2014 EMPLOYEE BENEFITS GUIDE

Transcription

1 2014 EMPLOYEE BENEFITS GUIDE S H I N O L A D E T R O I T

2 WELCOME Offering a comprehensive and competitive benefits package is one way the Company recognizes your contribution to our success. This benefits guide has been designed to provide you with information about the benefit choices available to you. The Company offers eligible employees a number of benefit programs. These programs include Medical coverage, Dental coverage, Vision coverage, Flexible Health and Dependent Care Spending Accounts, Basic Life insurance, Basic Accidental Death and Dismemberment insurance, Short Term Disability, Long Term Disability, and 401(k) options. S H I N O L A 1 D E T R O I T

3 C H A P T E R CONTENTS 3...ENROLLMENT 5...MEDICAL PLAN 8...DENTAL PLAN 1O...VISION PLAN 11...FLEXIBLE SPENDING ACCOUNTS (FSAS) 14...SURVIVOR BENEFITS 17...INCOME PROTECTION 18...PLANNING FOR RETIREMENT 20...ADDITIONAL BENEFITS p Employee Assistance Program/Paid Time Off p Employee Discount/Employee Watch Program 22...REQUIRED NOTICES See Page 24 for important information concerning Medicare Part D coverage. NOTE In this guide we use the term Company to refer to the Shinola. This guide is intended to describe the eligibility requirements, enrollment procedures, and coverage effective dates for the health and welfare benefits program offered by the Company. It is not a legal plan document and does not imply a guarantee of employment or a continuation of benefits. This guide is not intended to answer all of your questions, but to provide you with a tool to answer most of your questions. Full details of the plans are contained in the summary plan descriptions (SPDs), which govern each plan s operation. Whenever an interpretation of a plan benefit is necessary, the actual plan documents will be used. S H I N O L A 2 D E T R O I T

4 C H A P T E R ENROLLMENT TIP It is against the law to elect coverage for an ineligible person. Violations may result in prosecution and/or expulsion from the plan for up to five years. ELIGIBILITY As a full-time employee of the Company who is regularly scheduled to work at least 35 hours per week, you are eligible to participate in the medical, dental, vision, life, and disability plans, as well as the Flex Spending Accounts, 401(k) and supplemental plans. YOUR ELIGIBLE DEPENDENTS Dependents eligible for coverage in the Company benefit plans include: Your legal spouse. Your domestic partner. Your married and unmarried dependent children up to age 26. THINGS TO CONSIDER Before you enroll, it is a good opportunity for you to re-assess your benefit decisions and determine if you need to make changes. The elections you make are effective on January 1, 2014 and remain in effect for all of 2014 unless you have a qualified life event. Does your spouse have benefits coverage available through another employer? Did you get married, divorced or have a baby recently? If so, do you need to add or remove any dependent(s) or update your beneficiary designation? Did any of your covered children reach their 26th birthday this year? If so, they are not eligible for benefits. S H I N O L A 3 D E T R O I T

5 QUALIFYING LIFE EVENTS INCLUDE: Change in your legal marital status (marriage, divorce, or legal separation) Change in the number of your dependents (for example, through birth or adoption, or if a child is no longer an eligible dependent) Change in your spouse s employment status (resulting in a loss or gain of coverage) Change in your employment status from full-time to part-time, or part-time to full-time, resulting in a gain or loss of coverage Entitlement to Medicare or Medicaid Change in your address or location that affects the plans for which you are eligible. PREPARING TO ENROLL The Company pays a significant portion of the cost of your benefits, and the remaining amount you pay will depend on the plan choices that you make. Payroll contributions for your Medical, Dental, Vision and FSA benefits are deducted on a pre-tax basis. Your taxes are based on the reduced salary resulting in a lessened tax liability. Please note that employee contributions for medical, dental and vision coverage vary depending on the plan you select. In general, the higher level of benefits the plan provides to you, the higher your employee contribution will be. Keep in mind that you may select any combination of Medical, Dental, and/or Vision plans and any combination of coverage categories. For example, you could select medical coverage for you and your entire family, but select dental and vision coverage only for yourself. The only requirement is that you, as an employee, must elect coverage for yourself in order to elect any dependent coverage. You have the option to select the coverage most suitable to your needs from the following categories: Employee Only Employee + Spouse Employee + Child(ren) Employee + Family (spouse and child(ren)) Be sure to have the Social Security numbers and birth dates for any eligible dependent(s) that you plan to enroll. You cannot enroll your dependent(s) without this information. S H I N O L A 4 D E T R O I T

