people in the program, it can negotiate discounts with Physicians and Hospitals and then pass these discounts on to the members. Your HealthLink provider should bill the program directly for Services rendered. This practice is necessary because all payments for HealthLink claims must be paid directly to the healthcare provider rather than to the patient. It is then the provider's responsibility to contact you if there are any remaining charges for the Services or if you are due a refund. HealthLink does not guarantee the quality of care or the status of the PPO providers in their Network. A HealthLink Network Provider directory is available by accessing Principal’s website at www.principal.com/health or by calling 866.482.6028. To locate a HealthLink network Physician via the Principal website, follow the steps below:

� Visit the Principal website at www.principal.com/health.

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� Select ‘Provider Directory’ from the Resources list on the left side of the page.

� Select ‘Search for a Medical Provider’ to locate physicians and medical facilities in your provider network.

� Under ‘Select Your Network’, choose ‘Healthlink Ameren PPO’.

� You can then tailor your search by selecting the type of provider, specialty, physician name, etc. But, at a minimum, you will need to enter your zip code or city and state before you select the ‘Show Results’ button at the bottom of the page.

� If you would prefer to speak to a customer service representative, you may call Principal at 866.482.6028. Whether using the internet or paper directory, we recommend that you (1) verify your provider's participation in the network before seeking Treatment and (2) confirm PPO participation with Your provider when making Your appointment. If you are in the Basic Medical Plan, it was determined that the HealthLink Network was not adequate in your area at this time. You may use the Physician or Hospital of Your choice, and benefits will be paid according to the Basic Plan Schedule of Benefits shown above using Reasonable and Customary Charges as the basis for processing your claims. Private Health Care Systems (PHCS) Healthy Directions

PHCS Healthy Directions is a shared savings program. The program provides access to healthcare providers (who are not part of the HealthLink network) but through which You may receive Treatment at a negotiated rate. The PHCS Healthy Directions program may provide a solution for unforeseen illness or medical Treatment You receive outside the HealthLink Service Area. If You have to seek Treatment outside of the HealthLink Service area and You use a PHCS provider, benefits will be paid at the PPO Network level (if You are a participant in the HealthLink Standard PPO or HealthLink Health Savings PPO Plans). In addition, if You travel outside the HealthLink network area (e.g. vacation) or a Covered Dependent resides 50 or more miles outside the HealthLink Network area (e.g. child in college) and a PHCS Provider is not available when an unforeseen illness or medical Treatment is needed, the Plan will pay 80% of the Reasonable and Customary Charges (after Deductible) for medical care received from the Non-Network Provider. Participants in the Basic Plan also have access to the PHCS healthcare providers. If You use a PHCS provider, the Plan will still pay 80% of Reasonable and Customary charges; however, the negotiated PHCS Healthy Directions rate is generally less than the prevailing rate among providers who do not participate in this network, therefore, Your Out-of-Pocket Expenses could be less. To locate a provider participating in PHCS Healthy Directions, call 800.241.6350. This number is also shown on Your medical ID card. Uncontrollable Providers

This provision is applicable only to participants in the HealthLink Standard PPO or the HealthLink Health Savings PPO Plan. You and Your Covered Dependents will receive the PPO Network level of benefits (up to Reasonable and Customary Charges) for Services provided by a

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radiologist, pathologist, anesthesiologist and/or Emergency Room Physician at an In-Network PPO Hospital or In-Network PPO licensed free-standing surgical center. For example, if You receive Treatment at a PPO Hospital, and the radiologist who performs a Service for this visit is an Out-of-Network Physician, the radiologist’s bill for Service will be paid at the PPO level of benefit. If the radiologist’s charge is higher than what is considered Reasonable and Customary (R&C), the maximum that the Plan will pay is the R&C amount. Utilization Management Review Requirements

Medical benefits payable for Hospital Confinement Charges will be reduced by $200 unless the pre-certification requirements described in the UTILIZATION MANAGEMENT REVIEW section of this booklet are satisfied. Mental Health/Alcohol/Substance Abuse

MENTAL HEALTH, ALCOHOL or SUBSTANCE ABUSE (Inpatient and Outpatient Treatment)

Administered By Magellan Behavioral Health (MBH)

� Approved by Magellan Behavioral Health (MBH).

� Not approved by Magellan Behavioral Health (MBH).

You pay Deductible, then the Plan pays 90% (for participants in the HealthLink Standard PPO and HealthLink Health Savings PPO).

The Plan pays 80% after the Deductible for participants in the Basic Plan.

You pay Deductible, then the Plan pays 50%

of Covered Expenses

Alcohol Treatment is limited to 30 days per calendar year and Substance Abuse Treatment (other than alcoholism) is limited to 30 days per calendar year.

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Schedule of Benefits for Medicare Eligible Retirees

Conventional Plan – Schedule of Benefits

CONVENTIONAL PLAN For Medicare Eligible Participants

PLAN FEATURE PROVIDER OF CHOICE

Lifetime Maximum Benefit (includes drugs unless You elect a “medical only” option)

$200,000*

Calendar Year Deductible (the annual amount You pay per calendar year before the Plan begins paying benefits)

$150 per person $300 per family

Hospital (Inpatient and Outpatient)

You pay the Deductible, then the Plan pays 80%

Office Visits

You pay the Deductible, then the Plan pays 80%

Ambulance You pay the Deductible, then the Plan pays 80%

Chiropractic Services (medically necessary)

You pay the Deductible, then the Plan pays 80%

Mammograms You pay the Deductible, then the Plan pays 80%

One baseline mammogram for women age 35 through 39

An annual mammogram for women age 40 and older

Eyeglasses The Plan pays 80% after Deductible only when eyeglasses are necessary to repair

damage caused solely by an accident that occurred while covered under the Plan and

charges are incurred within 6 months of accident

X-Ray and Lab (medically necessary, not for routine diagnosis)

You pay the Deductible, then the Plan pays 80%

Blood You pay the Deductible, then the Plan pays 80%

Provider doesn’t accept Medicare Assignment

Covered charges for amounts over the Medicare-approved amounts are payable up to the prevailing fee or the limiting charge

Home Health Care You Pay the Deductible, then the Plan pays 80% of covered charges (no visit limit)

Skilled Nursing Facility (Room and Board charges are not covered)

You pay the Deductible, then the Plan pays 80%

Hospice Care You pay the Deductible, then the Plan pays 80% (no day or dollar limit)

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CONVENTIONAL PLAN (continued) For Medicare Eligible Participants

PLAN FEATURE PROVIDER OF CHOICE

Medicare Approved Durable Medical Equipment

You pay the Deductible, then the Plan pays 80%

Foreign Travel Emergency

You pay the Deductible, then the Plan pays 80%

Inpatient and Outpatient Mental Health, Alcohol or Substance Abuse

You pay the Deductible, then the Plan pays 80%

All other Covered Expenses

You pay the Deductible, then the Plan pays 80%

If $10,000 or more in benefits are paid for any one injury or disease, additional Covered Expenses will be paid at 100% for the injury or disease, up to the Lifetime Maximum Benefit. If no expenses are incurred for that injury or disease for six consecutive months, further expenses will be treated as a new injury or disease. *When You and Your Eligible Dependents become Medicare-eligible, Your lifetime maximum is reset to zero. In other words, any amount previously accumulated under the lifetime maximum provision when You or Your Eligible Dependents were not eligible for Medicare is disregarded and You start with a zero balance under the Medicare eligible Plan. Medicare Supplement Plan – Schedule of Benefits

MEDICARE SUPPLEMENT PLAN** For Medicare Eligible Participants

PLAN FEATURE PROVIDER OF CHOICE

Lifetime Maximum Benefit (includes drugs unless You elect a “medical only’ option)

$200,000*

Calendar Year Deductible (the annual amount You pay per calendar year before the Plan begins paying benefits)

$0 for Part A Equal to Medicare Part B Deductible

(Medicare changes the Part B deductible each year)

Hospital (Inpatient and Outpatient)

Part A – The Plan pays 100% of eligible expenses up to the Medicare approved charge (less the actual amount paid by Medicare)

Part B – The Plan pays 100% of charges not payable by Medicare after the Part B Deductible is met

Office Visits

Part B – The Plan pays 100% of charges not payable by Medicare after the Part B Deductible is met

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MEDICARE SUPPLEMENT PLAN** (continued) For Medicare Eligible Participants

PLAN FEATURE PROVIDER OF CHOICE

Ambulance Part B – The Plan pays 100% of charges not payable by Medicare after the Part B Deductible is met

Chiropractic Services (medically necessary)

Part B – The Plan pays 100% of Covered Expenses (less the actual amount paid by Medicare) for manipulation of spine after the Part B Deductible is met. All other modalities and chiropractic Treatment provided are not covered.

Mammograms The Plan does not pay benefits for these expenses.

Eyeglasses Part B – The Plan pays 100% of Covered Expenses (less the actual amount paid by Medicare) for one pair of eyeglasses following cataract surgery after Part B Deductible is met.

X-Ray and Lab (excluding routine care) Part A – The Plan pays 100% of Covered Expenses up to the Medicare approved charge (less the actual amount paid by Medicare).

Part B – The Plan pays 100% of Covered Expenses (less the actual amount paid by Medicare) after the Part B Deductible is met.

Blood Part A – The Plan pays 100% of Covered Expenses up to the Medicare approved charge (less the actual amount paid by Medicare) for the 1st 3 units received (unless You or someone else donates blood to replace what You use).

Part B – The Plan pays 100% of Covered Expenses (less the actual amount paid by Medicare) after the part B Deductible is met for the 1st 3 units received (unless You or someone else donates blood to replace what You use).

Provider doesn’t accept Medicare Assignment

Covered charges for amounts over the Medicare-approved amounts are not covered.

Skilled Nursing Facility The Plan does not pay benefits for these expenses.

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MEDICARE SUPPLEMENT PLAN** (continued) For Medicare Eligible Participants

PLAN FEATURE PROVIDER OF CHOICE

Hospice Care The Plan does not pay benefits for these expenses.

Home Health Care The Plan does not pay benefits for these expenses.

Medicare Approved Durable Medical Equipment

Part B – The Plan pays 100% of charges not payable by Medicare after the Part B Deductible is met.

Foreign Travel Emergency The Plan does not pay benefits for these expenses.

Inpatient and Outpatient Mental Health, Alcohol and Substance Abuse

Part B – The Plan pays 50% of charges not payable by Medicare after the Part B Deductible is met.

*When You and Your Eligible Dependents become Medicare-eligible, Your lifetime maximum is reset to zero. Any amount previously accumulated under the lifetime maximum provision when You or Your Eligible Dependents were not eligible for Medicare is disregarded and You start with a zero balance under the Medicare eligible Plan. **Covered Expenses under this Plan are limited to Medicare-approved charges. Plan Options When One Participant is Medicare Eligible and the Other is not Medicare Eligible

In the case where one participant is Medicare eligible and the other participant is not, the following Plan options are available:

Option #1 Option #2

Medicare Eligible Participant Conventional Plan Medicare Supplement Plan

Non-Medicare Eligible Participant HealthLink Standard PPO HealthLink Standard PPO

In either case, all covered family members must choose the same prescription drug coverage option (either 3-tier or Coinsurance). Once a covered participant turns age 65, he or she will choose one of the Medicare-eligible options (Conventional or Medicare Supplement) at that time. The non-Medicare eligible Spouse/domestic partner or other family member must, at the same time, move into the HealthLink Standard PPO Plan. An Enrollment Worksheet will be sent to the Medicare-eligible Participant. This worksheet will outline the options available and the associated costs. The participant can then make his/her elections by logging into myAmeren Benefits Web at www.myAmeren.com or by calling the Ameren Benefits Center at 877.7my.Ameren (877.769.2637). If You do not make an election for coverage under the Medicare Supplement or Conventional Plan, You will be defaulted to the Plan option listed below:

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Currently enrolled in . . . Default Medical Plan (if no election is made)

Default Prescription Drug Plan (if You don’t make an election)

HealthLink Standard PPO Medicare Supplement Plan

Same Prescription Drug option You were enrolled in prior to Your age 65.

Basic Plan Medicare Supplement Plan

Same Prescription Drug option You were enrolled in prior to Your age 65.

HealthLink Health Savings PPO

Medicare Supplement Plan

Coinsurance Prescription Drug option

HMO (Group Health Plan, Personal Care or United Healthcare of the River Valley)

Medicare Supplement Plan

Same Prescription Drug option You were enrolled in prior to Your age 65.

Plan Provisions Applicable to All Retirees

Important Notice for Mastectomy Patients

If a Covered Retiree or a Covered Dependent elects breast reconstruction in connection with a mastectomy, such individual is entitled to coverage under this Plan for: (1) Reconstruction of the breast on which the mastectomy was performed; (2) Surgery and reconstruction of the other breast to produce a symmetrical appearance; (3) Prosthesis and Treatment of physical complications at all stages of the mastectomy, including lymphedemas. Such Services will be performed in a manner determined in consultation with the attending Physician and the patient. This coverage is also addresses within the MEDICAL EXPENSE COVERAGE and COVERED EXPENSES sections of this booklet. Deductible Amounts

The Deductible Amount for each calendar year is the amount specified in the applicable Schedule of Benefits. The Plan will subtract the Deductible Amount from Covered Expenses and will then pay the Covered Expenses as stated in the applicable Schedule of Benefits. If You enrolled in the HealthLink Standard PPO, the Basic Plan, the Conventional Plan or the Medicare Supplement Plan, You pay one individual Deductible Amount each calendar year for medical expenses. For satisfaction of the family Deductible Amount, no more than one individual Deductible Amount will apply for any one person. A separate Deductible may apply for prescription drugs. Any co-payment amounts paid under the Emergency Room provision and the Prescription Drug Card Program cannot be used to help satisfy this Deductible Amount. If You enrolled in the HealthLink Health Savings PPO Plan, the individual Deductible Amount applies only if You enrolled in Retiree Only coverage. The family Deductible Amount applies if You and any family member are enrolled, and the full amount may be applied to one individual. This Deductible Amount includes prescription drugs. Any penalties incurred as a result of failure to comply with Utilization Management requirements may not be used to help satisfy Your Deductible.

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Common Accident Provision

IMPORTANT NOTE FOR PARTICIPANTS IN THE MEDICARE SUPPLEMENT PLAN: If You are a participant in the Medicare Supplement Plan, this Common Accident provision will not apply to You and Your eligible dependents. If You are enrolled in the Healthlink Standard PPO Plan or the Basic Plan, in the event of an accident which injures two or more family members, only one Deductible is applied to the medical expenses due to the accident. The Deductible will apply to all covered individuals involved in the accident for the calendar year the accident occurred and also in the following calendar year for the continuing therapeutic Treatment of injuries due to the accident. This common accident provision does not cover medical expenses which are not related to the common accident. For example, if a covered individual involved in a common accident has medical expenses unrelated to the accident, the Deductible for those medical expenses will be the same as if no common accident had occurred. If You are enrolled in the HealthLink Health Savings PPO Plan, this common accident provision does not apply. You will be required to meet the family deductible before benefits are paid under the Plan. Out-of-Pocket Expense Maximums

The maximum Out-Of-Pocket Expense is the amount of Covered Expenses a Covered Retiree or Dependent would pay in a Plan Year before the Plan begins to pay 100% of covered medical expenses. This amount consists of any Deductible payments and the Covered Retiree or Dependent’s portion of Covered Expenses. Once a Covered Retiree or Dependent has incurred total Out-Of-Pocket Expenses, the Plan will pay 100% of all covered medical expenses for the remainder of the Plan Year. The Out-of-Pocket Expense Maximum does not include the following:

� the amount of Covered Expenses paid by the Retiree for mental health, alcohol or substance abuse Treatment which is not approved by Magellan Behavioral Health; or

� the amount You pay because of penalty charges for failure to comply with the Utilization Management Review Requirements; or

� prescription drug Co-pays, Coinsurance amounts or Deductibles under the Express

Scripts Prescription Card Program, if applicable; or � expenses not covered by the Plan, including amounts that exceed Reasonable and

Customary allowances. Lifetime Maximum Benefit

The maximum benefit payable under this Plan during any covered individual’s lifetime is $750,000 for non-Medicare eligible participants and $200,000 for Medicare eligible participants. The lifetime maximum benefit is re-set to zero when a participant becomes Medicare eligible and moves into the Conventional Plan or the Medicare Supplement Plan. Any amounts

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previously accumulated under the lifetime maximum provision when You or Your Eligible Dependents were not eligible for Medicare is disregarded and You start with a zero balance under the Medicare eligible Plan options. Effective January 1, 2008, the lifetime maximum benefit is the total benefit amount that the Plan will pay for covered medical and prescription drug expenses incurred by a participant in his or her lifetime. Important Note: Expenses incurred by Retirees and their Covered Dependents prior to January 1, 2008 will not apply toward the lifetime maximum benefit. This means that on January 1, 2008, You and Your Covered Dependents were treated as new participants who had not used any of Your lifetime maximum. Medical Expense Coverage

Covered Expenses

Covered Expenses will be the actual cost charged to You or one of Your Covered Dependents for Medically Necessary Care, but only to the extent that the actual cost charged does not exceed Reasonable and Customary Charges or the Medicare allowable charge if You are enrolled in the Medicare Supplement Plan. Except for the wellness benefits6 and colonoscopies (for non-Medicare eligible participants only) outlined under Covered Expenses, the expenses must be ordered by a Physician for therapeutic Treatment of an injury or sickness and not be listed as an exclusion under Expenses Not Covered in this booklet. The Covered Expenses listed below are applicable for all Plan options, unless specifically mentioned as an exclusion for any particular Plan option. Covered Expenses include the Reasonable and Customary or Charges for:

� Hospital for room and board, Intensive Care Accommodations and necessary Services and supplies furnished by the Hospital. Reasonable and Customary Charges do not include charges for private Hospital room and board and general nursing care that exceed the Hospital Room Daily Limit. Pre-certification is required for all inpatient confinements for all Retirees and Dependents not eligible for Medicare;

� Birthing Center Services;

� Ambulatory Surgery Center Services;

� the Services of a Physician or surgeon for professional Services;

� the Services of a Health Care Extender;

� the Services of a licensed practical nurse (L.P.N.) or a licensed registered nurse (R.N.);

� physical therapy Services up to 20 outpatient visits per calendar year. Pre-certification is required for more than 20 visits in a calendar year. IMPORTANT NOTE FOR PARTICIPANTS IN THE CONVENTIONAL PLAN AND THE MEDICARE SUPPLEMENT PLAN: If You are a participant in the Conventional Plan or the Medicare Supplement Plan, the 20 visit limit will not apply;

6 Important Note: Wellness and preventive care services are not covered under the Conventional Plan. In addition, under the Medicare Supplement Plan, wellness and preventive care services are only covered if Medicare provides coverage for the service.

