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Do Not Resuscitate Order For Philip Morris International Employees

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Healthcare Provider Update: Healthcare Provider for Philip Morris International Philip Morris International (PMI) primarily collaborates with global health insurance providers rather than being tied to a specific healthcare provider. The focus of PMI's health-related initiatives is primarily in supporting public health efforts linked to tobacco control and transitioning towards smoke-free products, reflecting its corporate commitment to sustainability and consumer health. Anticipated Healthcare Cost Increases in 2026 As the healthcare landscape evolves, significant increases in healthcare costs are anticipated for 2026. Record hikes in ACA premiums are projected, with some states reporting increases exceeding 60%. Contributing factors include rising medical costs, the potential expiration of federal premium subsidies, and aggressive pricing strategies from major insurers. Without congressional action to renew enhanced tax credits, many consumers may face out-of-pocket premium increases exceeding 75%, exacerbating the financial strain for millions of Americans. These factors collectively signal a challenging healthcare environment ahead. Click here to learn more

What Is It?

As a Philip Morris International employee, you have the right to decline medical treatment, even if you die as a result of your decision. Depending on your medical condition, your prognosis, and your views on the quality of life, you may wish to refuse lifesaving measures, such as cardiopulmonary resuscitation (CPR). Executing a do not resuscitate (DNR) order is one way of doing this. A DNR is a doctor's order that tells all other medical personnel not to perform CPR if you go into cardiac arrest. Cardiac arrest occurs when your heart stops beating, blood flow to your brain stops, and you stop breathing. If the blood flow is not quickly restored, permanent damage to the brain and other organs can occur. CPR simulates heartbeat and breathing, while attempting to restart these functions.

The term  CPR  actually encompasses a variety of separate procedures, including cardiac compression, endotracheal intubation, assisted ventilation, defibrillation, and cardiac medications. Most states recognize two types of DNRs. One is effective only while you are hospitalized. The other is used by people outside the hospital--for example, nursing home residents, hospice patients, and even those who are not receiving medical treatment.

Typically, terminally ill patients and elderly individuals execute DNRs to avoid prolonging their final illnesses. However, some states allow healthy adults to execute the orders, as well. Depending on the laws of your state, a DNR used outside the hospital may be called a 'pre-hospital DNR,' 'out-of-hospital DNR,' 'outpatient DNR,' 'DNR for EMS,' or 'CPR directive.' As a result of your request, your doctor generally notes an in-hospital DNR order on your chart. Out-of-hospital DNRs take various forms, depending on the laws of your state. ID bracelets, MedicAlert necklaces, and wallet cards are some methods of noting DNR status.

When Can It Be Used?

Availability of DNRs Is Determined By State Law

Not all states have DNR laws. For Philip Morris International employees, you may want to consider how your state's laws govern whether DNRs are permissible, who can execute a DNR, and what form the order must take. These laws may permit in-hospital DNRs, out-of-hospital DNRs, both of these, or neither of these. Some state laws allow any person of legal age to execute a DNR, while others permit DNRs only for individuals with terminally ill conditions. Some states allow children to participate in decisions regarding DNR in certain cases. Check the laws of your state and any other states where you spend a significant amount of time.

Strengths

Allows You to Exercise Choice In Medical Treatment

Cardiopulmonary resuscitation (CPR) has produced some miraculous results when used on normally healthy individuals in trauma situations. However, it can be a painful and even violent procedure. Its effectiveness is limited when used on terminally ill or hopelessly deteriorated patients. In some cases, CPR only delays the moment of death.

For example, CPR could restore your heartbeat, but if permanent brain or organ damage occurs during cardiac arrest, you may be dependent on life support machines. Executing a do not resuscitate (DNR) order allows you to choose a natural death.

Example(s):  Hal is hospitalized with a terminally ill condition. He is on a respirator and knows he has only a short time to live. Hal consults his doctor and learns that the laws of his state permit in-hospital DNRs. This will allow him to forego CPR if his heart fails. Hal asks his doctor to execute a DNR as soon as possible. The following week, Hal's heart stops. Because of Hal's DNR, hospital personnel do not attempt CPR.

Specifically Intended for an Emergency Situation

If you go into cardiopulmonary arrest, your DNR lets medical personnel know that you don't want CPR. Because of the emergency nature of this situation, other types of advanced directives are usually not timely enough to accomplish this goal.

Tradeoffs

Extremely Limited Usefulness

Although a do not resuscitate (DNR) order is a very powerful instrument, it is only effective under specific conditions. Generally, a DNR comes into play only if you go into cardiac arrest, and it frequently only allows you to refuse cardiopulmonary resuscitation (CPR), although in some states it may allow you to decline other drastic medical treatment as well. A living will or durable power of attorney for health care may be needed to convey other medical treatment instructions, such as your wishes regarding life support and intravenous feeding.