6 C H A P T E R MEDICAL PLAN TIP Using Urgent Care Centers when appropriate can save you time and money. Medical coverage is one of the most important benefits that the Company can provide. Medical benefits provide significant support for and protection against potentially large financial expenses as well as covering preventive care. The Company is committed to keeping employees healthy and productive by offering the following health care plans. It is up to you to choose the plan that best matches your preferences. There are two plans to choose from, the traditional PPO Plan or the new High Deductible Health Plan with an HSA (Health Savings Account). Please keep in mind that the option you choose will be in place for all of 2014, unless you have a qualifying life status change. All pharmacy benefits will be administered by CIGNA. That means you will have a CIGNA ID card for medical and for pharmacy benefits. HOW TO FIND A PROVIDER To see the most current list of CIGNA providers online, go to Click Find a Doctor or Hospital (right hand side), Select Guest Search and PPO or HDHP, Enter Criteria, and Search. If you do not have access to the website, please call CIGNA Customer Service at for assistance. ELIGIBILITY WAITING PERIOD COVERAGE START DATE COVERAGE END DATE 30 days after date of hire 1st of the month following date of hire End of the calendar month MEDICAL EMPLOYEE PREMIUMS Premium contributions for medical will be deducted from your paycheck on a before-tax basis. Your level of coverage will determine your premiums. CIGNA MEDICAL COVERAGE (EMPLOYEE PER PAY PERIOD PREMIUM) PPO HDHP EMPLOYEE ONLY $31.70 $13.18 EMPLOYEE + SPOUSE $ $84.39 EMPLOYEE + CHILD(REN) $98.72 $63.29 EMPLOYEE + FAMILY $ $ S H I N O L A 5 D E T R O I T

7 MEDICAL PLAN SUMMARY The chart below gives a summary of the CIGNA medical plans. All covered services are subject to medical necessity as determined by the plan. All out-of-network services are subject to reasonable and customary (R&C) limitations. CIGNA MEDICAL COVERAGE PPO HDHP DEDUCTIBLE PER PLAN YEAR* IN-NETWORK OUT-OF-NETWORK IN-NETWORK OUT-OF-NETWORK Individual $750 $1,500 $2,500 $5,000 Family $2,250 $4,500 $3,000 $5,500 OUT-OF-POCKET MAXIMUMS (EXCLUDES DEDUCTIBLE) Individual $3,250 $4,500 $1,500 $3,000 Family $6,750 $13,500 $4,500 $9,000 MEDICAL CARE Inpatient Care 20% 40% 20% 40% Outpatient Surgery 20% 40% 20% 40% Emergency Room $200 Copay $200 Copay 20% 20% Urgent Care Facility $50 Copay $50 Copay 20% 20% Co-Insurance 20% 40% 20% 40% OFFICE VISITS Preventive Care 100% 40% 100% 40% Physician (PCP) $25 Copay 40% 20% 40% Specialist $50 Copay 40% 20% 40% * Deductibles benefit maximums, and out-of-pocket maximums accumulate on a calendar year basis. The 2014 plan year is January 1, 2014t through December 31, After Deductible. PRESCRIPTION DRUG COVERAGE FOR MEDICAL PLANS Your prescription drug program will be coordinated through CIGNA. Your cost is determined by the tier assigned to the prescription drug product. All prescription drug products on the prescription drug list are assigned as Tier 1, Tier 2 and Tier 3. You may find individualized information on your benefit coverage and search for network pharmacies by logging on to or calling the Customer Care number on your ID card. CIGNA PRESCRIPTION DRUG COVERAGE PPO HDHP RETAIL PHARMACY (30-DAY SUPPLY) Generic Drug $10 Copay 20% After Deductible Preferred Brand Name Drug $40 Copay 20% After Deductible Non-Preferred Brand Drug $60 Copay 20% After Deductible MAIL ORDER PHARMACY (90-DAY SUPPLY) Generic Drug $30 Copay 20% After Deductible Preferred Brand Name Drug $120 Copay 20% After Deductible Non-Preferred Brand Drug $180 Copay 20% After Deductible S H I N O L A 6 D E T R O I T