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� occupational and speech therapy Services up to a combination of 20 visits per calendar year. Speech therapy benefits will be covered for a residual speech impairment resulting from a stroke, accidental injury, or surgery to the head and neck. Pre-certification is required for more than 20 visits in a calendar year. IMPORTANT NOTE FOR PARTICIPANTS IN THE CONVENTIONAL PLAN: If You are a participant in the Conventional Plan or the Medicare Supplement Plan, the 20 visit limit will not apply;

� chiropractic Services up to a 10 visits per calendar year if deemed Medically Necessary as determined by the Claims Administrator. Pre-certification is required for more than 10 visits in a calendar year. IMPORTANT NOTE FOR PARTICIPANTS IN THE CONVENTIONAL PLAN AND THE MEDICARE SUPPLEMENT PLAN: If You are a participant in the Conventional Plan or the Medicare Supplement Plan, the 10 visit limit will not apply. In addition, if You are a participant in the Medicare Supplement Plan, the only covered chiropractic Service is manipulation of the spine; all other chiropractic modalities/Treatment provided are not covered;

� drugs and medicines requiring a Physician's prescription and approved by the Food and Drug Administration for general marketing (excluding those charges paid under the Express Scripts Prescription Drug Card Program, if applicable);

� surgical dressings, covered orthotics, casts, splints, braces, crutches, artificial limbs, and artificial eyes;

� Durable Medical Equipment, including repair, adjustment, or replacement of purchased Durable Medical Equipment, and certain replacement parts such as batteries, cases and tubing, unless damage results from Your or Your Covered Dependent's negligence or abuse of such equipment. Covered Expenses will not include charges which are in excess of the purchase price of the equipment;

� anesthesia and its administration;

� blood transfusions (including the cost of blood and blood plasma). IMPORTANT NOTE FOR PARTICIPANTS IN THE MEDICARE SUPPLEMENT PLAN: If You are a participant in the Medicare Supplement Plan, the 1st 3 units of blood that You receive as part of an inpatient stay are covered (unless You or someone else donates blood to replace what You use.) All costs (after Deductible) for the 1st 3 units of blood that You receive as part of an outpatient procedure are covered (unless You or someone else donates blood to replace what You use);

� oxygen and rental of equipment for its administration, and nebulizers and related charges.

� x-ray and laboratory examinations made for diagnostic purposes in connection with the therapeutic Treatment (including professional components that are billed by a pathologist in connection with the laboratory testing);

� x-ray, radium, and radioactive isotope therapy;

� professional ambulance Service for transportation to a local Hospital for Emergency Treatment or from the Hospital after confinement;

� transportation within the continental United States and Canada by railroad or regularly scheduled flight of a commercial airline from the location where the individual becomes disabled due to any covered injury or disease to (but not returning from) a legally constituted Hospital equipped to furnish special Treatment for such disability;

� eye exams or glasses that are necessary to repair damage that was caused solely by an accidental injury that occurred while You or Your Dependent were covered under the Plan

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and provided such charges are incurred within six months of the date of the accident. IMPORTANT NOTE FOR PARTICIPANTS IN THE MEDICARE SUPPLEMENT PLAN: If You are a participant in the Medicare Supplement Plan, the only covered expense for eyeglasses is for one pair of glasses following cataract surgery. For all other medical plans, glasses or contacts following cataract surgery are not covered;

� Cosmetic Treatment and Services or complications arising therefrom that results from a sickness or an accidental injury, provided the procedure or Service is completed within 24 months after the onset date of that sickness or injury;

� Dental Services to repair damage to the jaw and sound natural teeth, if the damage is the direct result of an accident (but did not result from chewing) and provided such charges are incurred within six months of the date of the accident

� Home Health Care as described in this booklet. IMPORTANT NOTE FOR PARTICIPANTS IN THE MEDICARE SUPPLEMENT PLAN: If You are a participant in the Medicare Supplement Plan, Home Health Care Services are not covered;

� Hospice Care as described in this booklet. IMPORTANT NOTE FOR PARTICIPANTS IN THE MEDICARE SUPPLEMENT PLAN: If You are a participant in the Medicare Supplement Plan, Hospice Care Services are not covered;

� Skilled Nursing Facility as described in this booklet. IMPORTANT NOTE FOR PARTICIPANTS IN THE MEDICARE SUPPLEMENT PLAN: If You are a participant in the Medicare Supplement Plan, Skilled Nursing Facility Services are not covered;

� Treatment or Service related to Mental Health and alcohol or other substance abuse as described under Magellan Managed Care Program For Mental Health And Alcohol Or Substance Abuse;

� Non-Experimental and non-Investigational human to human organ or bone marrow transplants (Participants in the HealthLink Standard PPO, HealthLink Health Savings PPO and the Basic Plan should refer to the Transplant Services portion of this booklet for more information);

� Treatment or Service related to the pregnancy of a Retiree or the Dependent Spouse/domestic partner of a Retiree;

� Treatment or Service provided in a Veterans Administration Hospital for non-Service connected illness;

� Treatment or Service provided while confined in a military medical facility incurred by a U.S. military Retiree (and any Covered Dependents); and

� Reconstructive breast surgery in connection with a mastectomy for:

- reconstruction of the breast on which a mastectomy has been performed; - surgery and reconstruction of the other breast to produce a symmetrical

appearance; and - prosthetic devices and physical complications of the mastectomy, including

lymphedemas. An expense is considered "incurred" on the date the Services or supplies related to the charge are provided or received.

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Additional Covered Expenses

The following expenses are covered only for participants in the HealthLink Standard PPO, HealthLink Health Savings PPO and Basic Plan options

� dental care provided in a Hospital (including the charges provided by the Hospital, Physician, or nurse) as described under General Anesthesia–Hospital Charges for Dental and subject to utilization review by the Cost Containment Administrator;

� Treatment or Service due to any form of temporomandibular joint disorder (malfunction, degeneration, or disease related to the joint that connects the jaw to the skull), including but not limited to braces, splints, appliances, or surgery of any type;

� the Services of licensed speech pathologists, audiologists, and speech language pathologists for a residual speech impairment resulting from a stroke, accidental injury, or surgery to the head and neck;

� hearing aids as follows:

- otologic examination of each ear by a Physician; - audiologic examination and hearing evaluations of each ear by a certified or

licensed audiologist; - one personal hearing aid for each ear during the lifetime of each covered individual

prescribed as a result of the above examinations. Covered Expenses will include: ear molds; the hearing aid; the initial batteries, cords and other necessary equipment; a warranty; and follow-up consultation within 30 days after delivery of the hearing aid;

� wellness and preventive care Services as recommended, up to an annual maximum benefit of $750 per person (Deductible will be waived);

� colonoscopies Case Management

If You are a participant in the HealthLink Standard PPO, HealthLink Health Savings PPO and Basic Plan, Covered Expenses will also include case management Services provided pursuant to this Plan, to utilize a more cost effective Generally Accepted form of Medically Necessary Care, when compared to use of Covered Expenses contained in this Plan. Case management is a process which coordinates health care Services for an individual to promote quality, Appropriate, cost-effective outcomes. The process involves early intervention and proactively working with the patient, family, Treatment team, insurance company or employer, and community or government resources to address problems, barriers, fragmentation of care, and solutions. Multiple Surgical Procedures

If You or one of Your Covered Dependents undergoes two or more procedures during the same anesthesia period, Covered Expenses for the Services of the Physician, facility, or other covered provider for each procedure that is clearly identified and defined as a separate procedure will be based on:

� 100% of Reasonable and Customary Charges for the first or primary procedure; and

� 50% of Reasonable and Customary Charges for the second procedure; and

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� 25% of Reasonable and Customary Charges for each of the other procedures.

Covered Expenses For An Assistant During Surgical Procedures

Benefits will be payable for the Services of an assistant to a surgeon if the skill level of an M.D. or D.O. would be required to assist the primary surgeon. Covered Expenses for such Services will be paid at up to 20% of Reasonable and Customary Charges of the covered surgical procedure if the procedure is performed by a Physician or a Health Care Extender. Note: The percentiles described in the ‘MULTIPLE SURGICAL PROCEDURES’ section above will be applied. General Anesthesia–Hospital Charges for Dental

The following section is only applicable to participants in HealthLink Standard PPO, HealthLink Health Savings PPO and Basic Plan Covered Charges will include charges incurred for the administration of general anesthesia in a Hospital, surgical center, or office for the Treatment of dental care. Covered Charges will also include Hospital and facility charges related to the dental care received while under anesthesia. Benefits are payable when incurred by You or Your Covered Dependent who:

� is less than five years of age; or

� is severely disabled; or

� who has a medical or behavioral condition which requires Hospitalization or general anesthesia when dental care is provided.

Benefits will be payable the same as for any other covered Treatment or Service. Home Health Care

This section is not applicable to participants in the Medicare Supplement Plan. If You are a participant in the Medicare Supplement Plan, Home Health Care is not a covered expense. Covered Expenses will include charges by a Home Health Care Agency for:

� part-time or intermittent home nursing care by or under the supervision of a licensed registered nurse (R.N.); and

� part-time or intermittent home care by a Home Health Aide; and

� physical, occupational, speech, or respiratory therapy; and

� intermittent Services of a registered dietician or social worker; and

� drugs and medicines which require a Physician's prescription, as well as other supplies prescribed by the attending Physician; and

� laboratory Services. The Home Health Care Services must be rendered in accordance with a prescribed Home Health Care Plan. The Home Health Care Plan must be:

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� established prior to the initiation of the Home Health Care Services; and

� prescribed by the attending Physician. The general exclusions listed in this section under Expenses Not Covered will apply to Home Health Care. In addition, Covered Expenses will not include charges for:

� Services or supplies not included in the Home Health Care Plan; or

� the Services of any person in Your or Your Covered Dependent's Immediate Family, or any person who normally lives in Your or Your Covered Dependent's home; or

� Custodial Care; or

� transportation Services. Hospice Care

This section is not applicable to participants in the Medicare Supplement Plan. If You are a participant in the Medicare Supplement Plan, Hospice Care is not a covered expense. Covered Expenses will include charges for Hospice Care Services provided by a Hospice, Hospice Care Team, Hospital, Home Health Care Agency, or Skilled Nursing Facility for:

� any terminally ill individual (You or any one of Your Covered Dependents) who chooses to participate in a Hospice Care Program rather than receive aggressive medical Treatment to promote cure, and who, in the opinion of the attending Physician, is not expected to live longer than six months; and

� the family (You and Your Covered Dependents) of any such individual; but only to the extent that such Hospice Care Services are provided under the terms of a Hospice Care Program and are billed through the Hospice that manages that program. Hospice Care Services consist of:

� inpatient and outpatient care, home care, nursing care, homemaking Services, dietary Services, social counseling, and other supportive Services and supplies provided to meet the physical, psychological, spiritual, and social needs of the dying individual; and

� drugs and medicines (requiring a Physician's prescription) and other supplies prescribed for the dying individual by any Physician who is a part of the Hospice Care Team; and

� instructions for care of the patient, social counseling, and other supportive Services for the family of the dying individual.

The general exclusions listed in this section under Expenses Not Covered will apply to Hospice Care. In addition, Covered Expenses will not include Hospice Care charges that:

� are for Hospice Care Services not approved by the attending Physician and the Claims Administrator; or

� are for transportation Services; or

� are for Custodial Care; or

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� are for Hospice Care Services provided at a time other than during an Episode of Hospice Care.

Skilled Nursing Facility Confinement

This section is not applicable to participants in the Medicare Supplement Plan. If You are a participant in the Medicare Supplement Plan, Skilled Nursing Facility Confinement is not a covered expense. Covered Expenses will include charges required for Treatment*, provided the confinement:

� is certified by a Physician as necessary for recovery from a sickness or injury; and

� requires skilled nursing Services. * See Room and Board charges below to determine if these are Covered Expenses under Your Plan

option. Room and Board Charges IMPORTANT NOTE FOR PARTICIPANTS IN THE CONVENTIONAL PLAN: Covered Expenses will not include room and board charges in a Skilled Nursing Facility. If You are a participant in the HealthLink Standard PPO, the HealthLink Health Savings PPO or the Basic Plan, the Plan will cover room and board charges; however, the covered charges for each day will be not more than:

� the actual room charge (if Hospital confinement was in a semi-private room); or

� the Hospital Room Daily Limit (if the Hospital confinement was in a private room); of the Hospital in which You or Your Covered Dependent was confined before the Skilled Nursing Facility confinement. If You or Your Covered Dependent were not confined immediately prior to admission to the Skilled Nursing Facility, this will be calculated based on the room rate of the most recent Hospital confinement within the past 90 days. If You or Your Covered Dependent have not been Hospital confined during this period, the room rate will be based on the room rate at the Hospital Your Physician would have admitted You to for this sickness or injury if Hospitalization had been required. Covered charges will not include charges incurred for a Skilled Nursing Facility confinement after the date the attending Physician stops Treatment or withdraws certification. Magellan Managed Care Program For Mental Health and Alcohol or Substance Abuse

Only Retirees or Dependents who are not eligible for Medicare participate in the Magellan Behavioral Health (MBH) Managed Care Program. All Treatment for covered individuals for mental health, or alcohol or substance abuse must be accessed through and approved by Magellan Behavioral Health (MBH), an independent company, in order for the Treatment to be covered under the regular schedule of benefits. If You or a Covered Dependent need Treatment for mental health, or alcohol or other substance abuse problems, You or Your Covered Dependent must contact MBH at 800.289.1109 for pre-

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certification of Treatment. An appointment will be scheduled with the patient to see a counselor. The counselor will assess the problem, determine the Appropriate Treatment, and refer the patient to the Appropriate provider. While the patient is receiving Treatment, Magellan will continue to follow the patient's progress and authorize any changes in the course of Treatment. This Program covers Treatment on both an inpatient and an outpatient basis. In the case of Emergency Treatment, MBH must be notified within 24 hours of admission to a facility for Treatment. MBH counselors are available 24 hours a day, 7 day a week. If Magellan approves, benefits will also be payable for confinements in an alternate Inpatient Alcohol or Drug Abuse Treatment Facility defined as an institution that:

� is licensed by the proper authority of the state in which it is located; and

� is primarily engaged in providing alcohol or drug detoxification or rehabilitation Treatment Services; and

� is supervised on a full-time basis by a Doctor of Medicine (MD) or Doctor of Osteopathy (DO); and

� provides 24-hour a day on-site nursing care by licensed registered nurses (RN). Coverage for the Treatment of alcoholism is limited to 30 days each calendar year and coverage for the Treatment of substance abuse (other than alcoholism) is limited to 30 days each calendar year. For covered individuals who receive Treatment for mental health, or alcohol or substance abuse problems without accessing the Treatment through MBH, reimbursement under the Plan will be reduced to 50% of the Covered Expenses. Benefit Determinations If a covered individual (or authorized representative) requests pre-certification of Treatment of a mental health or substance abuse condition but fails to follow the Plan’s procedures for filing pre-Service requests, Magellan will notify such person orally of the failure within five (5) days (within 24 hours if the request involves urgent care) and of the proper procedures to follow. If a request for certification of mental health or substance abuse Treatment is denied in whole or in part, Magellan will provide notice of the denial to the covered individual and his or her provider. An authorized representative is a person the Covered Retiree or Covered Dependent authorizes, in writing, to act on his or her behalf or a person given authority by court order to request Treatment or submit claims on such person’s behalf. In the case of urgent care, a health care professional with knowledge of the covered person’s condition may always act as the authorized representative. Urgent Care If the Service, supply or procedure requires advance approval before a benefit will be payable, and Magellan or the Physician determines that the request is for urgent care, the covered

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individual will be notified orally of Magellan’s decision within 72 hours after Magellan receives the request, so long as all information needed to process the request was provided to Magellan along with the request. Urgent care means Services needed to treat a condition for which delay in notification or certification could seriously jeopardize one’s life or health or the ability to regain maximum function, or that, in the opinion of the Physician, could cause severe pain that could not be adequately managed without prompt Treatment. If additional information is needed to process the request, Magellan will notify the covered individual within 24 hours of receipt of the request. The covered individual will be given at least 48 hours to submit the information, and You will be notified of the decision no later than 48 hours after the end of that additional time period (or after Magellan’s receipt of the information, if earlier). Pre-Service and Post-Service Requests Notification of Magellan’s decision will be provided no later than:

� For pre-Service requests -- within 15 days after Magellan’s receipt of the request.

� For post-Service requests-- 30 days after receipt of the request. A pre-Service request is a request for certification of MHSA Treatment made to Magellan before MHSA care is received (other than requests relating to urgent care). A post-Service request is a request for certification of MHSA Treatment made to Magellan after MHSA care is received. Magellan may extend the determination time period for up to an additional 15 days if the extension is necessary due to circumstances outside Magellan’s control. In that case, the covered individual will be notified of the extension before the end of the initial 15 or 30-day period. If Magellan extends the time period in order to allow necessary information to be furnished, the covered individual will be given an additional period of at least 45 days after receiving the notice to furnish that information. The covered individual will be notified of Magellan’s decision no later than 15 days after the end of that additional time period (or after Magellan’s receipt of the information, if earlier). Ongoing Course of Treatment If a covered individual is receiving an ongoing course of MHSA Treatment previously authorized by Magellan, Magellan will notify the individual in advance if it intends to terminate or reduce benefits so that the individual will have an opportunity to appeal the decision before the termination or reduction takes effect. If the course of Treatment involves urgent care, and a request for an extension of the course of Treatment is made at least 24 hours before expiration of the certification, Magellan will notify the individual of its decision within 24 hours after receipt of the request.

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Notice of Adverse Benefit Determination Magellan will notify a claimant in writing if his or her request for certification of MHSA Treatment is denied in whole or in part. This notice will include the following information:

� the specific reason or reasons for Magellan’s determination;

� a reference to specific Plan provisions on which the determination is based;

� a description of any additional material or information necessary for an appeal review and an explanation of why it is necessary;

� a description of Plan procedures and time limits for appealing the decision, including a description of the expedited appeal process if the request involves urgent care;

� a statement of the claimant’s right to bring a civil action under section 502(a) of ERISA if Your appeal is unsuccessful;

� a statement of the claimant’s right to receive, free of charge, upon Your request, any internal rule, guidelines, protocol or similar criterion relied on in making the determination; and

� a statement of the claimant’s right to receive, free of charge, upon Your request, an explanation of the scientific or clinical judgment for the determination if it is based on medical necessity or Experimental Treatment or similar exclusion or limit.

If an Urgent Care, a Pre-Service or a Post-Service request for certification for MHSA Treatment is denied, the covered individual (or authorized representative) may appeal the decision to Magellan as described in the Plan’s appeal procedures. Transplant Services

The information in this section is only applicable to participants in the HealthLink Standard PPO, HealthLink Health Savings PPO and Basic Plan "Transplant Services" means Covered Expenses incurred in connection with the Covered Transplants listed below that are for Medically Necessary Care and not considered to be an Experimental or Investigational Measure. The following benefits are payable for Treatment or Service for Transplant Services. These benefits will be payable instead of any other benefits described in this booklet, unless otherwise indicated below. The following human-to-human organ or bone marrow transplant procedures are considered Covered Charges, subject to all limitations and maximums described in this section, for a patient that is covered under this Plan.

