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BENEFITS - Loading TEDS EveryOne

BENEFITSfor Management EmployeesapRiNTED JaNUaRY 2013mEDica l OpTiONSIn-Network BENEFITS (Out-of-Network deductibles and coverage not shown)Meet Health Requirements 1Do NOT Meet Healthy Requirements1 Preferred CopayPreferred AccountCopayStandardHealthy RewardEmployee s contributions are lower than for CopayCompany funded HRA: Emp Only: $600 / year Emp + 1: $900 / year Family: $1,200 / year Lower Annual Out-of-Pocket MaxNot ApplicableNot ApplicableAnnual Deductible 2,3 Individual: $200 Family: $600 Individual: $1,200 Family: $2,400 Individual: $200 Family: $600 Individual: $1,200 Family: $2,400 Annual Out-of-Pocket Maximum 2,3 Individual: $2,500 Family: $5,000 Individual: $3,000 Family: $6,000 Individual: $2,500 Family: $5,000 Individual: $4,000 Family: $8,000No DeductibleAnnual Physical Exam, Routine Screenings, & Well Baby Care 4 Company pays 100%Company pays 100%Company pays 100%Company pays 100%Deductible AppliesInpatient Facility BENEFITS $100/day copay per confinement (up to $1,000), then Company pays 100% Company pays 80%$100/day copay per confinement (up to $1,000), then Company pays 100%Company pays 80%Inpatient Physician ServicesCompany pays 100%Company pays 100%Outpatient Primary Care Physician Services$15 copay then Company pays 100% $15 copay then Company pays 100%Outpatient Specialist Physician Services$40 copay then Company pays 100% $40 copay then Company pays 100%Outpatient Facility BENEFITS $100 copay then Company pays 10

BENEFITS for Management Employees a pRiNTED JaNUaRY 2013 mEDical OpTiONS In-Network Benefits (Out-of-Network deductibles and coverage not shown) Meet Health Requirements 1 Do NOT Meet Healthy Requirements1 Preferred Copay Preferred Account Copay Standard

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Transcription of BENEFITS - Loading TEDS EveryOne

1 BENEFITSfor Management EmployeesapRiNTED JaNUaRY 2013mEDica l OpTiONSIn-Network BENEFITS (Out-of-Network deductibles and coverage not shown)Meet Health Requirements 1Do NOT Meet Healthy Requirements1 Preferred CopayPreferred AccountCopayStandardHealthy RewardEmployee s contributions are lower than for CopayCompany funded HRA: Emp Only: $600 / year Emp + 1: $900 / year Family: $1,200 / year Lower Annual Out-of-Pocket MaxNot ApplicableNot ApplicableAnnual Deductible 2,3 Individual: $200 Family: $600 Individual: $1,200 Family: $2,400 Individual: $200 Family: $600 Individual: $1,200 Family: $2,400 Annual Out-of-Pocket Maximum 2,3 Individual: $2,500 Family: $5,000 Individual: $3,000 Family: $6,000 Individual: $2,500 Family: $5,000 Individual: $4,000 Family: $8,000No DeductibleAnnual Physical Exam, Routine Screenings, & Well Baby Care 4 Company pays 100%Company pays 100%Company pays 100%Company pays 100%Deductible AppliesInpatient Facility BENEFITS $100/day copay per confinement (up to $1,000), then Company pays 100% Company pays 80%$100/day copay per confinement (up to $1,000), then Company pays 100%Company pays 80%Inpatient Physician ServicesCompany pays 100%Company pays 100%Outpatient Primary Care Physician Services$15 copay then Company pays 100% $15 copay then Company pays 100%Outpatient Specialist Physician Services$40 copay then Company pays 100% $40 copay then Company pays 100%Outpatient Facility BENEFITS $100 copay then Company pays 100%$100 copay then Company pays 100%Ancillary Services & General Expenses (x-rays, scans, lab tests, etc.)

2 5 Company pays 80%Company pays 80%Prescription DrugsTobacco cessation products 100% when obtained with a prescription Contraceptives100% for females prescribed a device, generic drug or brand name drug that has no exact genericTier I drugs90% with $4 minimum & $10 maximum copay up to a 30-day supplyTier II drugs80% with $10 minimum & $25 maximum copay up to a 30-day supplyTier III drugs60% with $25 minimum copay up to a 30-day supply & no maximum copaySpecialty drugsMaximum copay of $150 up to a 30-day supply or $300 up to a 90-day supplyMaintenance drugsMust be filled through Mail Service Pharmacy or local CVS pharmacyMental HealthMental Health & Substance AbuseCompany pays 100% for first 6 outpaitient visits & deductible does not apply. Subsequent visits are covered same as medical physician & facility Assistance Program - receive help with work & personal issues. : Anthem Blue Cross Blue Shield PPO, Mental Health & Substance Abuse: ValueOptions, Prescription Drugs: CVS/Caremark, AdvocateYou, your spouse, children, and parents can receive assistance at no cost with health care & insurance related issues such as claims resolution and finding new heath care providers.