8 TIER 1 GENERIC DRUGS One way to get more value from your health care plan is to use generic drugs when they are available, thereby paying less for your personal health needs. A generic drug is chemically identical to the corresponding name brand version. The additional costs and marketing of name brand drugs are essentially the only difference between name brand drugs and the generic options. Same benefit. Lower price. Some drugs will not have an exact generic option, but you can ask for the generic equivalent. Although the core ingredient may be slightly different, these equivalents still offer the same medical benefit. A generic is not always prescribed and is not always available. However, that should not stop you from talking to your doctor about whether a generic is available and might be the right option for you. TIER 2 AND TIER 3 BRAND AND NON-PREFERRED BRAND DRUGS Non-preferred drugs have higher copayments and are typically newer drugs on the market. Like generic equivalents, you can request a preferred drug equivalent that can offer the same medical effect. You can be a better consumer by doing your research, asking the right questions and buying at the lowest price. MAIL ORDER PRESCRIPTION BENEFITS For long term or maintenance medications, you may use the mail order service to receive up to a 90-day supply of your medication. This program is not only convenient, but saves you money as well. Although your copayment will be three times the amount compared with using a retail pharmacy, you get a 90-day supply of your medication. All mail order prescriptions are filled by registered pharmacists and are processed and shipped via UPS or US Mail within 24 hours of receipt. For more information about the mail order service, log on to HEALTH SAVINGS ACCOUNT The Company offers a Health Savings Account (HSA) which works alongside the HDHP. An HSA is a personal health care bank account that you can use to pay out-of-pocket medical expenses with pre-tax dollars when you are enrolled in a HDHP. You are eligible to open and fund an HSA if: You are covered by an HSA-eligible High Deductible Health Plan (HDHP). You are not covered by your spouse s health plan, health care flexible spending account or health reimbursement account. You are not eligible to be claimed as a dependent on someone else s tax return. You are not enrolled in Medicare, TRICARE for Life. You have not received Veterans Administration Benefits. You can use HSA money to pay for eligible medical expenses now or in the future. Your HSA account can be used for your expenses and those of your spouse and dependents, even if they are not covered by the HDHP. CIGNA will issue you a debit card, giving you direct access to your account balance. Any time you have a qualified medical expense you may use your debit card to pay these out of pocket expenses. Not like an FSA, just like a bank account, you must have a balance to use your debit card. No receipts to submit for reimbursement. These expenses include doctor s office visits, eye exams, prescription expenses and LASIK surgery. IRS Publication 502 provides a complete list of eligible expenses and can be found on the website at S H I N O L A 7 D E T R O I T

9 C H A P T E R DENTAL PLAN TIP You don t have to enroll in a medical plan to have dental coverage. You can select dental coverage only. Proper dental care plays an important role in your overall good health. Our Dental plan is designed to encourage preventive treatment, allowing employees to achieve oral health while striving to minimize dental costs. The Company offers dental benefits administered by MetLife. NETWORK DENTISTS Similar to medical coverage, when using a network dentist, your out-of-pocket costs are lower. This is because the network dentists have agreed to charge lower fees, and your plan s in-network services cover a larger share of the charges. If you choose to go to a non-network provider, you may be balance billed for the difference between a network provider and what other providers in that geographical area would normally charge for service. To find a network dentist, go to OPTION 1: With your High Plan, you can visit any dentist, but you pay less out-of-pocket when you choose a PPO dentist. Out-of-network dentists are reimbursed based on the prevailing charge for their location. OPTION 2: With your Low Plan, you can visit any dentist, but you pay less out-of-pocket when you choose a PPO dentist and receive a higher benefit for services compared to the High Plan. Out-of-network dentists are reimbursed based on the PPO fee schedule. The Low Plan offers a higher benefit if you use PPO dentists but the out-of-network dentists are paid at a lower rate than under the High Plan. Your out-of-pocket expenses could be greater under the Low Plan IF you prefer to use an out-of-network dentist. NOTE: Once you elect your plan option (High or Low), you may not change your election until the next open enrollment period. S H I N O L A 8 D E T R O I T