� Heart;

� Heart/lung (simultaneous);

� Lung;

� Liver;

� Kidney;

� Pancreas;

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� Kidney-Pancreas;

� Small bowel;

� Bone marrow transplant or peripheral stem cell infusion when a positive response to standard medical Treatment or chemotherapy has been documented. Coverage is for one transplant or infusion only within a 12-month period, unless a tandem transplant or infusion is determined to be Generally Accepted and not considered Experimental or Investigational.

Cornea and skin transplants are not Covered Transplants for the purpose of this Transplant Services section. Instead, cornea and skin transplants are covered under the normal provisions of the Medical section, and are not subject to any conditions set forth in this Transplant Services section. Transplant Services Covered Expenses include all Services listed in the general Medical Covered Expenses section, including, but not limited to, Services by a Home Health Care Agency, Skilled Nursing Facility, or Hospice. Covered Expenses include cryopreservation and storage of bone marrow or peripheral stem cells when the cryopreservation and storage is part of a protocol of high dose chemotherapy, which has been determined by the Claims Administrator to be Medically Necessary Care, not to exceed $10,000 per approved transplant. Covered Expenses also include charges incurred by the organ donor for a Covered Transplant if the charges are not covered by any other medical expense coverage. For Transplant Services provided by a provider in the Transplant Network, benefits for Treat-ment or Service received are payable as described below:

� For those utilizing the HealthLink PPO Plan, benefits are paid at the PPO In-Network level of benefits; and

� For those utilizing the Basic Plan, benefits are paid at 80% after the calendar year Deductible is met.

If transplant related Services are provided by a provider in the Transplant Network, travel and lodging expenses for the transplant recipient and a travel companion are covered if the treating facility is greater than 100 miles one way from the transplant recipient’s home (excluding travel or lodging provided by a family member or friend). This would include ambulance expenses that would otherwise be excluded under the Medical ambulance benefit, if such expenses are incurred solely to meet timing requirements imposed by the transplant. Benefits payable cannot be used to satisfy any Deductible or Co-payment amount under the ambulance benefit in the normal provisions of the Medical section. If You are enrolled in the Healthlink PPO Plan or the Basic Plan, travel and lodging benefits are payable at 100% without application of any Deductible Amount, up to a maximum benefit of $10,000 for each approved transplant. If You are enrolled in the HealthLink Health Savings PPO Plan, travel and lodging benefits will be payable at 100% after the applicable deductible has been met, up to a maximum benefit of $10,000 for each approved transplant.

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For Transplant Services provided by any covered provider other than a provider in the Transplant Network, benefits are payable the same as any other covered Treatment or Service, subject to the same Deductibles and Coinsurance amounts for each covered Member or Dependent. No benefits are payable for travel and lodging expenses if Services are provided outside the Transplant Network. The general Medical limitations listed in the Expenses Not Covered Section of this booklet also apply to Transplant Services. Limitations specific to Home Health Care, Skilled Nursing Facility Confinement, and Hospice Care provisions apply to Transplant Services if those benefits are used in connection with a Covered Transplant. For each transplant episode Covered Expenses will be limited to:

� transplant evaluations from no more than two transplant providers; and

� no more than one listing with the United Network of Organ Sharing (UNOS). If the transplant is not a Covered Transplant under the Plan, all charges related to the transplant and all related complications will be excluded from payment under the Plan, including, but not limited to, dose-intensive chemotherapy. Benefits paid for Transplant Services will be applied to the Medical Overall Lifetime Maximum Benefit and this maximum will be reduced by the benefits paid. Expenses Not Covered

Expenses for which no benefits will be paid include but are not limited to (this is not an exhaustive list):

� Treatment or Service that is not for Medically Necessary Care; or

� Treatment or Service that is an Experimental or Investigational Measure. (The denial of any claim on the basis of the exclusion of coverage for Experimental or Investigational Treatment or Service may be appealed through the procedure described in the notice of that claim decision); or

� any part of a charge for Treatment or Service that exceeds Reasonable and Customary Charges; or

� the Services of any person in Your Immediate Family or any person in Your Covered Dependent's Immediate Family; or

� Treatment or Services by a Christian Science Practitioner; or

� Dental Services and materials including dental implants (except as described under Covered Expenses); or

� hearing aids or other implantable devices (except as described under Additional Covered Expenses); or

� eye examinations for the correction of vision or the fitting of glasses or frames or lenses (except as described under Covered Expenses); or

� acupuncture or acupressure Treatment; or

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� Treatment or Service for unattended home sleep studies; or

� drugs or medicines that do not require a Physician’s prescription or have not been approved by the Food and Drug Administration for general marketing; or

� vitamins, minerals, nutritional supplements (even if the only source of nutrition) or special diets (whether they require a Physician's prescription or not); or

� wigs or hair prostheses; or

� Treatment or Services for Custodial Care; or

� comfort or convenience Services and supplies such as personal hygiene items, air conditioners, humidifiers, diapers, underpads, bed tables, tub bench, Hoyer lift, gait belt, bedpans, physical fitness equipment, stair glides, elevators or lifts, motorized carts, scooters, strollers, amigo carts, standing frames, feeding chairs, feeding equipment, whether or not recommended by a Physician; or

� charges for heating pads, heating and cooling units, ice bags or cold therapy units; or

� cranial molding/remodeling helmets whether or not recommended by a Physician; or

� Cosmetic Treatment or Service or any complications arising therefrom (except as described under Covered Expenses); or

� Treatment or Service for educational or training problems, learning disorders, marital counseling, social counseling (except as provided under Home Health Care, Hospice Care, or if approved by Magellan), or education or training for developmental delay; or

� Treatment or Service for which You or Your Covered Dependent have no financial liability or that would be provided at no charge in the absence of coverage; or

� Treatment or Service that is paid for or furnished by the United States Government or one of its agencies (except as required under Medicaid provisions or Federal law); or

� Treatment or Service that results from war or act of war, whether declared or undeclared; or

� Treatment or Service to improve vision by changing the refraction such as, but not limited to: Kerato-Refractive Eye Surgery or LASIK (laser assisted in-situ keratomileusis) for myopia (nearsightedness), hyperopia (farsightedness), or astigmatism, including any complications there from (See ‘LASER VISION CORRECTION DISCOUNT’ for information on discounts for laser vision correction); or

� charges for telephone calls and/or telephone consultations; or

� charges for e-mail communication or e-mail consultations; or

� Charges for Physician overhead, including but not limited to equipment used to perform the particular Treatment or Service (i.e. laser equipment); or

� Treatment or Service for provider’s standby Services (“waiting time” by the provider); or

� Treatment or Service that results from a sickness that is covered by a Workers' Compensation Act or similar law; or

� Treatment or Service that results from an injury arising out of or in the course of any employment for wage or profit; or

� Treatment or Service related to preventive medical expenses such as annual physical exams, except mammograms (except as described under ‘Additional Covered Expenses’)

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� Treatment or Service related to the restoration of fertility or the promotion of conception including but not limited to in-vitro fertilization; Uterine embryo ravage; Embryo transfer; Artificial insemination; Gamete intrafallopian tube transfer; Zygote intrafallopian tube transfer; and Low tubal ovum transfer; or

� the reversal of voluntary sterilization; or

� barrier-free home modifications whether or not recommended by a Physician, including, but not limited to, ramps, grab bars, or railing; or

� sexual disorder therapy; or

� smoking cessation or nicotine addiction, gambling addiction, or stress management; or

� insertion, removal, or revision of breast implants, unless provided post-mastectomy; or

� missed appointments; or

� Treatment or Service for any sickness or condition for which the insertion of breast implants or the fact of having breast implants within the body was a contributing factor, unless the sickness or condition occurs post-mastectomy; or

� non-implantable communicator-assist devices, including but not limited to, communication boards, and computers; or

� Treatment or Service for work-hardening Services or vocational rehabilitation programs; or

� Treatment or Service leading to, in connection with, or resulting from sexual transformation or intersex surgery; or

� Treatment or Services for maintenance or supportive level of care, or when maximum therapeutic benefit (no further objective improvement) has been attained; or

� Treatment or Services for obesity, (except Medically Necessary Care for morbid obesity, including surgery will be covered); or

� cryopreservation or storage (except as described under Transplant Services); or

� Treatment or Service for and complications related to:

- human-to-human organ or bone marrow transplants, except as described under Transplant Services; or

- animal-to-human organ or tissue transplants; or - implantation within the human body of artificial or mechanical devices designed to

replace human organs; or

� Treatment or Service related to pregnancy of a Dependent Child of a Retiree; or

� Treatment or Service that results from the abortion of a pregnancy, except that benefits are payable for the abortion only if:

- continuation of the pregnancy would endanger the life of the mother; or - medical Treatment is required because of complications resulting from an abortion;

or

� Treatment or Service for foot care with respect to: corns, calluses, flat feet, fallen arches, trimming of toe nails, chronic foot strain, or symptomatic complaints of the feet, casting for orthotics, or any appliance (including orthotics). This limitation does not apply for Medically Necessary foot care (including Treatment for diabetes); or

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� Charges for travel and lodging except as described under Transplant Service; or (applicable to participants in the HealthLink Standard PPO, HealthLink Health Savings PPO and Basic Plan only)

� Treatment or Service provided outside the United States, when travel is primarily for the purpose of receiving medical diagnosis and Treatment; or

� Treatment or Service that results from participation in criminal activities; or

� Molecular genetic testing (specific gene identification) for the purposes of health screening or if not part of a treatment regimen for a specific sickness; or

� Additional charges incurred because care was provided after hours, on a Sunday, holidays, or weekend.

Laser Vision Correction Discount

Principal Life Insurance Company offers a laser vision correction discount for You and Your covered dependents. You can receive a 15% discount off of standard pricing or a 5% discount off of promotional pricing if the laser vision correction surgery is performed by a provider in the National Lasik Network (NLN), administered by LCA-Vision, Inc. To find out if there is a NLN provider in Your area, call 888.647.3937 or visit www.principallasik.com. Note: Treatment and service from the National Lasik Network is not covered under the medical plan. Utilization Management Review

The information in this section is only applicable to participants in the HealthLink Standard PPO, HealthLink Health Savings PPO and Basic Plan Notice of Utilization Management Review

The Cost Containment Administrator must be notified in advance if You or a Covered Dependent requires Hospitalization. If You, Your Covered Dependent, or authorized representative do not follow the Utilization Management procedures explained below, the level of benefits may be reduced. Note: For Hospital confinements due to a mental health condition, alcohol, or other substance abuse, You must contact Magellan Behavioral Health (MBH). See MAGELLAN MANAGED CARE PROGRAM

FOR MENTAL HEALTH AND ALCOHOL OR SUBSTANCE ABUSE. Hospital Admission Review Requirements

Hospital Admission Review requirements are only applicable when medical care is received from a Non-Network Provider. If You receive care from a Network Provider, You do not need to comply with the Hospital Admission Review Requirements. Benefits payable for inpatient Hospital Confinement Charges will be reduced by the first $200 of Covered Expenses unless a Hospital Admission Review is requested in a timely manner from the Cost Containment Administrator by You, Your Covered Dependent, or authorized representative. For a scheduled admission, a Hospital Admission Review must be initiated and completed prior to the first day of confinement. It is recommended that You initiate the process as soon as an inpatient confinement is scheduled. For an emergency admission, Your Hospital Admission Review must be completed within two business days of admission to the Hospital.

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If Your Hospital admission is not certified as Medically Necessary Care by the Cost Containment Administrator, benefits will be payable only for that part of the Hospital Confinement Charges the Cost Containment Administrator determines to be Medically Necessary Care. Certain exceptions apply to Hospital confinement for childbirth as described below. The $200 reduction in Benefits Payable is a penalty for failure to comply with the Utilization Management Review Requirements listed. The reduction will not count toward satisfaction of the Out-of-Pocket Expense limits described in the SCHEDULE OF BENEFITS section. For the purpose of these requirements, "Hospital Admission Review" means review by the Cost Containment Administrator of a Physician's report of the need for a Hospital confinement, scheduled or emergency, (unless it is for an automatically approved Hospital confinement for childbirth as described below). The Physician’s report (verbal or written) must include the:

� reason(s) for the Hospital confinement; and

� significant symptoms, physical findings, and Treatment plan; and

� procedures performed or to be performed during the Hospital confinement; and

� estimated length of the Hospital confinement. Hospital Admission Review for Maternity Care

Applicable to medical care received from Non-Network Providers Hospital Admission Review by the Cost Containment Administrator is required for all inpatient confinements (scheduled or emergency). The following exception applies to a Hospital confinement for childbirth. Medically Necessary requirements are waived and a Hospital Admission Review is not required for mother and baby, for:

� A 48-hour Hospital confinement following vaginal delivery; or

� A 96-hour Hospital confinement following cesarean section. A request for review by the Cost Containment Administrator of the need for continued Hospital confinement for mother or baby beyond the automatically approved time period stated above must be made by You, Your Covered Dependent, or an authorized representative before the end of that time period. If You, Your Covered Dependent, or authorized representative fail to request a Hospital Admission Review as specified in this section, benefits will be reduced as described above. Exception: For all Hospital Confinement Charges incurred beyond the 48-hour or 96-hour automatically approved Hospital confinement for childbirth, the penalty will be applied beginning on the date the automatically approved time period ends. Except as waived above, no benefits will be payable for any Treatment or Service that is not for Medically Necessary Care.

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Special Rights on Childbirth Group health plans generally may not, under federal law, restrict benefits for any Hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean section. However, federal law generally does not prohibit the mother’s or newborn’s attending provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable). In any case, plans may not, under federal law, require that a provider obtain authorization from the Plan or the Claims Administrator for prescribing a length of stay not in excess of 48 hours (or 96 hours). Continued Stay Review

If a Hospital confinement will exceed the approved number of days, the Cost Containment Administrator will initiate a Continued Stay Review. For the purpose of these requirements, "Continued Stay Review" means a review by the Cost Containment Administrator of a Physician's report of the need for continued Hospital confinement. The report (verbal or written) must include the:

� reason(s) for requesting continued Hospital confinement; and

� significant symptoms, physical findings, and Treatment Plan; and

� procedures performed or to be performed during the Hospital confinement; and

� estimated length of the continued Hospital confinement. Utilization Review Program

Notice of Utilization Review

For purposes of satisfying the claims processing requirements, receipt of claim will be considered to be met when the Cost Containment Administrator receives notification of utilization review services. If You, your Dependent, or designated patient representative fails to follow the Cost Containment Administrator’s procedures for filing a claim for a Hospital Admission Review, a Prospective Review or an Urgent Review, the Cost Containment Administrator will notify You, your Dependent, or designated patient representative of the failure and the proper procedures to be followed. Prospective Review

For an initial Prospective Review, a decision and notification of the decision will be made within 15 calendar days of the date the Cost Containment Administrator receives Notification of Utilization Review Services. If a decision cannot be made due to insufficient information, the Cost Containment Administrator will either issue a Noncertification or send an explanation of the information needed to complete the review prior to expiration of the 15 calendar days. If the Cost Containment Administrator does not issue a Noncertification and requests additional information to complete the review, You, the patient, the attending Physician or other Ordering Provider, or the facility rendering the service is permitted up to 45 calendar days to provide the necessary information. The Cost Containment Administrator will render a decision within 15 calendar days of either receiving the necessary information or the expiration of 45 calendar

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days, if no additional information is received. For certifications, the Cost Containment Administrator will provide notification to the attending Physician or other Ordering Provider, the facility rendering service and You or the patient. Upon request, the Cost Containment Administrator will provide written notification of the certification. For Noncertifications, notification will be made in writing to the attending Physician or other Ordering Provider, the facility rendering service, and You or the patient. Urgent Prospective Review

For Urgent Review of a Prospective Review, a decision and notification of the decision will be made within 72 hours of the date the Cost Containment Administrator receives Notification of Utilization Review Services. If a decision cannot be made due to insufficient information, the Cost Containment Administrator will either issue a Noncertification or send an explanation of the information needed to complete the review within 24 hours of receipt of Notification of Utilization Review Services. If the Cost Containment Administrator does not issue a Noncertification and requests additional information to complete the review, You, the patient, the attending Physician or other Ordering Provider or the facility rendering the service is permitted up to 48 hours to provide the necessary information. The Cost Containment Administrator will render a decision within 48 hours of either receiving the necessary information or if no additional information is received, the expiration of the 48 hours to provide the specified additional information. For certifications, the Cost Containment Administrator will provide notification to the attending Physician or other Ordering Provider, the facility rendering service and You or the patient. Upon request, the Cost Containment Administrator will provide written notification of the certification. For Noncertifications, notification will be made in writing to the attending Physician or other Ordering Provider, the facility rendering service and You or the patient. Concurrent Review

For a Concurrent Review that does not involve an Urgent Concurrent Review, a request to extend a course of treatment beyond the period of time or number of treatments previously approved by the Cost Containment Administrator will be decided within the timeframes and according to the requirements for Prospective Review. For an Urgent Concurrent Review, a request to extend a course of treatment beyond the period of time or number of treatments previously approved by the Cost Containment Administrator will be decided and notification of the decision will be made within 24 hours of receipt of the Notification of Utilization Review Services if the request is made at least 24 hours prior to the expiration of the previously approved period or number of treatments. If a request is made less than 24 hours prior to the expiration of the previously approved period or number of treatments, a decision and notification of the decision will be made within 72 hours of receipt of the Notification of Utilization Review Services. Retrospective Review

For a Retrospective Review, a decision and notification of the decision will be made within 30 calendar days after the date the Cost Containment Administrator receives Notification of Utilization Review Services. If a decision cannot be made due to insufficient information, the Cost Containment Administrator will either issue a Noncertification or send an explanation of the information needed to complete the review prior to the expiration of the 30 calendar days. If the Cost Containment Administrator does not issue a Noncertification and requests additional information to complete the review, You, the patient, the attending Physician or other Ordering Provider or the facility rendering the service is permitted up to 45 calendar days to provide the necessary information. The Cost Containment Administrator will render a decision within 15

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calendar days of either receiving the necessary information or the expiration of 45 calendar days, if no additional information is received. For certifications, the Cost Containment administrator will provide notification to the attending Physician or other Ordering Provider, the facility rendering service and You or the patient. Upon request, the Cost Containment Administrator will provide written notification of the certification. For Noncertifications, notification will be made in writing to the attending Physician or other Ordering Provider, facility rendering service, and You or the patient. Request for Reconsideration

When an initial decision is made not to certify an admission or other service and no peer-to-peer conversation has occurred, the Peer Clinical Reviewer that made the initial decision will be made available within one business day to discuss the Noncertification decision with the attending Physician or other Ordering Provider upon their request. If the original Peer Clinical Reviewer is not available, another Peer Clinical Reviewer will be made available to discuss the review. At the time of the conversation, if the reconsideration process is unable to resolve the difference of opinion regarding a decision not to certify, the attending Physician or other Ordering Provider will be informed of his or her right to initiate an appeal and the procedure to do so. For certifications, the Cost Containment Administrator will provide notification to the attending Physician or other Ordering Provider, the facility rendering service and You or the patient. Upon request, the Cost Containment Administrator will provide written notification of the certification. For Noncertifications, notification will be made in writing to the attending Physician or other Ordering Provider, the facility rendering service, and You or the patient. Appeal of Noncertifications

You, your Dependent, a designated patient representative, Physician, or other health care provider has the right to request two appeal reviews of any utilization management determination, by telephone, fax, or in writing. The Claims Administrator (or Magellan for mental health/substance abuse) will make a full and fair review of the Noncertification. The first level of appeal review must be completed before filing a civil action or pursuing any other legal remedies. Expedited Appeal Review and Voluntary Appeal Review

An Expedited Appeal Review is a request, usually by telephone but can be written, for a review of a decision not to certify an Urgent Review. An Expedited Appeal Review must be requested within 180 calendar days of the receipt of a Noncertification. A decision and notification of the decision on the expedited appeal of an Urgent Review decision will be made within 72 hours from request of an expedited appeal review. Written or electronic notification of the appeal review outcome will be made to the attending Physician or other Ordering Provider and You or the patient. If the Noncertification is affirmed on the appeal review, You, the patient, attending Physician or other Ordering Provider can request a voluntary appeal. The appeal may be requested by telephone, fax, or in writing. You, the patient, attending Physician or other Ordering Provider may submit written comments, documents, records, and other information relating to the request for appeal. The Claims Administrator will make a decision within 30 calendar days of request for a voluntary appeal. However, if the appeal cannot be processed due to incomplete information, the Claims Administrator will send a written explanation of the additional

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information that is required or an authorization for You or the patient’s signature so information can be obtained from the attending Physician or other Ordering Provider. This information must be sent to the Claims Administrator within 45 calendar days of the date of the written request for the information. Failure to comply with the request for additional information could result in declination of the appeal. A decision will be made and notification of the outcome will be provided within 30 calendar days of the receipt of all necessary information to properly review the appeal request. Election of a second appeal is voluntary and does not negate your right or the patient’s right to bring civil action following notification of the decision rendered during the expedited appeal, nor does it have any effect on your rights or the patient’s rights to any other benefit under the group plan. The voluntary appeal process is offered in an effort that the claim may be resolved in good faith without legal intervention. At any time during the second appeal process, You or the patient may file a civil action or pursue any other legal remedies. Note: The expedited appeal process does not apply to Retrospective Reviews. Standard Appeal Review and Voluntary Appeal Review

A standard appeal may be requested either in writing or verbally. It must be requested within 180 calendar days of the receipt of a Noncertification.