3 Enrollment in a Preferred option requires an employee and covered spouse to be tobacco-free for 90 days prior to enrollment and every month thereafter, and commit to seeing a health care provider during the not include expenses for non-covered services, prescription drugs or amounts paid in excess of the Allowable & Out-of-Pocket maximums accumulate separately for In-Network & Out-of-Network Includes preventive care required to be covered without cost-sharing as directed by the federal government under the health care reform law. A current list of preventive care procedures and screenings is available on the x-rays, MRI and CT scans, lab tests, medical equipment, allergy injections and physical therapy at a OpTiONSB asicPremiumDeductibleIndividual: $50 Family: $100 Individual: $25 Family: $50 Preventive100%, no deductible100%, no deductibleGeneral Care80%80%Major Care50%70%Orthodontic Care(for children under age19)50%, $750 lifetime50%, $1,500 lifetimeAnnual Maximum per Person$1,000$1,500 NetworkDelta DentalviSiON OpTiONSpagE 2 | pRiNTED JaNUaRY 2013flExiBlE S pENDiNg accOUNTSH ealth Care Flexible Spending AccountSet aside money on a pre-tax basis to pay for your eligible out of pocket medical, dental, and vision Care Flexible Spending AccountSet aside money on a pre-tax basis to pay for your eligible work-related dependent care OpTiONS SUmmaRYBasicPremiumAnnual Routine Eye ExamNo ChargeNo ChargeAnnual Contact Lens Fitting15% discountNo ChargeAnnual Contact Lenses (in lieu of eyeglasses)Conventional - 20% discountDisposable -10% discount$100 allowance provided all purchases are made from one network provider per yearBiennial Eyeglass FramesFrames equal to or less than $70, you pay $40.

4 Frames greater than $70, you pay $40 plus the amount over $70 with 10% discountFree for Davis Vision Designer/Fashion Collection $25 co-payment for Davis Vision Premier Collection or$100 allowance toward the cost of any other frameAnnual Plastic/Glass Eyeglass Lenses (Single, Bifocal, Trifocal, or Lenticular)Range from $35 to $110No ChargeAnnual Plastic/Glass Eyeglass Lenses (Cataract or Oversize)No discountNo ChargeLens OptionsSee Plan Summary for detailsAdditional eyewear20% discount on non-prescription sunglasses 10% discount on other ancillary products/solutions20% discount10% off disposable contact lenseslifE iNSURaNcEGroup Term Life InsuranceCoverage equal to 3 times salary provided at no cost, or elect $10,000 (minimum), $50,000, 1 or 2 times salary and receive cash or credit Accident$200,000 coverage at no cost to travel and other on-duty AccidentalDeath & Dismemberment$50,000 to $500,000 in $50,000 only or family Y plaNSSalary ContinuanceFor short-term illness or injury, based on years of servicewith the companyafter 6 monthsfull salary up to 1 monthafter 1 yearfull salary up to 3 monthsafter 4 yearsfull salary up to 4 monthsafter 8 yearsfull salary up to 5 monthsafter 19 yearsfull salary up to 6 monthsLong-Term Disability Coverage provided at no cost to employee.

5 1-year non-agreement service required. 50% salary, less offset for other payments. Medical, dental, vision, and life insurance BENEfi TSVacation (Based on years of service)Hired prior to June 1 1 weekHired on/after June 1 NoneAfter 1 year of service2 weeksAfter 4 years of service3 weeksAfter 8 years of service4 weeksAfter 19 years of service5 weeksPre-Tax TransportationContribute to a pre-tax parking account or purchase transit passes on a before-tax : pRiNTED JaNUaRY 2013 | pagE 3 NOTES: RETiREmENT BENEfi TSRetirement Plan (Defined Benefit Plan - 100% Company funded) Pays a monthly pension to you. The higher your compensation and the longer your service, the larger your pension. Fully vested after 5 years of service. Retire at age 60 with full pension or at age 55 with reduced pension - 10 years service required. Surviving spouse receives a portion of your pension. Retiree Life Insurance$5,000 life insuranceThe BENEFITS described herein are in effect at the time this document was printed.

6 Should any conflict arise between this benefit summary and the related Plans or Policies, the terms of the Plans or Policies will govern. Norfolk Southern reserves the right to change or terminate these BENEFITS at any 4 | pRiNTED JaNUaRY 2013401(K) ThRifT aND iNvESTmENT plaN (Tip) Eligible immediately. Automatic enrollment at a 3% contribution level. Contributions will automatically increase annually by 1% up to 6%. May opt out. May elect to contribute up to the annual IRS contribution limits. COMPANY MATCHING FORMULA Norfolk Southern will match 100% of the first 1% of pay you contribute to TIP, and 50% of additional contributions up to 6% of your pay. Immediate vesting. 21 investment options. A variety of both free and fee-based investment advisory services. 2013 Norfolk Southern Corp All rights reserved.


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