Out-of-Hospital DNR May Not Be Effective In Other States

As a Philip Morris International employee, it is beneficial to understand how an out-of-hospital DNR that is valid in your state may not be valid in other states. Therefore, if you spend a significant amount of time in another state, you should find out whether that state's laws recognize DNRs, whether you are eligible to have a DNR in that state, and what restrictions are placed on the form of the DNR.

Doctors May Be Hesitant to Broach This Topic or Reluctant to Write a DNR

If you are hospitalized with a serious illness, your doctor may not bring up the option of executing a DNR. If you don't want to be resuscitated, you should initiate this discussion with your doctor. Also, studies indicate that many doctors are slow to write DNRs, even when they are aware of their patients' preferences, although the reasons for this vary. If you are a Philip Morris International employee and want to ensure your wishes are followed, you should touch base with your doctor to make sure the DNR is placed on your chart.

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How to Do It

Research Your State's Laws Regarding Dnrs

Not all states provide for these orders. Each state has its own eligibility requirements, particularly for out-of-hospital DNRs.

Discuss Your Wishes With Your Doctor

Your doctor should be able to provide information on your prognosis and counsel you on your options. If you are a Philip Morris International employee, your doctor's signature will most likely be required on any DNR you execute.

Execute Your Out-of-Hospital DNR Properly And Keep It With You

If you are a Philip Morris International employee interested in DNR, you must consider how if your state allows out-of-hospital DNRs, there is probably a required format for the order. Examples of state-required DNR formats include ID bracelets, necklaces, wallet cards, and letter-size forms. If your DNR is not in the required form, it may not be honored. If medical personnel can't find your DNR order, they are obligated to give full and immediate care. Thus, it is extremely important to execute your DNR order properly and keep it with you (or in an appropriate place) at all times.

Example(s):  Hal is a resident of an assisted-living facility. Hal is 89 years old and feels he has lived a good life. He does not want to die in a hospital or be dependent on machines for his survival. Hal discusses his feelings with his doctor. Hal's doctor suggests executing an out-of-hospital DNR, which will instruct medical personnel not to perform cardiopulmonary resuscitation (CPR) if Hal goes into cardiac or respiratory arrest. Hal agrees and receives an ID bracelet noting his DNR status. Hal wears his bracelet faithfully. Six years later, Hal's heart fails as he jogs in the park. Medical personnel arrive on the scene, but immediately notice  Hal's DNR ID bracelet. CPR is not attempted.

Tell People About Your Decision

In general, other people cannot reverse your decision once you execute a DNR. As a Philip Morris International employee however, if your DNR is misplaced or for some reason is not followed, it would be important for your family and friends to understand your wishes. Although this topic may be difficult to discuss, those close to you are more likely to support and uphold your decision if they understand how you feel and why you feel that way. If you have appointed a representative in a durable power of attorney for health care (DPAHC) , it is especially important that this person be aware of your decision.

Coordinate All Advanced Directives

Since a DNR is so limited in scope, you may wish to establish a living will and/or DPAHC as well. If you do so, make sure your wishes are stated consistently throughout these documents. In some states, the most recent document will govern if there is a conflict, so you must make sure your wishes are clear.

Tax Considerations for Philip Morris International Employees

Income Tax

None

Gift And Estate Tax

None

Questions & Answers for Philip Morris International Employees

What If You Go Into a Coma Before Executing Your DNR, And You Can't Express Your Wishes?

Your healthcare representative, if you have appointed one, may be able to have a DNR executed on your behalf. As a Philip Morris International employee, there must be evidence that this is what you would want. You might include these instructions in your durable power of attorney for health care , especially if the laws of your state do not allow out-of-hospital DNRs. Be aware, however, that this method of instruction is useless in an emergency if your representative is not present. In some states, with your family's consent, your doctor may be able to execute a DNR on your behalf. Again, it would be unwise to rely on this course of action in an emergency.

Can You Change Your Mind?

Yes, it is possible to revoke a DNR order. If you have an out-of-hospital DNR, you may be able to revoke it by simply removing the bracelet or the wallet card. However, some states also have a database of DNR patients. If this is true in your state, you may need to take additional steps to revoke your DNR. When your doctor writes the DNR, ask what steps are necessary to revoke the order.

Additionally, medical personnel must give emergency care to anyone who requests it. For example, Emergency Medical Service guidelines in Wisconsin instruct personnel to perform cardiopulmonary resuscitation (CPR) if a person rips off his or her DNR bracelet or asks for CPR during cardiac arrest.