A decision and notification of the decision will be made in writing to You or the patient, the attending Physician or other Ordering Provider within 30 calendar days from receiving the request for an appeal review. If the Noncertification is affirmed on the appeal review, You, the patient, attending Physician or other Ordering Provider can request a voluntary appeal. The appeal may be requested by telephone, fax, or in writing. You, the patient, attending Physician or other Ordering Provider may submit written comments, documents, records, and other information relating to the request for appeal. A determination will be made within 30 calendar days of request for a voluntary appeal. However, if the appeal cannot be processed due to incomplete information, the Claim Administrator will send a written explanation of the additional information that is required or an authorization for your or the patient’s signature so information can be obtained from the attending Physician or other Ordering Provider. This information must be sent to the Claims Administrator within 45 calendar days of the date of the written request for the information. Failure to comply with the request for additional information could result in declination of the appeal. A decision will be made and notification of the outcome will be provided within 30 calendar days of the receipt of all necessary information to properly review the appeal request. Election of a second appeal is voluntary and does not negate your right or the patient’s right to bring civil action following notification of the decision rendered during the standard appeal, nor does it have any effect on your rights or the patient’s rights to any other benefit under the group plan. The voluntary appeal process is offered in an effort that the claim may be resolved in good faith without legal intervention. At any time during the second appeal process, You or the patient may file a civil action or pursue any other legal remedies.

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Prescription Drug Card Program

(Administered by Express Scripts Inc.) Note: This section DOES NOT apply if You have elected coverage under the HealthLink Health Savings PPO Plan. The Prescription Drug Card Program is designed to provide several convenient options for obtaining prescription drugs. Whenever You or a Covered Dependent has a prescription to be filled, use the Prescription Drug Card Program. If the prescription is needed immediately, You should use the participating retail pharmacy of Your choice. For ongoing prescriptions taken over longer periods of time (sometimes referred to as maintenance medications), You should consider using the mail-order option. For certain specialty medications, You will need to use the CareLogic™ specialty pharmacy to fill Your prescription. Schedule of Prescription Drug Benefits for Non-Medicare Eligible Participants

PRESCRIPTION DRUG CARD PROGRAM Administered by Express Scripts (ESI)

THREE TIER PRESCRIPTION DRUG

PROGRAM

COINSURANCE PRESCRIPTION DRUG

PROGRAM**

Deductible $0 $200 per individual $400 per family Note: This Deductible is separate from any medical Deductible.

Out-of-Pocket Limit (includes Deductibles)

None $500 per individual $1,000 per family Note: This out-of-pocket limit is separate from any medical out-of-pocket limit.

Retail Drugs

$7 for Generic Drugs $20 for Preferred Brand Name Drugs $35 for Non-Preferred Brand Name Drugs 34 day supply*

You pay Deductible, then the Plan pays 80% (You pay 20% of Express Scripts discounted price) for each prescription or refill up to the Out-of-Pocket Expense limits. 34 day supply* The Retail Drugs Deductibles and Out-of-Pockets Expense limits are combined with the Mail Order Drugs Deductibles and Out-of-Pockets Expense limits.

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PRESCRIPTION DRUG CARD PROGRAM (continued) Administered by Express Scripts (ESI)

THREE TIER PRESCRIPTION DRUG

PROGRAM

COINSURANCE PRESCRIPTION DRUG

PROGRAM** Mail Order Drugs

$14 for Generic Drugs $40 for Preferred Brand Name Drugs $70 for Non-Preferred Brand Name Drugs 90 day supply*

You pay Deductible, then the Plan pays 80% (You pay 20% of Express Scripts’ discounted price) for each prescription or refill up to the Out-of-Pocket Expense limits. 90 day supply* The Mail Order Drugs Deductibles and Out-of-Pockets Expense limits are combined with the Retail Drugs Deductibles and Out-of-Pockets Expense limits.

Currently, the Plan pays the full cost of a covered drug, which is prescribed for You or a Covered Dependent, after the Co-pay or Coinsurance (after applicable Deductible) is paid. The drug Co-pay or Coinsurance is not reimbursable under any other medical Plan provision and cannot be applied to the calendar year medical Deductible or medical Out-of-Pocket maximum. *Drug Quantity Limits – Criteria may apply to determine whether specific drugs are limited to a certain quantity. The criteria are based on Food and Drug Administration (FDA) approved dosing guidelines and the medical literature. Therefore, if Your Physician writes a prescription above the recommended quantity for a particular drug, Your pharmacist will only dispense the limited amount for Your Co-pay. You may call Express Scripts at 888.256.6131 if You have questions about coverage and/or quantity limits for a specific prescription drug. **Coinsurance Prescription Drug Program - The Plan will subtract the Deductible Amount from covered prescription drug expenses and will then pay the covered prescription drug expenses as stated in the Schedule of Benefits for the Coinsurance Prescription Drug Program. You pay one individual Deductible Amount each calendar year. For satisfaction of the family Deductible Amount, no more than one individual Deductible Amount will apply for any one person. The Out-of-Pocket Expense Limits is the amount of covered prescription drug expenses a Covered Employee or Dependent would pay in a Plan Year before the Plan begins to pay 100% of covered prescription drug expenses. This amount consists of any Deductible payments and the Covered Employee or Dependent’s portion of covered prescription drug expenses. Once a Covered Employee or Dependent has incurred total Out-Of-Pocket Expense Limits, the Plan will pay 100% of all covered prescription drug expenses for the remainder of the Plan Year for that covered individual.

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Schedule of Prescription Drug Benefits for Medicare Eligible Participants

PRESCRIPTION DRUG CARD PROGRAM

(Administered by Express Scripts, Inc.)

(Cannot be elected alone; must choose a medical option also)

Medical Only Option

(No Prescription Drug Coverage)

Three-Tier Prescription Drug

Program

(available with Conventional Plan

or Medicare Supplement Plan)

Co-Insurance Prescription Drug

Program**

(available with Medicare Supplement Plan only)

Available if enrolled in the

Conventional Plan or the Medicare Supplement Plan

Deductible $0 $200 per individual $400 per family (Separate from any medical deductible)

Out of Pocket Limit

None $500 per individual $1,000 per family (Separate from any medical out of pocket limit)

Retail Drugs

$7 for generic drugs $20 for preferred brand name drugs $35 for non-preferred brand name drugs. 34 day supply*

You pay Deductible, then the Plan pays 80% (You pay 20% of Express Scripts discounted price) for each prescription or refill up to the Out-of-Pocket Expense limits.

34 day supply*

The Retail Drugs Deductibles and Out-of-Pockets Expense limits are combined with the Mail Order Drugs Deductibles and Out-of-Pockets Expense limits.

Mail Order Drugs

$14 for generic drugs $40 for preferred brand name drugs $70 for non-preferred brand name drugs. 90 day supply*

You pay Deductible, then the Plan pays 80% (You pay 20% of Express Scripts’ discounted price) for each prescription or refill up to the Out-of-Pocket Expense limits. 90 day supply*

The Mail Order Drugs Deductibles and Out-of-Pockets Expense limits are combined with the Retail Drugs Deductibles and Out-of-Pockets Expense limits.

No prescription drug coverage through the Ameren Retiree Medical Plan. Participants should enroll in a Medicare Part D plan for prescription drug coverage. This option is only available to participants when all covered family members are Medicare-eligible. (For example when the retiree and spouse/domestic partner are both Medicare-eligible.)

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Currently, the Plan pays the full cost of a covered drug, which is prescribed for You or a Covered Dependent, after the Co-pay or Coinsurance (after applicable Deductible) is paid. The drug Co-pay or Coinsurance is not reimbursable under any other medical Plan provision and cannot be applied to the calendar year medical Deductible or medical Out-of-Pocket maximum. *Drug Quantity Limits – Criteria may apply to determine whether specific drugs are limited to a certain quantity. The criteria are based on Food and Drug Administration (FDA) approved dosing guidelines and the medical literature. Therefore, if Your Physician writes a prescription above the recommended quantity for a particular drug, Your pharmacist will only dispense the limited amount for Your Co-pay. You may call Express Scripts at 888.256.6131 if You have questions about coverage and/or quantity limits for a specific prescription drug. **Coinsurance Prescription Drug Program - The Plan will subtract the Deductible Amount from covered prescription drug expenses and will then pay the covered prescription drug expenses as stated in the Schedule of Benefits for the Coinsurance Prescription Drug Program. You pay one individual Deductible Amount each calendar year. For satisfaction of the family Deductible Amount, no more than one individual Deductible Amount will apply for any one person. The Out-of-Pocket Expense Limits is the amount of covered prescription drug expenses a Covered Employee or Dependent would pay in a Plan Year before the Plan begins to pay 100% of covered prescription drug expenses. This amount consists of any Deductible payments and the Covered Employee or Dependent’s portion of covered prescription drug expenses. Once a Covered Employee or Dependent has incurred total Out-Of-Pocket Expense Limits, the Plan will pay 100% of all covered prescription drug expenses for the remainder of the Plan Year for that covered individual. If You Have Questions

The following chart is a quick reference for You to use if You have questions about this benefit.

Information Needed Who to Call Website Address

If You have questions about: � Retail network

pharmacies � Status of Your claim or

mail order prescription � Claim history � How to request a drug

through the Mail Order Program

� Your cost or coverage for Your drug

Express Scripts Customer Service

888.256.6131

Be sure to identify Yourself as a Participant in the Ameren Retiree Medical Plan and have the Retiree’s social security number, or the Express Scripts assigned alternative identification number, available.

www.express-scripts.com

You can create Your own personal profile so Your information will only be available to You.

Specialty Pharmacy CareLogic™ Customer Service

866.848.9870

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Prescription Drugs Obtained at a Participating Retail Pharmacy

You may obtain up to a 34-day supply of a covered prescription at the retail pharmacy. Your prescription drug Plan identification card must be presented to the pharmacist when You have the prescription filled. There are no claim forms to complete if the prescription is purchased from a participating pharmacy that honors this Prescription Drug Card Program. The Co-pays under this Program cannot be used to satisfy any applicable annual Deductible or annual Out-of-Pocket Expense Maximum under the Ameren Group Medical Plan. Under this Program, the prescription quantity dispensed by the pharmacist will be limited to the lesser of the amount normally prescribed by a Physician, or for certain drugs the amount indicated through Clinical Programs (see CLINICAL PROGRAMS within this PRESCRIPTION DRUG CARD PROGRAM section). Under no circumstance may a retail prescription exceed a 34-day supply. Since the Express Scripts organization is recognized nationwide, the Prescription Drug Card will be easy to use wherever You or Your Covered Dependents are. Most pharmacies in the United States participate in the Express Scripts pharmacy network, but You should contact Your pharmacy to verify its participation. You may also call Express Scripts at 888.256.6131 or access Express Scripts online at www.express-scripts.com to find participating pharmacies. If You are told at a retail pharmacy that the Ameren Group Medical Plan does not cover Your prescription, please contact Express Scripts at 888.256.6131 to determine the reason. Prescription Drugs Obtained at a Non-Participating Retail Pharmacy

If a prescription is filled at a non-participating pharmacy, (for example, You visit a non-participating pharmacy while on vacation), the full cost of the prescription must be paid at the time of purchase and a completed claim form submitted to Express Scripts for reimbursement within 365 days of the purchase. Claim forms may be obtained either by calling Express Scripts at 888.256.6131 or by visiting their website: www.express-scripts.com. Reimbursement will be made based on the Ameren negotiated discounted Average Wholesale Price (AWP) of the drug minus the applicable $7, $20, or $35 Co-pay, or 20% Coinsurance amount, regardless of what is actually paid for the drug. For example, if You fill a generic prescription at a non-participating pharmacy at a cost of $40, and the discounted Average Wholesale Price of the Generic drug is actually $35, You will be reimbursed $28 (the $35 discounted wholesale cost less the $7 Generic Co-pay). Prescription Drugs Obtained Through the Mail Order Program

All covered individuals in the Prescription Drug Card Program may purchase prescription drugs through the Express Scripts mail-order prescription drug service. This program works best for people who are taking maintenance drugs to treat chronic or long-term health conditions such as arthritis, diabetes, asthma, heart conditions, and high blood pressure. By using the mail-order service, You or a Covered Dependent may obtain up to a 90-day supply of a drug, and

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pay the equivalent of two retail Co-payments if You are participating in the Three Tier Prescription Drug Plan. You will pay the 20% Coinsurance (after applicable Deductible) if You are participating in the Coinsurance Prescription Drug Plan.

Therefore it is most economical if a Physician prescribes a 90-day supply whenever appropriate. A maximum of a 90-day supply of a drug may be ordered at a one time. Refills will not be dispensed until 60 days of a 90-day supply have been used. If You or a Covered Dependent needs medication immediately, ask the Physician to write two prescriptions, one for a 30-day supply and the other for a 90-day supply. Fill the 30-day prescription at a local participating pharmacy for medication to take until the first mail order arrives.

To enroll in the mail order program, complete an Express Scripts patient profile/order form and send it with the prescription and applicable Co-pay or Coinsurance amount, to the address printed on the form. The form may be obtained either by calling Express Scripts at 888.256.6131 or visiting their website: www.express-scripts.com. The Co-pay or Coinsurance amount may be paid either by check or by credit card. The form explains how to pay by credit card. The prescription may also be refilled online (over the internet) by visiting the Express Scripts web site at www.express-scripts.com. All prescriptions are reviewed by a pharmacist, checked for adverse drug interactions, and verified by quality control before they are dispensed and mailed. Generic medication will be dispensed when available and allowed by law, unless a Physician has indicated on the prescription that a Brand Name Drug must be provided. It will usually take ten (10) to fourteen (14) working days to receive an order. Some drugs cannot be sent through the mail. For example, drugs that require refrigeration must be obtained at a local pharmacy. You or Your Covered Dependents may call Express Scripts Customer Service at 888.256.6131 if You have questions or need to check the status of an order. Covered individuals must identity themselves as participants in the Plan and must be prepared to provide the Retiree’s Social Security number or the Express Scripts assigned alternate identification number. Specialty Pharmacy for Treatment of Chronic Illness

Your medical benefits include a specialty pharmacy service from CareLogic™, a subsidiary of Express Scripts. CareLogic™ specializes in oral and injectible specialty medications that treat certain chronic conditions like multiple sclerosis, rheumatoid arthritis and hepatitis C, and offers many products and services that You don’t get from other pharmacies, such as: � A patient care coordinator, who serves as Your personal advocate and Your point of contact.

This highly trained individual works closely with Your doctor to obtain prior authorizations and coordinate billing. Your coordinator will even contact You when it’s time to refill Your prescription.

� A complete specialty pharmacy inventory, with many specialty medications that aren’t readily available at a local pharmacy.

� Delivery of Your medications directly to You or Your doctor.

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� Providing supplies needed to administer Your medications, at no additional cost.

� Clinically based care-management programs, which include consultation with Your doctor, to help You get the most benefit from the specialty medications Your doctor has prescribed.

CareLogic™ provides these services at no additional cost to You. You pay the Co-pay or Coinsurance (and Deductible, if applicable) required under the prescription drug option for a maximum 30-day supply. If Your doctor prescribes a medication covered by the specialty pharmacy program, CareLogic™ will be the only covered source for that medication. It will not be covered if purchased from other pharmacies. If Your doctor prescribes a medication in the specialty pharmacy program, Your local pharmacy will be able to fill a one-time 30 day supply. CareLogic™ will then contact Your doctor to set up the next prescription. To contact CareLogic™, call 866.848.9870 or have Your Physician fax in Your script to 888.773.7386 from 8 a.m. to 9 p.m. (Eastern), Monday through Friday, and from 9 a.m. to 1 p.m. (Eastern) on Saturday). Out-of-Pocket Expense Maximums

The maximum Out-Of-Pocket Expense is the amount of covered prescription drug expenses a Covered Retiree or Dependent would pay in a Plan Year before the Plan begins to pay 100% of covered prescription drug expenses. This amount consists of any Deductible payments and the Covered Retiree or Dependent’s portion of Covered Expenses. Once a Covered Retiree or Dependent has reached the total Out-Of-Pocket Expense maximum for prescription drug coverage, the Plan will pay 100% of all covered prescription drug expenses for the remainder of the Plan Year. The Out-of-Pocket Expense Maximum does not include prescription drug expenses not covered by the Plan. Covered Drugs

The following is a list of the types of drugs covered under the Prescription Drug Card Program:

� Any drug which under the applicable state or federal law may be dispensed only upon the written prescription of a Physician or other lawful prescriber;

� Compounded medication of which at least one ingredient is a prescription drug;

� Insulin, glucose monitors and other diabetic supplies including pump supplies (however, insulin pumps are covered under the medical portion of the Plan, see DURABLE MEDICAL

EQUIPMENT within the COVERED EXPENSES section of this booklet);

� Tretinoin, all dosage forms (e.g. Retin A) for individuals through the age of twenty-five (25) years, unless patient over age twenty-five (25) is prescribed the medication for medical necessity (prescribed to treat or control a medical condition and not for cosmetic purposes). Prior authorization is required for individuals over age twenty-five (25).

� Smoking Cessation prescription drugs up to a maximum of $500 annually.

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Additional criteria may apply to determine whether specific drugs are covered and in what dosage or quantity amount (see CLINICAL PROGRAMS within this section). Drugs Not Covered

The following drugs are not covered under the Prescription Drug Card Program:

� Contraceptives, oral or other, whether medication or device, unless Medically Necessary (prescribed to treat or control a medical condition and not used for contraceptive purposes);

� Prescription drugs to treat infertility;

� Over-the-counter drugs or any other drugs (excluding insulin) which do not require a prescription from a lawful prescriber;

� Over-the-counter equivalents obtained with a prescription;

� Vitamins, minerals, nutritional supplements or special diets (whether they require a Physician’s prescription or not) and legend homeopathic medications;

� Prescriptions which are classified as cosmetic (this includes drugs for weight loss);

� Charges for the administration or injection of any drug;

� Therapeutic devices or appliances (except as described under Covered Drugs), glucose monitors in excess of one (1) per 365 days;

� Prescriptions which an eligible person is entitled to receive without charge from any Workers' Compensation Laws, or any municipal, state, or federal program;

� Drugs labeled "Caution-limited by federal law to Investigational use," or Experimental drugs, even though a charge is made to the individual;

� Immunization agents, biological sera, blood, or blood plasma (except as included herein);

� Medication which is to be taken or administered to an individual in whole or in part, while a patient in a licensed Hospital, Skilled Nursing Facility, convalescent Hospital, or similar institution which operates on its premises, or allows to be operated on its premises, a facility for dispensing pharmaceuticals;

� Any prescription refilled in excess of the number specified by a Physician, or any refill dispensed after one year from the Physician's original order;

� Smoking deterrents; or

� Any drug where Clinical Program criteria are not met (see CLINICAL PROGRAMS section below).

Clinical Programs

The Plan has review programs in place that are designed to provide covered individuals and their Physician with the latest information about medications and Treatment. By monitoring certain medications for safety and effectiveness, as well as potential drug interactions, these programs protect You and Your Covered Dependents against potential harm due to prolonged or inappropriate use of certain drugs. These programs work behind the scenes and usually do not require You to do anything; however, on occasion, a Physician may need to contact Express Scripts and provide additional information for approval. The Plan’s Clinical Programs are

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described below. For more information, covered individuals may contact Express Scripts at 888.256.6131. Drug Utilization Review Clinical drug therapy is monitored for various drug interactions, duplicate therapy, high use of addictive substances, and other potential drug therapy concerns. If concerns are identified, a Physician will receive notification of the concern that was identified along with the most current information to address the issue. Drug Quantity Limits Criteria may apply to determine whether specific drugs are limited to a certain quantity. The criteria are based on Food and Drug Administration (FDA) approved dosing guidelines and the medical literature. Therefore if a Physician writes a prescription above the recommended quantity for a particular drug, the pharmacist will only dispense the limited amount for the applicable Co-pay. You may call Express Scripts if You have questions about coverage and/or quantity limits for a specific prescription drug.

Prior Authorization Prior authorization is a program which ensures certain medications are covered for only proven, Medically Necessary uses. If a Physician prescribes a drug that requires prior authorization, online messaging will instruct the pharmacist that the Physician needs to contact Express Scripts Prior Authorization Services for approval. If a medication is not approved for coverage, You or Your Covered Dependent will have to pay the full cost of the drug or the Physician may change the prescription to another covered drug. Contact Express Scripts for the most current list of drugs that require prior authorization. These programs are subject to change at any time without notice in order to keep up-to-date with current medical practice. Termination of Benefits

Retirees

Your coverage under this Plan will end on the earliest of the following dates:

� End of the month that You last paid the required premium for coverage;

� End of the month of Your death;

� Date of discontinuance of the Group Plan;

� Date the Company amends the Group Plan to eliminate coverage for the class of eligible individuals to which You are a member;

� Date You become covered under another Group Plan sponsored by Ameren (for example, You are covered under another active health plan of a company which has been purchased by Ameren, while also covered as a retiree under this Plan); or

� Date You or a Covered Dependent participates in fraud or misrepresentation of a material fact in enrolling or making claims for benefits under the Plan. Under those

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circumstances, the Plan will have the right to recover the full amount of benefits paid on behalf of You or a Covered Dependent;

Dependents

Coverage for Your Covered Dependents will end on the earliest of the following dates:

� End of the month that Your coverage ends except by reason of Your death (See CONTINUATION OF BENEFITS FOR SURVIVING DEPENDENTS OF DECEASED RETIREES);

� End of the month that Your Dependent(s) is no longer eligible (See ELIGIBILITY);

� End of the month that You last paid the required payroll deduction for Your Dependent's coverage.

However, You and Your Covered Dependents may be eligible for temporary healthcare continuation benefits as required by federal law. (See COBRA CONTINUATION in this booklet). Right to Certificate of Creditable Coverage

When health care coverage for You or Your Covered Dependents under this Plan ends, the Plan is required to provide a written certificate of how long coverage for the affected individual was in effect. The purpose of this “Certificate of Creditable Coverage” is to help You or Your Covered Dependent obtain coverage under another Plan. A Certificate of Creditable Coverage will automatically be sent at the time the covered individual’s coverage ends and again when continuation of coverage under COBRA (if elected) ends. You or a Covered Dependent also may request a Certificate of Creditable Coverage from the Plan administrator at any time within the 24-month period after Your Plan coverage ends by calling the Ameren Benefits Center at 877.7my.Ameren (877.769.2637). You should contact the Ameren Benefits Center if a preexisting condition limitation applies to Your new coverage and a certification of prior coverage is needed. If Your new health insurance is obtained through a plan other than an employer-sponsored group health plan, contact Your state’s insurance department for more information. Continuation of Benefits for Surviving Dependents of Deceased Retirees

In the event of Your death, Your Covered Dependents may automatically continue benefits offered by the Ameren Retiree Medical Plan or elect the continuation benefits in compliance with federal law (COBRA). The following paragraphs explain the difference between the two types of benefits. Upon Your death, the Company currently continues medical benefits under this Plan for Your Covered Dependents until the end of the month in which Your death occurred. Furthermore, the Company continues medical benefits under this Plan for Your Covered Dependents following Your death as long as the applicable premium is paid for the respective months, and Your Covered Dependents have not elected to terminate the coverage. If Your Covered Dependents chose to continue the coverage offered by the Ameren Retiree Medical Plan, the coverage will end on the earliest of the following dates:

� End of the month in which Your surviving Spouse remarries (coverage ends only for surviving Spouse)

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� End of the month in which Your surviving domestic partner marries or enters a new domestic partnership (coverage ends only for the surviving domestic partner)

� End of the month in which Your surviving Dependent becomes covered under any other group medical care plan (coverage ends only for the surviving Dependent with the other coverage).

� End of the month in which Your surviving Dependent Children no longer meet the eligibility requirements for Dependent Children (coverage ends only for the ineligible Dependent).

� End of the month in which Your surviving Dependents fail to pay the premium on time.

� Date of Termination of the Plan.

� Date of Amendment of the Plan to eliminate such continuation coverage. The cost of this coverage is outlined in the section entitled “COST OF COVERAGE”. Continuation of Benefits for Certain Surviving Dependents of Deceased Active Employees Where Dependent is Now Eligible for Medicare

Except as defined below, if You had ten (10) Years of Service prior to Your death7, Your Covered Dependent Spouse/domestic partner or Dependent Child who becomes eligible for Medicare benefits will be given the opportunity to elect coverage under the Ameren Retiree Medical Plan. The following surviving Covered Dependents are not eligible for continued coverage at the time they become eligible for Medicare:

� Surviving Covered Dependents of employees who had less than 10 Years of Service at the time of death;

� Surviving Covered Dependents of AmerenCILCO management employees who died prior to January 1, 2004;

� Surviving Covered Dependents of employees who were represented by a collective bargaining agreement with AmerenCILCO and IBEW Local 51 and who died prior to January 1, 2005;

� Surviving Covered Dependents of employees who were represented by a collective bargaining agreement with AmerenEnergy Resources Generating Company and NCF&O Local 8 and who died prior to January 1, 2007;

� Surviving Covered Dependents of AmerenIP management employees who died prior to January 1, 2007.

When eligible surviving Covered Dependent(s) (of an employee who died while actively employed at Ameren) become eligible for Medicare coverage, Medicare will become primary payer of medical expenses and the Ameren Retiree Medical Plan will be the secondary payer. The surviving Covered Dependent(s) will be required to pay the appropriate monthly premium, subject to the maximum premium provisions of the Plan.

7 Medicare-eligible surviving dependents of deceased active AmerenUE management employees who died between January 1, 1992 and June 30, 1993 and deceased active AmerenUE contract employees who died between January 1, 1992 and June 30, 1994 do not have to meet the 10 years of service requirement in order to be eligible for coverage under the Ameren Retiree Medical Plan.

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It is very important that Covered Dependent(s) enroll in Medicare when they are eligible for Medicare benefits because if they are eligible for Medicare but don’t enroll, they will still be covered under either the Conventional Plan or the Medicare Supplement Plan, just as though they were enrolled in Medicare. This means the Plan will estimate and subtract the benefits Medicare would have paid and then pay benefits on the balance of the claim in accordance with Plan provisions. COBRA Continuation

Continuation of Coverage Under the Consolidated Omnibus Budget Reconciliation Act of 1985

Ameren and ACS have partnered with Ceridian as the COBRA administrator. Ceridian’s website (www.ceridian-benefits.com) can be accessed through www.myAmeren.com. Instructions to access the Ceridian website are provided when a COBRA event is initiated. Ceridian’s website allows COBRA participants to elect coverage, update addresses, print forms to add or drop dependents due to a qualifying status change, or update dependent information. COBRA participants can also view the status of their account, including payment dates, payment amounts and COBRA coverage begin and end dates. COBRA participants can also check on the status of their account by calling Ceridian at 800.877.7994. Ceridian customer service representatives are available Monday through Friday, from 7:00 a.m. to 7:00 p.m. Central Standard Time (CST). COBRA continuation coverage is a continuation of Plan coverage when coverage would otherwise end because of a life event known as a Qualifying Event. After a Qualifying Event, COBRA continuation coverage must be offered to each person who is a Qualified Beneficiary. (Note: A domestic partner is not a Qualified Beneficiary under COBRA, and therefore is not eligible for continuation coverage under COBRA. However, Ameren has chosen to offer continuation coverage to domestic partners for a period which does not exceed COBRA coverage and under the same terms as outlined in this section. For those purposes, a domestic partner will be treated as a Qualified Beneficiary under COBRA.) Depending on the type of Qualifying Event, You, Your Covered Spouse and Covered Dependent Children may be Qualified Beneficiaries. Certain newborns, newly-adopted children and alternate recipients under a Qualified Medical Child Support Order may also be Qualified Beneficiaries. Under the Plan, Qualified Beneficiaries who elect COBRA continuation coverage must pay for such coverage. Note: Continuation coverage for Participants who selected continuation coverage under a prior plan which was replaced by coverage under this Plan shall terminate as scheduled under the prior plan or in accordance with the terminating events set forth below, whichever is earlier. A Qualified Beneficiary does not have to show that he/she is insurable to choose COBRA continuation coverage. COBRA continuation is provided, subject to the person’s eligibility for coverage under the Plan. Retiree

A Covered Retiree will have the right to continue coverage in accordance with this Section if coverage is lost due to the filing of bankruptcy by Ameren Corporation.

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Spouses

A Covered Spouse will have the right to continue coverage in accordance with this Section if coverage is lost for any of the following reasons:

� The death of the Covered Retiree.

� Divorce or legal separation from the Covered Retiree.

� The Covered Retiree becomes entitled to Medicare.

� Filing of bankruptcy by Ameren Corporation. Domestic Partners

A Covered domestic partner does not meet the guidelines of a Qualified Beneficiary under COBRA. However, if coverage is lost under the Plan because of any of the following events, Ameren will offer continuation coverage for the same length of time as a Covered Spouse would be offered coverage under COBRA:

� The death of the Covered Retiree

� Termination of the domestic partnership with the Covered Retiree

� The Covered Retiree becomes entitled to Medicare.

� Filing of bankruptcy by Ameren Corporation Dependent Children

Your Covered Dependent Child has the right to continue coverage in accordance with this Section if the coverage is lost for any of the following reasons:

� The death of the Covered Retiree.

� Divorce or legal separation of the Covered Retiree.

� The Covered Retiree becomes entitled to Medicare.

� The Dependent Child ceases to satisfy the Plan Sponsor's eligibility rules for Dependent status.

� Filing of bankruptcy by Ameren Corporation. Newborn or Adopted Children

If, during the period of COBRA coverage, a Covered Retiree or a Covered Dependent Spouse gives birth to a child, or if a child is placed with a Covered Retiree or Dependent Spouse for adoption, the Covered Retiree may elect COBRA continuation coverage for that child. Coverage for the newborn or adopted child will continue for the same period of time that coverage for any other Dependent Children is or could have been provided. If You have a status change and want to add a new Dependent, You must complete the appropriate enrollment process by either enrolling on-line through www.Ceridian-benefits.com, calling Ceridian at 800.877.7994, or by completing the appropriate form and mailing to Ceridian at the address listed on the form.

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Note: Newborn or adopted children of a Covered domestic partner are not considered to be a Qualified Beneficiary under COBRA. However, under the circumstances listed above, Ameren will offer continuation coverage for the same length of time as a newborn or adopted child of a Covered Retiree or Covered Spouse would be offered under COBRA. Special Enrollment Rules for Qualified Beneficiaries

A Qualified Beneficiary receiving COBRA continuation coverage is also entitled to enroll eligible family members in the Plan under the Special Enrollment rules set forth in this document the same as if the Qualified Beneficiary was a Retiree within the meaning of those rules. If You have a status change and want to add a new Dependent, You must complete the appropriate enrollment process by either enrolling on-line through www.Ceridian-benefits.com, calling Ceridian at 800.877.7994, or by completing the appropriate form and mailing to Ceridian at the address listed on the form. Note: Domestic partners will also be allowed to enroll eligible family members in the Plan under the Special Enrollment Rules set forth in this document, as if they were a Qualified Beneficiary. Length of Coverage

A Qualified Beneficiary’s coverage may continue under COBRA as follows:

� Coverage for eligible Dependents may be continued up to a maximum of thirty-six (36) months, if coverage is terminated due to:

(1) the Covered Retiree’s death; (2) the Covered Retiree’s divorce or legal separation; (3) a Dependent Child's ceasing to satisfy rules for Dependent status; or (4) the Covered Retiree becoming entitled to Medicare.

Note: A Covered domestic partner will be allowed to continue coverage for the same period of time as outlined above for covered dependents who are considered Qualified Beneficiaries under COBRA. Notification and Election Requirements

The Plan will offer COBRA continuation coverage to Qualified Beneficiaries only after the Plan Administrator has been notified that a Qualifying Event has occurred. When the qualifying event is the death of the Retiree, commencement of a proceeding in bankruptcy or the Covered Retiree becoming entitled to Medicare benefits, You are not required to notify the Plan Administrator. However, each Covered Retiree and each eligible Dependent has the responsibility to inform the Plan Administrator of a divorce, legal separation, or a child losing Dependent status under the Plan within sixty (60) days of the qualifying event. Notice must be provided through myAmeren Benefits Web or by calling the Ameren Benefits Center at 877.7my.Ameren (877.769.2637). Failure to provide this notification within sixty (60) days will result in the loss of continuation coverage rights and may result in retroactive cancellation of coverage. The Plan may seek reimbursement from the Qualified Beneficiary for any benefits paid after the qualifying event. Once the Plan Administrator receives notice that a Qualifying Event has occurred, COBRA continuation coverage will be offered to each Qualified Beneficiary. Each Qualified Beneficiary

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will have an independent right to elect COBRA continuation coverage. Covered Retirees may elect COBRA continuation coverage on behalf of their Spouses and parents may elect COBRA continuation coverage on behalf of their Spouses and parents may elect COBRA continuation coverage on behalf of their children. Each eligible Dependent must elect COBRA continuation coverage within sixty (60) days of the date that coverage would end, or if later, within sixty (60) days of the date that notice of the right to elect COBRA continuation coverage is initially sent. Failure to elect continuation coverage within the applicable sixty (60) day period will result in loss of COBRA continuation coverage rights. The Plan will notify the qualifying individual of continuation coverage rights, or the unavailability of continuation coverage, within forty-four (44) days of receiving notice of the qualifying event. Once the Covered Retiree or the qualifying individual receives the COBRA enrollment packet, the Qualified Beneficiary may elect continuation of coverage by completing the COBRA enrollment process either by enrolling on-line at www.ceridian-benefits.com, calling Ceridian at 800.877.7994, or mailing the completed Continuation of Group Health Coverage Election Agreement (COBRA) form to Ceridian at the address listed on the form. Note: The notification and election requirements outlined above also apply to a domestic partner who is eligible to continue coverage under the Plan. Payment for Coverage

If a Covered Retiree or Qualified Beneficiary elects COBRA continuation coverage, the first payment must be made within 45 days after the date of the election. If the entire amount of the first payment is not made within the 45 days, the Qualified Beneficiary will lose all continuation coverage rights under the Plan. The amount of the first payment will cover the cost of COBRA continuation coverage from the time coverage under the Plan would have otherwise terminated up to the time of the first payment. After the first payment, payments for each subsequent month of coverage will be due on the first of the month. Although the payments are due on the first of the month, there is a grace period of 30 days for each payment. COBRA continuation coverage will be provided each month as long as the payment for that month is made before the end of the grace period for that payment. Failure to make a monthly payment before the end of the grace period will result in a permanent loss of all rights to COBRA continuation coverage under the Plan. COBRA participants can check on the status of their account by calling Ceridian at 800.877.7994, or by visiting Ceridian’s website at www.ceridian-benefits.com. Note: The payment requirements outlined above also apply to a domestic partner who has elected to continue coverage under the Plan. Termination of Coverage

Under federal law and under this Plan, COBRA continuation coverage will end on the first of the following dates:

� The date the Plan Sponsor terminates all group health plans.

� End of the month that a required premium or contribution is due and not paid on time.

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� End of the month that a Qualified Beneficiary becomes covered by another group plan without an enforceable preexisting condition exclusion or limitation.

� End of the month that a Qualified Beneficiary becomes entitled to Medicare.