How does the investment strategy outlined by the Philip Morris Group Pension Plan aim to ensure that sufficient assets are available to pay members’ benefits as they fall due? What specific return objectives has the Trustee established that reflect the financial goals of the Philip Morris Group Pension Plan?

Investment Strategy and Return Objectives: The primary objective of the Trustee's investment strategy is to ensure sufficient assets are available to pay members’ benefits as they fall due. The return objective set by the Trustee is to achieve a return above that achievable on index-linked gilts. The Trustee is mindful that growth can come from both investment performance and company contributions​(Philip_Morris_Group_Pen…).

In what ways does the Philip Morris Group Pension Plan address the risks associated with inadequate long-term returns, and how has the Trustee structured the investment portfolio to mitigate potential stock market underperformance relative to inflation?

Addressing Risks and Portfolio Structure: The Philip Morris Group Pension Plan mitigates risks associated with inadequate long-term returns by investing around 20% of its portfolio in equities expected to outperform gilts. Approximately 50% of the portfolio is in index-linked gilts to provide protection from inflation​(Philip_Morris_Group_Pen…).

What considerations does the Trustee of the Philip Morris Group Pension Plan have for environmental, social, and governance (ESG) factors in their investment strategy, and how do these considerations impact the overall financial performance of the Plan?

ESG Considerations: The Trustee acknowledges that environmental, social, and governance (ESG) factors are sources of risk, potentially impacting financial performance. Although the Plan's primary investment manager tracks market indexes without specific ESG constraints, the Trustee expects them to account for financially material considerations when engaging with investee companies​(Philip_Morris_Group_Pen…).

How does the Philip Morris Group Pension Plan incorporate diversification within its investment strategy to protect against extreme stock market fluctuations, and what specific controls have been implemented by the Trustee to maintain an appropriate balance among asset classes?

Diversification Strategy and Controls: The Trustee implements diversification to protect against stock market fluctuations by investing in a variety of global asset classes and bonds. A mix of UK and overseas equities, along with government bonds, ensures appropriate balance and protection from extreme market volatility​(Philip_Morris_Group_Pen…).

What procedures are in place for the Trustee of the Philip Morris Group Pension Plan to review and potentially revise the investment strategy based on performance assessments, market conditions, and changes in the economic environment?

Review and Revision of Strategy: The Trustee reviews the investment strategy periodically, especially following significant changes in investment policy or economic conditions. These reviews involve performance assessments and market evaluations in consultation with advisers​(Philip_Morris_Group_Pen…).

How can members of the Philip Morris Group Pension Plan keep informed about any significant developments in investment strategy that may affect their benefits, and what communication methods does the Trustee employ to ensure transparency?

Member Communication and Transparency: Members are informed about significant developments in the Plan’s investment strategy through direct communications from the Trustee. Members can request a copy of the Statement of Investment Principles for further details​(Philip_Morris_Group_Pen…).

What is the role of the investment manager, State Street Global Advisors, in the governance and performance of the Philip Morris Group Pension Plan's assets, and how does the Trustee evaluate the success of this partnership?

Role of State Street Global Advisors: State Street Global Advisors is responsible for the day-to-day management of the Plan’s assets. The Trustee evaluates the performance of State Street Global Advisors annually and ensures that their investment approach aligns with the Plan’s objectives​(Philip_Morris_Group_Pen…).

How does the Philip Morris Group Pension Plan handle the issue of Additional Voluntary Contributions (AVCs), especially considering the decision to no longer allow active members to make these contributions since April 2006?

Additional Voluntary Contributions (AVCs): Active members have been unable to make Additional Voluntary Contributions to the Plan since April 2006. The Plan offers various options for members with existing AVCs, including investments in passive funds and with-profits funds​(Philip_Morris_Group_Pen…).

What specific risks, aside from investment risks, does the Trustee of the Philip Morris Group Pension Plan need to prepare for, such as mortality or sponsor risks, and how do these factors influence the overall funding strategy of the Plan?

Other Risks (Mortality, Sponsor, etc.): The Trustee prepares for non-investment risks like mortality risk and sponsor risk, which can affect the Plan’s funding strategy. These risks are considered alongside investment risks to manage overall funding risk​(Philip_Morris_Group_Pen…).

For employees seeking more information regarding the content of the Philip Morris Group Pension Plan documents, what are the best channels to contact the company, and who specifically should they reach out to within human resources or benefits administration?

Contact for More Information: Employees seeking more information about the Philip Morris Group Pension Plan should contact the Plan administrators, Lane Clark & Peacock LLP, or reach out to human resources or benefits administration for assistance​(Philip_Morris_Group_Pen…).

With the current political climate we are in it is important to keep up with current news and remain knowledgeable about your benefits.
Philip Morris International provides RSUs and stock options to eligible employees.
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