� End of the month that the applicable period of continuation coverage is exhausted.

Note: The termination of coverage provisions outlined above also apply to a domestic partner who has elected to continue coverage under the Plan. Cost of Continuation Coverage

Except as a higher amount is allowed in accordance with the COBRA regulations, the Plan may require all Qualified Beneficiaries to pay a premium for continuation coverage of up to one hundred two percent (102%) of the Plan's cost for a "similarly situated" eligible covered individual. Note: A domestic partner who has elected to continue coverage under the Plan will also be required to pay a premium for continuation coverage up to one hundred two percent (102%) of the Plan’s cost for a ‘similarly situated’ eligible covered individual. Address Changes

In order to protect Your family’s rights, You should keep the Plan Administrator informed of any changes in the addresses of family members who have continued their benefit coverage under COBRA, either by going on-line at www.ceridian-benefits.com, or by calling Ceridian at 800.877.7994. You should also keep a copy, for Your records, of any notices You send to the Plan Administrator. If You Have Questions

Questions concerning Your Plan or Your COBRA continuation coverage rights should be addressed to the Ameren Benefits Center at 877.7my.Ameren (877.769.2637). Questions concerning your or any of your dependents’ coverage under COBRA should be addressed to Ceridian by calling 800.877.7994. The Ceridian customer service representatives are available Monday through Friday, from 7:00 a.m. to 7:00 p.m., Central Standard Time (CST). Privacy Practices

In addition to this Summary Plan Description, there are also other formal documents that govern the Plan’s operation. One of these documents is a document adopted by the Plan that describes how the Company, as Plan Sponsor, may use and disclose certain information that may be considered “protected health information” under the federal law known as the Health Insurance Portability and Accountability Act of 1996 (HIPAA). This law provides comprehensive requirements concerning Your protected health information. Most of the comprehensive requirements are outlined in the “Notice of Privacy Practices” You have received from the Plan. This notice can also be found on myAmeren Benefits Web at www.myAmeren.com by selecting ‘Documents & Forms’ from the top of the page, then selecting ‘Healthcare & Life’ under the Notices section, and finally choosing the ‘HIPAA Privacy Notice’. In addition, You have the right to receive a paper copy of this notice upon Your request by contacting the Ameren Benefits Center at 877.7my.Ameren (877.769.2637).

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The Plan is permitted to use and disclose Your protected health information without Your consent or authorization, as necessary, to carry out Plan functions and duties. For example, the Plan may obtain health claims information and provide it to the Claims Administrator to perform claims adjudication and appeals. The Company and the Plan will comply with any law that requires a disclosure of Your protected health information, such as a court order. Please review the Notice of Privacy Practices for a more complete discussion about how the Plan and the Company may use Your protected health information and disclose it to third parties. Right to Receive and Release Information

The Contract Administrator, pursuant to the reasonable exercise of its discretion, may release to, or obtain from any other company, organization or person, without consent of or notice to any person, any information regarding any person which the Plan Administrator or Contract Administrator deems necessary to carry out the provisions of the Plan, or to determine how, or if, they apply. To the extent that this information is protected health information as described in 45 C.F.R. 164.500, et seq., or other applicable law, the Plan Administrator or Contract Administrator may only use or disclose such information for Treatment, payment or health care operations as allowed by such applicable law. Any claimant under the Plan shall furnish to the Contract Administrator such information as may be necessary to carry out this provision. The only employees or other persons under the direct control of the Plan Sponsor who are allowed access to the protected health information of other individuals are those employees or persons with direct responsibility for the control and operation of the Plan and only to the extent necessary to perform the duties as Plan Administrator as determined pursuant to the reasonable exercise of discretion of the Plan Administrator. In addition, the Plan Sponsor hereby certifies and agrees that it will:

a) Not use or further disclose the information other than as permitted or required by the Plan or as required by law;

b) Ensure that any agents, including a subcontractor, to whom it provides protected health information received from the Plan agree to the same restrictions and conditions that apply to the Plan Sponsor with respect to such information;

c) Not use or disclose the information for employment-related actions and decisions or in connection with any other benefit or employee benefit plan of the Plan Sponsor;

d) Report to the appropriate representative of the Plan Administrator any use or disclosure of the information that is inconsistent with the uses or disclosures provided for of which it becomes aware;

e) Make available protected health information in accordance with 45 C.F.R. 164.524;

f) Make available health information for amendment and incorporate any amendments to protected health information in accordance with 45 C.F.R. 164.526;

g) Make available the information required to provide an accounting of disclosures in accordance with 45 C.F.R. 164.528;

h) Make its internal practices, books, and records relating to the use and disclosure of protected health information received from the Plan available to the Secretary of Health and Human Services for purposes of determining compliance by the Plan with

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the privacy requirements of 45 C.F. R. 164.500, et. Seq.;

i) If feasible, return or destroy all protected health information received from the Plan that the Plan Sponsor still maintains in any form and retain no copies of such information when no longer needed for the purpose for which disclosure was made, except that, if such return or destruction is not feasible, limit further uses and disclosures to those purposes that make the return or destruction of the information infeasible; and

j) Ensure that the adequate separation between the Plan and the Plan Sponsor is established and maintained pursuant to 45 C.F.R. 164.504(f)(2)(iii).

The use of protected health information by the Plan shall be in accordance with the privacy rules established by 45 C.F. R. 164.500, et. seq. Any issues of noncompliance with the provisions of this Section shall be resolved by the privacy officer of the Plan Administrator.

PRINCIPAL LIFE INSURANCE COMPANY CALLER VERIFICATION POLICY

Principal Life Insurance Company has a caller verification policy that is set up to ensure that your private health information (PHI) is only shared with you or someone you have authorized.

The policy requires that the person requesting information must provide Principal with the member’s privacy ID number, the name of the covered person and two of the following additional items:

� Policy account number � Member’s privacy ID number � Date of birth of the member or the member’s Dependent � Member’s address (postal or electronic) � Member’s phone number � Employer’s name � Date of employment

Coordination With Other Benefits

Introduction

This Coordination with other Benefits provision applies when a covered individual has health care coverage under more than one health plan (as defined below). This method of coordination of benefits is sometimes referred to as the “integration of benefits” method. The intent of this provision is to look at the total covered charges and what this Plan will pay after the other plan as primary plan pays. The order of benefit determination rules below determine which health plan will pay as the primary health plan. The primary health plan pays first without regard to the possibility that another health plan may cover some expenses. The secondary health plan pays after the primary health plan and may reduce the benefits it pays according to the terms of the secondary health plan.

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Definitions

The term “health plan” shall have the meaning set forth below whenever used in this section of this document.

� “Health plan” shall mean any of the following that provides benefits or Services for medical or dental care or Treatment. However, if separate contracts are used to provide coordinated payment for covered individuals of a group, the separate contracts are considered parts of the same health plan and there is no integration or coordination of benefits among those separate contracts, unless specifically indicated.

� “Health plan” includes: group insurance, closed panel or other forms of group or

group-type payment (whether insured or uninsured); Hospital indemnity benefits in excess of $200 per day; medical care components of group long-term care contracts, such as skilled nursing care; and Medicare, Medicaid or other governmental benefits as permitted by law.

� “Health plan” does not include: amounts of Hospital indemnity insurance of $200 or

less per day; school accident type payment, benefits for non-medical components of group long-term care policies; Medicare supplement policies, Medicaid policies and payment under other governmental plans, unless permitted by law.

Each contract for payment under this section is a separate health plan. Also, if a contract has two parts and integration of benefits or coordination of benefit rules apply only to one of the two, each of the parts is a separate health plan. Integration of Benefits

When this Plan is the primary health plan, it shall provide payment under this Plan without regard to the possibility that another health plan may cover some expenses unless expressly stated otherwise in this Plan. When this Plan is secondary, benefits under the primary health plan shall be coordinated with coverage provided under this Plan. This Plan will look at the total covered charges, subtract the amount that the primary health plan has already paid, and then pay the remaining or left over amount at this Plan’s normal Coinsurance rate. The Plan reserves the right to:

� Obtain reimbursement from any other health plan(s) for the cost of the Covered Services provided, which are payable under the other health plan(s) but not in excess of 100% of the cost of Covered Services covered under this Plan in the aggregate;

� Deny payment for such coverage and require the covered individual to seek payment from the other health plan; and

� Pay to other health plan(s) any amount that the Plan determines will satisfy the intent of these Coordination with other Coverage provisions, in which case the amount paid will be considered payment for the applicable Coverage and the Plan will have no further liability.

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Further, the Plan retains all rights of recovery, including, but not limited to, such rights against the Workers' Compensation insurer or other entity where applicable and permitted by law. Duty to Notify the Plan of Other Payment

Retirees and Dependents covered under this Plan must notify the Plan of the existence of any and all other payment under other health plans, as well as the benefits payable under such health plans. The Retiree agrees to assist the Plan in the implementation of its right to integrate or coordinate with other coverage, including the execution of any assignment or other documents necessary to authorize or facilitate such payment to Claims Administrator or to any of its contracting participating providers. The Plan shall have the right to release to, or receive from any Physician, other medical professional, insurance company, or any other person or organization, any claim information, including copies of records relating thereto, necessary for the administration of this Coordination with other Benefits provision. Order of Benefit Determination

When a Covered Retiree or Covered Dependent is eligible for coverage under more than one health plan, this Plan shall be the secondary health plan, unless the other health plan has rules coordinating its benefits with the coverage of this Plan and both the other health plan's rules and the rules of this Plan, inclusive below, require that benefits be covered under this Plan before the benefits of the other health plan. A health plan that does not contain an integration of benefits or coordination of benefits provision is always primary. This Plan determines coverage by using the first of the following rules that apply.

1. The health plan that covers the person as an employee is the primary health plan. The health plan that covers the person as a Dependent is the secondary health plan.

2. The health plan that covers a person as an employee who is neither laid-off nor a Retired Employee (nor that employee's Dependent) is the primary health plan. The health plan that covers a person as a laid-off or Retired Employee or that employee's Dependent is the secondary health plan. If the other health plan does not have this rule, and if as a result, the health plans do not agree on the order of benefits, this rule is ignored.

3. The health plan that covers a person as an employee, participant, subscriber, or Retiree (or as the person’s Dependent) is the primary health plan. The health plan that covers a person due to a right of continuation provided by federal or state law is the secondary health plan. If the other health plan does not have this rule, and if as a result, the health plans do not agree on the order of benefits, this rule is ignored.

4. When this Plan and another health plan cover the same child as a Dependent of different persons, called "parents":

a. The primary health plan is the plan of the parent whose birthday is earlier in the year if:

(1) the parents are married;

(2) the parents are not separated (whether or not they ever have been married); or

(3) a court decree awards joint custody without specifying that one party has the responsibility to provide health care payment.

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b. If the specific terms of a court decree state that one of the parents is responsible for the child’s health care expenses or health care payment and the health plan of that parent has actual knowledge of those terms, that health plan is primary. This rule applies to claim determination periods or calendar years commencing after the health plan is given notice of the court decree.

c. If the parents are not married, or are separated (whether or not they ever have been married) or are divorced, or have terminated a domestic partnership, the order of benefits is:

(1) the plan of the custodial parent;

(2) the plan of the Spouse/domestic partner of the custodial parent;

(3) the plan of the non-custodial parent; and then

(4) the plan of the Spouse/domestic partner of the non-custodial parent.

If none of the above rules determine the order of benefits, the health plan that covered the patient for the longer period of time is the primary health plan.

Here is an example of how this might work in a hypothetical situation:

John is an Ameren Retiree with family coverage under the HealthLink Standard PPO Plan, with benefits for Hospital emergency room Services payable at 100% after a $50 Co-pay. Mary, his wife, works for ABC Corp., and is covered under another plan with Hospital benefits payable at 80% after a $250 Deductible.

$1000 Allowable Charges for Hospital Services for Mary - 250 Minus Mary’s Deductible 750 Covered Amount subject to 80% Coinsurance x 80% $ 600 Paid by Mary’s Plan with ABC Corp. $ 400 Remaining amount of Allowed Charge for Hospital Services for Mary - 50 Ameren Emergency Room Co-pay (HealthLink Standard PPO Plan

benefit) $ 350 Amount subject to Ameren’s Coinsurance (secondary Plan) x 100% Ameren Emergency Room Coinsurance (secondary Plan) $ 350 Amount payable by Ameren Plan

Medicare Exception

Unless otherwise required by Federal law, benefits payable under Medicare will be determined before the benefits payable under this Plan. Federal law will usually apply in such instances if the benefits are applicable to an active (rather than a retired) employee or to that employee's Spouse/domestic partner. When You become eligible for Medicare, Medicare will become the primary payer of medical benefits and the Ameren Retiree Medical Plan will be the secondary payer. Claims for benefits should be filed with Medicare first and then submitted under this Plan. If You do not enroll in Medicare Part A and Part B, the Retiree Medical Plan will estimate the benefit that would have been payable by Medicare and will consider payment based on the remaining

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charges. Therefore, it is very important that You enroll in Medicare Parts A and B as soon as You are eligible. If You are a participant in the Medicare Supplement Plan, covered charges for amounts over the Medicare-approved amounts are not covered. When Medicare is the primary payer for You or a Covered Dependent, You will no longer need to contact the Cost Containment Administrator for pre-certification or Magellan Behavioral Health for mental health, alcohol or substance abuse Treatment (See MAGELLAN MANAGED CARE

PROGRAM FOR MENTAL HEALTH AND ALCOHOL OR SUBSTANCE ABUSE). However, Your Dependents who are not eligible for Medicare, if any, will still need to contact the Cost Containment Administrator and/or follow Magellan procedures. Subrogation and Reimbursement

Applicability

This section will apply if You or one of Your Covered Dependents:

� receives benefit payment under this Plan as the result of a sickness or injury; and

� has a lawful claim against another party or parties or insurer (including uninsured, underinsured, and no-fault automobile insurers) for compensation, damages, or other payment because of that same sickness or injury.

The Plan will have the first priority right to recover benefits paid from the claim settlement, award or judgment, regardless of whether or not (1) You or Your Covered Dependent have been fully compensated, or “made-whole” for his/her loss; (2) liability for payment is admitted by You or Your Covered Dependent or any other party; or (3) the recovery by You or Your Covered Dependent is itemized or called anything other than a recovery for medical expenses. Transfer of Rights

In those instances where this section applies, the rights of You or one of Your Covered Dependents to claim or receive compensation, damages, or other payment from the other party or parties will be transferred to Ameren, but only to the extent of benefit payments made under this Plan. Member and Dependent Obligations

To secure the rights of Ameren under this section, You or one of Your Covered Dependents have the following responsibilities:

� Fully cooperate with the Plan and its agents in obtaining information about the loss and its cause.

� Notify the Plan of any claim for damages made or lawsuit filed in connection with the loss.

� Include the amount of the benefits paid by the Plan on behalf of You or Your Covered Dependent in claims for damages against other parties.

� Notify the Plan of a proposed settlement at least 30 days before any claim or lawsuit is settled in regard to the loss.

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� Provide the Plan with a lien to the extent of the cash value of paid Plan benefits. This lien may be filed with the third party whose act caused the injuries, the third party’s agent or court having jurisdiction in the matter.

� Reimburse the Plan for any damages collected for benefits paid under the Plan immediately upon collection of damages by whatever means.

� Pay the Plan all costs and expenses, including attorney’s fees, which were incurred or expended by the Plan in obtaining or attempting to obtain payment from You or Your Covered Dependent who refuses to reimburse the Plan pursuant to this provision.

� Permit the Plan to file a lawsuit in the name of Yourself or Your Covered Dependent against the person whose act caused injuries.

� The Plan shall be reimbursed first from any judgment, payment or settlement regardless of whether Your or Your Covered Dependent is fully compensated. If any amount remains, it will be given to You or Your Covered Dependent.

� Refrain from taking any action that prejudices the rights of this Plan. If You and/or Your Covered Dependents enter into litigation or settlement negotiations regarding obligations of other parties, You and/or Your Covered Dependents must not prejudice, in any way, the subrogation rights of the Plan.

� Costs of legal representation retained by Ameren in matters related to subrogation will be borne solely by Ameren. The costs of legal representation retained by You and/or Your Covered Dependents will be borne solely by You or Your Covered Dependents.

Claim Filing Procedures

Except in the case of medical care received from Network Providers, claim forms and other information needed to prove loss must be filed with the Claims Administrator in order to obtain payment of plan benefits within the time periods specified in the Medical and Prescription Drug Claim Filing Procedures below. The Claims Administrator will provide forms and other filing assistance. If forms are not provided within 15 calendar days after the Claims Administrator receives such notice of claim, you will be considered to have complied with the requirements of the group plan regarding proof of loss upon submitting, within the time specified below for filing proof of loss, written proof covering the occurrence, character, and extent of the loss. For purposes of this section, "Claimant" means You, Your Covered Dependent, or Beneficiary. When You become covered, You will be issued an identification card. This card should be presented to each provider at the time You or a Dependent receives medical care. Medical Claim Filing Procedures

For participants in the HealthLink Standard PPO, HealthLink Health Savings PPO and the Basic Plan: Participating HealthLink PPO Network Providers will file Your claims for You. Those participating providers will send Your claim to HealthLink. If they incorrectly forward Your claim to Principal, Principal will notify the provider that the claim must be resubmitted to HealthLink. All other medical claims (for example, claims for Services You receive from providers who do not participate in the HealthLink network) must be filed with the Claims Administrator at the address in the table below in order to obtain payment of Plan benefits.

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For participants in the Conventional Plan or the Medicare Supplement Plan Medical claims must be filed with the Claims Administrator at the address in the table below in order to obtain payment of Plan benefits. All medical claims must be received by the Claims Administrator within one year after the end of the year in which the expense is incurred. For example, all expenses incurred during 2009 must be received by the Claims Administrator by December 31, 2010. No benefits are payable for claims filed after the deadline. When filing a medical claim Yourself, please be sure Your claim includes the patient's name, Your name (if different from patient's name), provider of Services, dates of Service, diagnosis, description of Treatment or Service provided and cost of the Service. The Claims Administrator may request additional information to substantiate Your claim or require a signed unaltered authorization to obtain that information from the provider. Your failure to comply with such request could result in declination of the claim. Prescription Drug Claim Filing Procedures

If You and Your Covered Dependents are participating in the HealthLink Standard PPO Plan, Basic Plan, Conventional Plan or Medicare Supplement Plan and therefore are participating in a prescription drug benefit Plan administered by Express Scripts, Express Scripts’ network pharmacies will file Your prescription drug claims for You. If You purchase prescription drugs without using the prescription drug card at non-participating retail pharmacies, You must pay the full cost of the prescription at the time of purchase and submit a completed claim form to Express Scripts for reimbursement. Claim forms may be obtained either by calling Express Scripts at 888.256.6131 or by visiting their website: www.express-scripts.com. Submit those claims to the address shown in the chart below. All pharmacy claims must be received by Express Scripts, the pharmacy benefits administrator, within 365 days of the date of prescription purchase. No benefits are payable for claims received after the deadline. If You and Your Covered Dependents are participating in the HealthLink Health Savings PPO Plan and purchase prescription drugs at a participating Caremark retail pharmacy, Caremark will file Your prescription drug claims for You with Principal Life Insurance Company. If You purchase prescription drugs at non-participating Caremark retail pharmacies, , You must pay the full cost of the prescription at the time of purchase and file a completed Caremark claim form to Caremark for reimbursement. Claim forms may be obtained either by calling Caremark at 877.683.6838, or by visiting their website: www.Caremark.com. Submit those claims to the address shown in the chart below. The following chart provides a summary of the mailing instructions for different types of medical and prescription drug claims:

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Medical – HealthLink PPO providers Your medical care provider will file Your claims for You. Claims will be sent to: HealthLink P.O. Box 419104 St. Louis, MO 63141-9104 Electronic Claims:90001

Medical – Non-HealthLink providers and Medicare Eligible Claims

You or Your non-HealthLink medical care provider should forward Your claims to: Principal Life Insurance Company P. O. Box 39710 Colorado Springs, CO 80949-3910

Prescriptions – Participating Express Scripts retail pharmacy

Your participating Express Scripts pharmacy will submit Your claim for You.

Prescriptions – Non-participating Express Scripts retail pharmacies

If You purchase a prescription drug from a non-participating Express Scripts pharmacy, You must submit a claim for reimbursement to Express Scripts at the following address: Express Scripts, Inc. P.O. Box 66773 St. Louis, MO 63166-6773 Attn: Claims Department

Prescriptions – participating Caremark pharmacies under the (Managed Indemnity Prescription Drugs) HealthLink Health Savings PPO Plan

Your Caremark pharmacy provider will submit Your claim for You to: Principal Life Insurance Company P. O. Box 39710 Colorado Springs, CO 80949-3910

Prescriptions – Non-participating Caremark pharmacies under the (Managed Indemnity Prescription Drugs) under the HealthLink Health Savings PPO Plan

If You purchase a prescription drug from a non-participating Caremark pharmacy, You must submit a Caremark claim form for reimbursement to Caremark at the following address: Caremark P. O. Box 52116 Phoenix, AZ 85072-2116

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Post-Service Claim Filing Procedures Payment, Denial, and Review

The Claims Administrator will make a benefit determination and notify the Claimant or his or her authorized representative in writing within 30 calendar days from receipt of a post-Service claim. (See the Utilization Management Review Procedures for filing pre-Service, concurrent care or urgent care medical claims and the Magellan Managed Care Program for pre-certification of Mental Health and Substance Abuse Treatment.) The initial 30-day determination period may be extended up to 15 additional days due to reasons beyond the Claims Administrator’s control. If such an extension is needed, the Claims Administrator will notify the Claimant (or authorized representative) in writing within the initial 30-day period of the reason necessitating the extension and the date by which a decision is expected to be made. If a claim cannot be processed due to incomplete information, the Claims Administrator will send written notification prior to the expiration of the 30 calendar days explaining the specific information needed. The Claimant is then allowed up to 45 calendar days to provide all additional information requested. The Claims Administrator will render a decision within 15 calendar days of either receiving the necessary information or upon expiration of 45 calendar days if no additional information is received. In actual practice, benefits under the group Plan may be processed and paid within a few days after the Claims Administrator receives the completed claim. If a claim cannot be paid, the Claims Administrator will promptly explain why. Notice of Adverse Benefit Determination

If a claim is partially or wholly denied, the Claimant or his or her authorized representative will be notified in writing (usually in the form of an Explanation of Benefits). The notice will be given in writing or electronically and include the specific reason(s) the claim was denied and reference the specific Plan provisions on which the denial is based. The notice will describe any additional information necessary to perfect the claim and why such information is necessary. If an internal rule, guideline, protocol, or similar criterion was relied upon in making the determination, the notice will include the rule, guideline, protocol or other criterion, or state that Claimant will be provided with a copy free of charge upon request. Notice of a denial based on medical necessity, Experimental Treatment or a similar exclusion or limit will either explain the scientific or clinical judgment for the decision as applied to the medical circumstances or state that an explanation will be provided upon request, without charge. A Claimant will also be informed of the Plan’s appeal procedures and of the Claimant’s right to bring a civil action under Section 502(a) of ERISA. Appeal Rights

If a medical or prescription drug claim results in an Adverse Benefit Determination, the Claimant or authorized representative may appeal the decision as described below. Informal Inquiry Process for Medical and Prescription Drug Claims

Inquiries Regarding Medical Claims Claimants should direct informal inquiries regarding medical claims to the Plan via Principal Monday through Friday from 8:00 AM to 5:00 PM Central Time at 866.482.6028.

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A Customer Service Representative will review, research and resolve the inquiry. The Claimant will be informed of the resolution. At the time of the resolution, if the decision is adverse to the Claimant, the Claimant will be advised of his/her rights to request a formal appeal. Claimants also have the right to bypass the informal inquiry process and immediately file a formal first level appeal. Inquiries Regarding Prescription Drug Claims Participants enrolled in a prescription drug Plan administered by Express Scripts should direct informal inquiries regarding prescription drug claims to Express Scripts Customer Service Department. They are available 24 hours a day, 7 days a week, at 888.256.6131. A Customer Service Representative will review and research the inquiry. The Claimant will be informed of the resolution and if the decision is adverse to the Claimant, the Claimant will be advised of his/her rights to request a formal Appeal. Claimants also have the right to bypass the informal inquiry process and immediately file a formal appeal. Participants enrolled in the HealthLink Health Savings PPO should direct informal inquiries regarding prescription drug claims to Caremark Monday through Friday from 5:00 a.m. to 9:00 p.m. Mountain Time, and Saturday and Sunday from 6:00 a.m. to 3:00 p.m. Mountain Time, at 877.683.6838 A Customer Service Representative will review, research and resolve the inquiry. The Claimant will be informed of the resolution. At the time of the resolution, if the decision is adverse to the Claimant, the Claimant will be advised of his/her rights to request a formal appeal. Claimants also have the right to bypass the informal inquiry process and immediately file a formal first level appeal. Appeal Process For Medical Claims (Except Appeals For Non-certification of Mental Health and Substance Abuse Treatment) And For Prescription Drug Claims under the HealthLink Health Savings PPO Plan:

Mandatory Level of Appeal A Claimant may appeal a claim denial by written request to the Claims Administrator within 180 calendar days of receipt of notice of the denial. The Claims Administrator will make a full and fair review of the claim. The Claims Administrator will notify the claimant or authorized representative in writing of the appeal decision within 60 calendar days of receiving the appeal request. A Claimant (or authorized representative) will have the opportunity to submit written comments, documents, records, and other information relating to the claim for benefits. Appeals will be conducted by an appropriate qualified individual who was not involved with the initial claim decision nor a subordinate to that original decision maker. Additionally, the Claimant will be provided, upon request and free of charge, reasonable access to, and copies of, all documents, records, and other information relevant to the claim for benefits. Any review will take into account all comments, documents, records, and other information You submit relating to the claim, without regard to whether the information was submitted or considered in the initial benefit determination, and will not afford deference to the initial benefit determination that is the subject of the appeal. If the claim was denied based on a medical judgment (including whether a Treatment, drug, or other item is Experimental, Investigational, or not Medically Necessary or Appropriate), the Claims Administrator will consult with a health care professional who has appropriate training and

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experience in the field of medicine involved in that judgment and who was not consulted on the initial decision. By appealing the initial denial, a Claimant consents to the review of medical information pertinent to the claim by the above-referenced health care professional consulted in connection with the appeal. The identification of any medical experts whose advice was obtained on behalf of the Plan in connection with the Adverse Benefit Determination will be provided upon request, without regard to whether the expert’s advice was relied upon in making the benefit determination. A document, record or other information is considered relevant to a claim if it was relied upon in making the benefit determination; was submitted, considered or generated in the course of making the benefit determination without regard to whether it was relied upon in making the benefit determination; demonstrates compliance with the administrative processes and safeguards designed to ensure and to verify that benefit claim determinations are made in accordance with the Plan and that Plan provisions have been applied consistently with respect to similarly situated claimants; or constitutes a statement of policy or guidance with respect to the Plan concerning the denied Treatment option or benefit for the Claimant’s diagnosis, without regard to whether such advice or statement was relied upon in making the benefit determination. If a claim is partially or wholly denied on Appeal, the notice will give the specific reason for the denial and reference Plan provisions on which the denial is based. The notice will include statements as to the Claimant’s right to obtain upon request, without charge, access to and copies of all documents, records and other information relevant to the claim, to bring a civil action under Section 502(a) of ERISA or to pursue other voluntary alternative dispute resolution options. The notice will also describe any voluntary appeal procedures under the Plan. If the Claims Administrator relied on a rule, guideline, protocol, or similar criterion in denying the appeal, the notice will either include a copy or state that it was relied on and will be provided upon request, without charge. Notice of a denial based on medical necessity, Experimental Treatment or a similar exclusion or limit will either explain the scientific or clinical judgment for the decision as applied to the medical circumstances or state that an explanation will be provided upon request, without charge. This first level of appeal review must be completed by the Claimant before filing a civil action or pursuing any other legal remedies. Voluntary Level of Appeal After exhaustion of the mandatory level of appeal, a Claimant may request a voluntary level of appeal. The second appeal must be requested in writing. The Claims Administrator will make a determination within 60 calendar days of request for a voluntary level of appeal. However, if the appeal cannot be processed due to incomplete information, the Claims Administrator will send a written explanation of the additional information that is required or an authorization for the Claimant's signature so information can be obtained from the provider. This information must be sent to the Claims Administrator within 45 calendar days of the date of the written request for the information. Failure to comply with the request for additional information could result in declination of the appeal. A determination will be made and notification of the outcome will be provided within 60 calendar days of the receipt of the request for a voluntary level of appeal. Election of this second level of appeal is voluntary and does not negate the Claimant's right to bring civil action following the first appeal, nor does it have any effect on the Claimant's right to any other benefit under the group Plan. The Plan waives any right to assert that a Claimant has

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failed to exhaust his or her administrative remedies because a Claimant does not elect a voluntary appeal review. The voluntary appeal process is offered in an effort that the claim may be resolved in good faith without legal intervention. At anytime during the voluntary appeal process, the Claimant may file a civil action or pursue any other legal remedies. The Plan agrees that any statute of limitations or other defense based on timeliness is tolled during the time that the voluntary appeal review is pending. Appeal Process for Non-certification of Mental Health/Substance Abuse Treatment

If a Claimant believes his or her request for certification of Mental Health/Substance Abuse Treatment was denied in error, the decision may be appealed. Except in the case of an appeal relating to urgent care, the Claimant must complete the first and second levels of appeal as described below before a lawsuit can be filed regarding a denial of Mental Health/Substance Abuse benefits. The Claimant’s initial appeal must be submitted to Magellan within 180 calendar days following receipt of the Non-certification notice. When appealing to Magellan, the Claimant should submit to Magellan the reasons for the appeal, along with any additional information or documentation to support the appeal. The Claimant may submit written comments, documents, records, and other information, whether or not the comments, documents, records, or information were submitted in connection with the initial request or, if applicable, the first appeal. Magellan staff who conduct appeal reviews will be different from the persons who made the original decision (and, for 2nd level appeals, the person who made the 1st appeal decision) and will not report directly to the original decision maker (or 1st appeal reviewer). Magellan will not give any special weight to the initial determination (or to the 1st appeal decision). If the Adverse Benefit Determination was based, in whole or in part, on a medical judgment, the appeal reviewer will consult with a health care professional with appropriate training and experience (someone other than the professional who was consulted for the original decision or the 1st appeal decision or his or her subordinate). If Magellan obtains the advice of an expert in connection with the denial of the request for benefits, Magellan will provide the Claimant with the name of each expert, upon request, even if Magellan does not rely on the expert’s advice in making its decision. Urgent Care Appeals Magellan provides one level of expedited appeal relating to urgent care. If the Claimant’s request involves urgent care that has not yet been received, the Claimant may initiate an expedited appeal by a telephone call to Magellan. The Claimant or an authorized representative may appeal urgent care denials either orally or in writing. All necessary information, including the appeal decision, will be communicated between the Claimant or the authorized representative and Magellan by telephone, facsimile, or other similar method. The Claimant will be notified of the decision orally no later than 72 hours after Magellan receives the appeal. Magellan will send a follow-up notice to the Claimant in writing. Pre-Service and Post-Service Appeals Pre-Service and post-Service appeals must be submitted to Magellan in writing. Magellan provides two levels of appeal for all MHSA pre-Service and post-Service requests. A Claimant will have 30 days to request a 2nd appeal if the 1st appeal determination upholds any part of the

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original determination. Magellan will notify the Claimant or the Claimant’s authorized representative of each appeal decision no later than 15 days (regarding pre-Service requests) or 30 days (regarding post-Service requests) after the appeal is received. Notice of Appeal Determination Magellan will give the Claimant written notice of appeal decisions. If the Adverse Benefit Determination is upheld on appeal, the notice will include the following information:

� the specific reason or reasons for the determination;

� a reference to the specific Plan provisions on which the determination is based;

� a statement of the Claimant’s right to receive, free of charge, upon request, any internal rule, guidelines, protocol or similar criterion relied on in making the determination;

� an explanation of the clinical judgment for the decision, if the Adverse Benefit Determination was based on lack of medical necessity or exclusion of Experimental Treatment;

� a statement of the Claimant’s right to receive, free of charge, reasonable access to, and copies of, all documents, records and other information relevant to the appeal;

� a statement of the Claimant’s right to the next level appeal, if applicable, and a description of the review procedures; and

� a statement regarding Your right to bring a civil action under ERISA section 502(a) following completion of the required level or levels of appeal.

Appeal Process for Prescription Drug Claims Administered by Express Scripts

If a Claimant disagrees with a prescription drug claim denial at a retail pharmacy or through the Mail Order Drug Program, the Claimant should contact Express Scripts at 888.256.6131. Express Scripts will research the inquiry and will respond providing the rationale behind the denial. It may be necessary for the Claimant or the Claimant’s Physician to provide additional information that will allow reconsideration of the claim. If it is determined that based upon Express Scripts’ analysis, the claim was properly denied, the Claimant (or authorized representative) may contact the Plan Administrator for further consideration. A written appeal should be submitted to: Employee Benefits Department Ameren Services 1901 Chouteau Avenue, Mail Code 533 Post Office Box 66149 St. Louis, MO 63166-6149 The Claimant’s written appeal should include the Covered Retiree’s (and Covered Dependent’s, if applicable) name, the date the Claimant attempted to fill the prescription, the prescribing Physician’s name, the drug name and quantity, the cost for the prescription (if applicable), the reason the Claimant believes the claim should be paid, and any other written documentation to support the request for review.

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The appeal must be submitted to the Plan Administrator within 180 calendar days after receipt of the initial claim denial from Express Scripts. If the claim appeal is not filed within the designated timeframe, the Claimant may lose the right to file suit in federal or state court. The Plan Administrator will take into account all information submitted relative to the claim. The Claimant has the right to request, free of charge, reasonable access to and copies of all documents, records and other information relevant to the claim for benefits. Appeals will be conducted by an appropriate qualified individual who was not involved with the initial claim decision nor a subordinate to that original decision maker. No deference to the initial claims denial will be given by the reviewer. If the claim was denied based on a medical judgment (including whether a Treatment, drug, or other item is Experimental, Investigational, or not Medically Necessary or Appropriate), the Plan Administrator will consult with a health care professional who has appropriate training and experience in the field of medicine involved in that judgment and who was not consulted on the initial decision. By appealing the initial denial, the Claimant consents to review of medical information pertinent to the claim by the above referenced health care professional consulted in connection with the review of the appeal. Upon request, the Claimant will be provided with the identification of medical experts whose advice was obtained in connection with the appeal whether or not the Plan relied on their advice. The Plan Administrator will advise the Claimant of the decision on the appeal in writing within 60 days of receipt of the appeal, unless the Claimant is notified that special circumstances require an extension of time. All claims decisions made by the Plan Administrator will be final, binding, and conclusive. Legal Action

When claiming a benefit under the Plan, You must follow the Claim Filing Procedures described in this section of this booklet. If Your claim is not paid to Your satisfaction, You have the right to request an appeal, the procedures for which are also described in this booklet section. If Your appeal is denied, You have the right to bring legal action against the Plan but no earlier than 90 calendar days after You filed Your claim for benefits. The mandatory claim appeal process must be exhausted before You can file legal action. Further, You may not bring legal action against the Plan after three (3) years have elapsed following the date of Your claim appeal. Facility of Payment

The Plan allows You to assign Your benefits to a Hospital or other Service provider. This means that benefits payable by the Plan will be paid directly to the Service provider and You will be billed for any remaining balance. Payment of benefits for Non-Network Providers will be made to You or a Covered Dependent, unless there is an assignment of benefits to be paid directly to that provider providing the Service. Also, in the special instances listed below, payment will be as indicated. All payments so made will discharge the Company to the full extent of those payments.

� If payment amounts remain due upon Your death, those amounts may, at the Company's option, be paid to Your estate, Spouse, domestic partner, child, parent, or provider of medical and dental Services.

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� If the Company believes a person is not legally able to give a valid receipt for a benefit payment, and no guardian has been appointed, the Company may pay whoever has assumed the care and support of the person.

� Benefits payable to a HealthLink PPO Network Provider will be paid directly to the HealthLink Network Provider on behalf of You or a Covered Dependent.

� Benefits payable to a provider in the Transplant Network will be paid directly to the provider. (Important Note: The Transplant Network is applicable only to participants in the HealthLink Standard PPO, HealthLink Health Savings PPO and the Basic Plan.)

Miscellaneous Provisions

Plan Administration

The Plan Administrator has delegated authority to administer the Plan on a day-to-day basis to the Administrative Committee. Except where the Administrative Committee has delegated the final discretionary authority for adjudicating claims to a Claims Administrator, insurance company, or other entity, the Administrative Committee has discretionary authority to construe and interpret the Plans, construe any ambiguous provision of the Plans, correct any defect, supply any omission or reconcile any inconsistency in such manner and to such extent as the Committee in its sole and absolute discretion may determine, and to decide all questions of eligibility and to make all determinations as to the right of any person to a benefit. To the extent the Administrative Committee has delegated such final and binding discretionary authority to a Claims Administrator, insurance company or other person, entity, or group, the determination of such Claims Administrator, insurance company, or other person, entity or group, shall be final and binding. Plan Amendment or Termination

The Company hopes and expects to continue the Ameren Retiree Medical Plan in the years ahead, but cannot guarantee to do so. Ameren Corporation, and any successor corporation which assumes the responsibilities of Ameren Corporation under the Plan, may amend or terminate the Plan or any benefit provided under the Plan from time to time or at any time, without advance notice thereof. Ameren Corporation, Ameren Services Company (as agent for Ameren Corporation), an officer of Ameren Corporation or Ameren Service Company, or such officer’s delegate may effect an amendment or termination of the Plan or a benefit provided under the Plan by written instruments describing the terms of such amendment or termination. Such amendment will be incorporated into this document. Applicability

Except as otherwise indicated, the provisions of this document shall apply equally to the Covered Retiree and Dependents and all benefits and privileges made available to Covered Retiree shall be available to Covered Retiree’s Dependents. Nontransferable Benefits

No person other than the Covered Retiree and Covered Dependent is entitled to receive health care Service coverage or other benefits to be furnished by the Plan. Such right to health care coverage or other benefits is not transferable.

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Severability

In the event that any provision of this document is held to be invalid or unenforceable for any reason, the invalidity or unenforceability of that provision shall not affect the remainder of this document, which shall continue in full force and effect in accordance with its remaining terms. Waiver

The failure of Claims Administrator, the Plan Sponsor or a covered individual to enforce any provision of this document shall not be deemed or construed to be a waiver of the enforceability of such provision. Similarly, the failure to enforce any remedy arising from a default under the terms of this document shall not be deemed or construed to be a waiver of such default. Lost Distributees

If any person to whom a check is issued in payment of a benefit under this Plan cannot be located or does not present the check for payment, the amount of the check may be applied to other Plan purposes; provided, if any such person subsequently appears and makes demand for such payment, the Plan Administrator shall direct that such payment be made in full as soon as practical. Recovery of Excess Payments

In the event payments are made in excess of the amount necessary to satisfy the applicable provision of the Plan, the Plan shall have the right to recover excess payments from any individual, insurance company or other organization to whom excess payments are made. The Plan shall also have the right to withhold payment of future benefits due until the overpayment is recovered. Your Rights Under ERISA

Federal law requires that this section be included in Your booklet. As a participant in this Plan, You are entitled to certain rights and protections under the Employee Retirement Income Security Act of 1974 (ERISA). ERISA provides that all Plan participants shall be entitled to:

� Examine, without charge, at the Plan Administrator’s office and at other specified locations, such as worksites and union halls, all documents governing the Plan, including insurance contracts and collective bargaining agreements, and a copy of the latest annual report (Form 5500 Series) filed by the Plan with the U. S. Department of Labor.

� Obtain, upon written request to the Plan Administrator, copies of documents governing the operation of the Plan, including insurance contracts and collective bargaining agreements, and copies of the latest annual report (Form 5500 Series) and the updated summary plan description. The administrator may make a reasonable charge for the copies.

� Receive a summary of the Plan’s annual financial report. The Plan Administrator is required by law to furnish each participant with a copy of this summary annual report.

� Continue health care coverage for Yourself, Your Spouse, Your domestic partner or Your dependents if there is a loss of coverage under the Plan as a result of a qualifying event. You or Your dependents may have to pay for such coverage. Review the summary plan description and the documents governing the plans on the rules governing Your COBRA continuation coverage rights.

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� Reduction or elimination of exclusionary periods of coverage for preexisting conditions under Your group health plan, if You have Creditable Coverage from another plan. You should be provided a certificate of Creditable Coverage, free of charge, from Your group health plan or health insurance issuer when You lose coverage under the plan, when You become entitled to elect COBRA continuation coverage, when Your COBRA continuation coverage ceases, if You request it before losing coverage, or if You request it up to 24 months after losing coverage. Without evidence of Creditable Coverage, You may be subject to a preexisting condition exclusion for 12 months (18 months for late enrollees) after the date You enrolled in Your coverage.

In addition to creating rights for Plan participants, ERISA imposes duties upon those who are responsible for the operation of the employee benefit plan. Those who operate Your Plan, called “fiduciaries” of the Plan, have a duty to do so prudently and in the interest of You and other Plan participants and beneficiaries. No one, including Your employer, Your union, or any other person, may fire You or otherwise discriminate against You in any way to prevent You from obtaining a (welfare) benefit or exercising Your rights under ERISA. If Your claim for a (welfare) benefit is denied in whole or in part, You must receive a written explanation of the reason for the denial. You have the right to have the Plan review and reconsider Your claim. Under ERISA, there are steps You can take to enforce the above rights. For instance, if You request materials from the Plan and do not receive them within 30 days, You may file suit in a Federal court. In such a case, the court may require the Plan Administrator to provide the materials and pay You up to $110 a day until You receive the materials, unless the materials were not sent because of reasons beyond the control of the Administrator. If You have a claim for benefits which is denied or ignored, in whole or in part, You may file suit in a state or Federal court. In addition, if You disagree with the Plan’s decision or lack thereof concerning the qualified status of a domestic relations order or a medical child support order, You may file suit in Federal court. If it should happen that Plan fiduciaries misuse the Plan’s money, or if You are discriminated against for asserting Your rights, You may seek assistance from the U. S. Department of Labor, or You may file suit in a Federal court. The court will decide who should pay court costs and legal fees. If You are successful, the court may order the person You have sued to pay these costs and fees. If You lose, the court may order You to pay these costs and fees, for example, if it finds Your claim is frivolous. If You have any questions about Your Plan, You should contact the Plan Administrator. If You have any questions about this statement or about Your rights under ERISA, You should contact the nearest office of the Employee Benefits Security Administration, U. S. Department of Labor, listed in Your telephone directory, or the Division of Technical Assistance and Inquiries, Employee Benefits Security Administration, U. S. Department of Labor, 200 Constitution Avenue, N.W., Washington, DC 20210. General Information About the Plan

Plan Name Ameren Retiree Medical Plan

Type of Plan A group health plan (a type of welfare benefits plan that is subject to the provisions of ERISA).

Plan Year January 1 through December 31

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Plan Number 510

Funding Medium and Type of Plan Administration

The Plan is generally funded by contributions made in part by the Plan Sponsor and in part by Plan Participants. With the exception of certain key Retirees, all contributions are paid directly to trusts established for the purpose of providing benefits under the Plan.

Plan Sponsor has a contract with Principal and Express Scripts (“Claims Administrator”) to process claims under the Plan. Claims Administrator does not serve as an insurer, but merely as a claims processor. Claims for benefits are sent to the Claims Administrator. It processes the claims, then requests and receives funds from the Trust to pay the claims. Benefits under the Plan are not guaranteed under a contract or insurance policy. The Plan Sponsor is ultimately responsible for providing the Plan benefits, and not the Claims Administrator.

Trustee To the extent permitted under applicable law, medical benefits are paid out of a trust held and managed by Mellon Global Securities Services, located at 135 Santilli Highway, Everett, Massachusetts, 02149. If the trust is terminated, the remaining assets will be distributed in accordance with the provisions of the trust agreement.

Plan Sponsor Ameren Corporation 1901 Chouteau Avenue, Mail Code 533 Post Office Box 66149 St. Louis, MO 63166-6149 877.7my.Ameren (877.769.2637)

Plan Sponsor’s Employer Identification Number

43-1723446

Plan Administrator Ameren Services 1901 Chouteau Avenue, Mail Code 533 Post Office Box 66149 St. Louis, MO 63166-6149 877.7my.Ameren (877.769.2637)

Claims Administrator Principal Life Insurance Company Post Office Box 39710 Colorado Springs, CO 80949-3910 and Express Scripts One Express Way St. Louis, MO 63121

COBRA Administrator Ceridian COBRA Continuation Service 3201 34th Street South St. Petersburg, FL 33711-3828 800.877.7994 www.ceridian-benefits.com

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Named Fiduciary Ameren Services 1901 Chouteau Avenue, Mail Code 533 Post Office Box 66149 St. Louis, MO 63166-6149 877.7my.Ameren (877.769.2637)

Agent for Service of Legal Process

General Counsel Ameren Services 1901 Chouteau Avenue, Mail Code 1300 Post Office Box 66149 St. Louis, MO 63166-6149 877.7my.Ameren (877.769.2637) Service of Legal Process also may be made upon the Plan

administrator.

Membership ID Card Every Retiree receives membership ID card(s). Retirees need to carry the Plan ID card(s) with them at all times, and present the appropriate ID card whenever the Retiree or a Dependent receives health care Services. If a medical Plan ID card, or a medical/prescription drug Plan ID if enrolled in the HealthLink Health Savings PPO Plan, is missing, lost, or stolen, contact Principal at 866.482.6028 to obtain a replacement. If a prescription drug Plan ID card for a prescription drug Plan administered by Express Scripts is missing, lost, or stolen, contact Express Scripts at 888.256.6131.

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Appendix A

The premiums described in this Appendix apply to the following eligible groups: Eligible Retiree Group Retirement Date All management and contract employees (except for AmerenCILCO and AmerenIP) and their surviving dependents

January 1, 1992 – present

Central Illinois Public Service Company (CIPS) full pay* retirees and their surviving dependents *Full Pay means: a) You retired before age 60; or b) You retired on or after age 60, but you had less than 25 years of service at the time of your retirement.

Retired from CIPS prior to January 1, 1992

AmerenCILCO management employees January 1, 2004 – present AmerenEnergy Resources Generating Company NCF&O Local 8 and their surviving dependents

January 1, 2007 – present

AmerenCILCO IBEW Local 51 and their surviving dependents

January 1, 2008 - present

Management Retirees – You are required to pay a portion of the Retiree medical premium to cover Yourself and Your eligible Dependents as described in the table below, labeled ‘Minimum Retiree Premiums’. Contract Retirees – If You are an AmerenUE, AmerenCIPS or Ameren Energy Generating Company contract employee and the labor agreement under which You retired has not expired, the Company currently will pay the full cost of medical coverage for You. You will be required to pay 20% of the monthly premium for Dependent coverage. The cost You pay for Dependent coverage will be adjusted every January 1, but the amount will not exceed two times the cost in effect in the year in which You retired. Once the labor agreement under which You retired expires, the following ‘Minimum Retiree Premiums’ will apply to You. For all other contract employees listed as an eligible group above, You are required to pay a portion of the Retiree medical premium to cover Yourself and Your eligible Dependents as described in the table below, labeled ‘Minimum Retiree Premiums’. Minimum Retiree Premiums

Management Retirees

The minimum amount you are required to pay is 25% of Ameren’s total monthly premium to cover yourself and 50% of Ameren’s total monthly premium to cover your eligible dependents. (Note: If you retired after September 1, 2002, see the section titled RETIREE MEDICAL CAPS below for additional information that may affect the amount of premium you will be required to pay). AmerenUE, AmerenCIPS and AmerenEnergy Generating Company Contract Retirees

If the labor agreement that was in effect when you retired has not yet expired, Ameren currently pays the full cost of medical coverage for you and you are currently required to pay 20% of the monthly premium to cover your dependents. The amount you pay for dependent coverage will be adjusted every January 1, but will not exceed two times the cost in effect in the year in which you retired.

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Once the labor agreement under which you retired expires, the minimum amount you are required to pay is 25% of Ameren’s monthly premium to cover yourself and 50% of Ameren’s monthly premium to cover your eligible dependents (Note: If you retired after September 1, 2002, see the section titled RETIREE MEDICAL CAPS below for additional information that may affect the amount of premium you will be required to pay). All Other Eligible Contract Retirees

The minimum amount you are required to pay is 25% of Ameren’s monthly premium to cover yourself and 50% of Ameren’s monthly premium to cover your eligible dependents. (Note: If you retired after September 1, 2002, see the section titled RETIREE MEDICAL CAPS below for additional information that may affect the amount of premium you will be required to pay). Retiree Medical Caps

If you retired after September 1, 2002, the Retiree Medical Cap established by Ameren will also affect your retiree medical premium calculation. The Retiree Medical Cap represents the maximum amount the Company will contribute toward your monthly retiree medical premium, regardless of the number of dependents you cover. The following chart outlines the groups that are affected by the Retiree Medical Cap:

Eligible Group Retirement Date Management employees who are not participants in the Voluntary Retirement Program (VRP) and their surviving dependents

Retired on or after October 1, 2002

AmerenCILCO IBEW Local 51 and their surviving dependents

Retired on or after January 1, 2008

AmerenEnergy Resources Generating Company NCF&O Local 8 and their surviving dependents

Retired on or after January 1, 2007

All other contract employees who are not participants in the Voluntary Retirement Program (VRP), and who have previously been participants in a union in which the contract in effect on their retirement date has expired.

Retired on or after October 1, 2002

Retirees who are subject to the Maximum Company Contribution limit may end up paying more than the minimum Retiree premiums listed above. The maximum the Company will pay towards Retiree medical coverage for You and Your Eligible Dependents is based on Your age and Years of Service at retirement. (Note: For survivors of retirees, the Retiree Medical Cap is based on the age and years of service of the retiree at the time of his/her retirement. For survivors of an active employee, the Retiree Medical Cap is based on the age and years of service of the employee at the time of his/her death.) If a Retiree does not have the minimum Years of Service as reflected in the chart below, but is otherwise eligible to participate in the Plan, the minimum number of Years of Service (10) along with the appropriate age at retirement is applied in determining the Company’s maximum monthly premium contribution. Retirees who are subject to the ‘Maximum Company Contribution’ limit are responsible for paying the greater of:

a. The minimum Retiree premium described in the applicable chart above; OR

b. The amount of the premium that exceeds the cap described in the table below. The following tables will help You determine what monthly Company contribution cap will apply to You:

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Retiree Medical Cap for Retirees Under Age 65

The following chart shows the maximum monthly amount Ameren will contribute towards your Retiree medical premiums if you are under age 65 and were not a participant in the Voluntary Retirement Program (VRP). Note: Age and Years of service are rounded down to the nearest year.

Age at Retirement (rounded down to the nearest year)

Years of

Service

55

56

57

58

59

60

61

62 or older

10 $387 $396 $405 $414 $423 $432 $441 $450

11 426 436 446 455 465 475 485 495

12 464 475 486 497 508 518 529 540

13 503 515 527 538 550 562 573 585

14 542 554 567 580 592 605 617 630

15 581 594 608 621 635 648 662 675

16 619 634 648 662 677 691 706 720

17 658 673 689 704 719 734 750 765

18 697 713 729 745 761 778 794 810

19 735 752 770 787 804 821 838 855

20 774 792 810 828 846 864 882 900

21 813 832 851 869 888 907 926 945

22 851 871 891 911 931 950 970 990

23 890 911 932 952 973 994 1014 1035

24 929 950 972 994 1015 1037 1058 1080

25 968 990 1013 1035 1058 1080 1103 1125

26 1006 1030 1053 1076 1100 1123 1147 1170

27 1045 1069 1094 1118 1142 1166 1191 1215

28 1084 1109 1134 1159 1184 1210 1235 1260

29 1122 1148 1175 1201 1227 1253 1279 1305

30 1161 1188 1215 1242 1269 1296 1323 1350

VRP Participants

If You retire under the Voluntary Retirement Program, the Company will contribute a maximum of $1,550 per month towards Your retiree medical coverage, while you are younger than age 65. Your actual age and Years of Service at the time of retirement are not used to calculate your retiree medical premium cap.

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Retiree Medical Cap for Retirees Age 65 and Older

The following chart shows the maximum monthly amount Ameren will contribute towards your Retiree medical premiums if you are age 65 and older and were not a participant in the Voluntary Retirement Program (VRP). Note: Age and Years of Service are rounded down to the nearest year.

Age at Retirement (rounded down to the nearest year)

Years of

Service

55

56

57

58

59

60

61

62 or older

10 $172 $176 $180 $184 $188 $192 $196 $200

11 189 194 198 202 207 211 216 220

12 206 211 216 221 226 230 235 240

13 224 229 234 239 244 250 255 260

14 241 246 252 258 263 269 274 280

15 258 264 270 276 282 288 294 300

16 275 282 288 294 301 307 314 320

17 292 299 306 313 320 326 333 340

18 310 317 324 331 338 346 353 360

19 327 334 342 350 357 365 372 380

20 344 352 360 368 376 384 392 400

21 361 370 378 386 395 403 412 420

22 378 387 396 405 414 422 431 440

23 396 405 414 423 432 442 451 460

24 413 422 432 442 451 461 470 480

25 430 440 450 460 470 480 490 500

26 447 458 468 478 489 499 510 520

27 464 475 486 497 508 518 529 540

28 482 493 504 515 526 538 549 560

29 499 510 522 534 545 557 568 580

30 516 528 540 552 564 576 588 600

VRP Participants

If You retire under the Voluntary Retirement Program, the Company will contribute a maximum of $700 per month towards Retiree medical coverage, while you are age 65 and older. Your actual age and Years of Service at the time of retirement are not used to calculate your retiree medical premium cap. Important Note

The minimum Retiree premiums and maximum Company contributions described in this Appendix are subject to change.

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Examples

It may be helpful to look at some EXAMPLES of how to estimate what You might pay for medical coverage once You retire: Example 1 Let’s say that Bill retires on March 1, 2009 at age 55 with 25 Years of Service. Let’s also assume that Ameren’s total monthly premium is $700 for 2009 for each non-Medicare eligible Participant. To cover only himself in 2009, Bill will pay the greater of:

Bill’s Minimum Retiree Premium (25% of $700) $ 175 ⇐⇐⇐⇐ Greater OR Total Monthly Premium (Bill only) $ 700 Less Retiree Medical Cap (age 55 with 25 Years of Service) $ 968 (Amount that exceeds the cap) - $ 268

In this first example, Bill’s monthly premium is $175. His Minimum Retiree Premium of $175 is greater than the amount that exceeds his Retiree Medical Cap(-$268). Example 2 Now, let’s assume that Bill’s wife is also covered. That would add an additional $700 to the total monthly premium, bringing the total premium required to cover Bill and his Spouse to $1,400 per month. To cover both himself and his Spouse in 2009, Bill pays the greater of:

Bill’s Minimum Retiree Premium (25% of $700) $ 175 Plus Spouse’s Minimum Premium (50% of $700) $ 350 Total Minimum Retiree Premium $ 525 ⇐⇐⇐⇐ Greater OR Total Monthly Premium ($700 for Bill plus $700 for Spouse) $1,400 Less Retiree Medical Cap (age 55 with 25 Years of Service) $ 968 (Amount that exceeds the cap) $ 432

In this second example, Bill pays $525 per month to cover both himself and his Spouse since his Minimum Retiree Premium ($525) is greater than the amount that exceeds his cap ($432).

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Example 3 Now, let’s assume that Bill wants to cover his spouse and his eligible children. Let’s assume that in 2009, Ameren’s total monthly cost is $400 to cover the children. We will continue to assume that it costs $700 to cover each non-Medicare eligible Participant. In this example, Bill will pay the greater of:

Bill’s Minimum Retiree Premium (25% of $700) $ 175 Plus Spouse’s Minimum Premium (50% of $700) $ 350 Plus Child Minimum Premium (50% of $400) $ 200 Total Minimum Retiree Premium $ 725 OR Total Monthly Premium ($700 for Bill, $70 for Spouse & $400 for Children)

$1,800

Less Retiree Medical Cap (age 55 with 25 Years of Service) $ 968 (Amount that exceeds the cap) $ 832 ⇐⇐⇐⇐ Greater

In this third example, Bill pays $832 per month to cover himself, his Spouse and children, because this amount is greater than the minimum retiree premium ($725).

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Notes