10 DENTAL EMPLOYEE PREMIUMS Premium contributions for Dental benefits will be deducted from your paycheck on a before-tax basis. Your tier of coverage will determine your per pay period premiums. METLIFE (PER PAY PERIOD RATES) Employee $7.52 Employee + Spouse $18.09 Employee + Child(ren) $26.60 Employee + Family $37.17 DENTAL PLAN SUMMARY METLIFE DENTAL PLANS HIGH PLAN LOW PLAN DEDUCTIBLE Individual $50 $50 Family $150 $150 ANNUAL MAXIMUM Per Calendar Year $1,750 per person $1,750 per person PREVENTIVE (Exams, cleanings, x-rays) 100% 2 cleanings per year 100% 2 cleanings per year BASIC SERVICES (Fillings, root canals, extractions) 80% after deductible 100% after deductible MAJOR SERVICES (Crowns, dentures) 50% after deductible 60% after deductible ORTHODONTIC SERVICES (Adults and children) 50% to $1,500 lifetime max 50% to $1,500 lifetime max S H I N O L A 9 D E T R O I T

11 C H A P T E R VISION PLAN TIP Eye health is an indicator of overall health. Regular eye exams can detect diseases like glaucoma, diabetes, and blindness. To ensure that you and your family will get the care you need, the Company provides an exam through EyeMed. The plan covers services through any licensed provider, but benefits are paid at a higher level when you use an in-network provider. VISION PLAN SUMMARY Plan Frequency: You get the following once every 12 months: Comprehensive exam Lenses (for glasses or contacts) You get the following once every 24 months: Frames VISION PLAN SUMMARY EYEMED VISION COVERAGE IN-NETWORK OUT-OF-NETWORK EXAMS (ONCE EVERY 12 MONTHS) Exams $10 Copay Up to $30 FRAMES (ONCE EVERY 24 MONTHS) Frames $25 Copay Up to $60 EYEGLASS LENSES (ONCE EVERY 12 MONTHS) Single $25 Copay Up to $25 Bifocal $25 Copay Up to $40 Trifocal $25 Copay Up to $60 Lenticular $25 Copay Up to $60 CONTACT LENSES Medically Necessary $25 Copay Up to $200 Cosmetic Elective Up to $120 reimbursement Up to $96 LASER CORRECTION SURGERY Laser Correction Surgery Discount Up to 15% off the usual charge or 5% off promotional price No discount VISION EMPLOYEE PREMIUMS Premium contributions will be deducted from your pay check on a before-tax basis. Your tier of coverage will determine your per pay period premiums. EMPLOYEE $0.00 Employee + Spouse $1.58 EMPLOYEE + CHILD(REN) $1.66 Employee + Family $3.97 S H I N O L A 10 D E T R O I T

12 C H A P T E R FLEXIBLE SPENDING ACCOUNTS (FSAS) TIP The FSA Debit Card cannot be used for dependent care expenses. A paper claim form along with any required documentation is necessary for reimbursement. HEALTH CARE REIMBURSEMENT ACCOUNT Health Care FSAs allow you to set aside up to $2,500 through payroll deductions on a pre-tax basis to pay for out-of-pocket health care expenses, such as deductibles, copays, coinsurance, dental expenses, vision expenses, Lasik and more. By paying for these expenses with pre-tax dollars, you reduce the amount of your taxable income and increase your take home pay. You may choose to participate in one or both FSA accounts whether or not you elect any other benefits. CHANGES TO OVER-THE-COUNTER (OTC) ELIGIBILITY Under the Patient Protection and Affordable Care Act (PPACA) that was signed into law on March 23, 2010, there are substantial changes to the requirements applicable to over-the-counter (OTC) medicines and drugs. OTC purchases will require a doctor s prescription in order for the OTC medicine or drug to be eligible for reimbursement from a flexible spending account (FSA). HOW DO I USE THE ACCOUNTS? The FSA Debit Card allows you to pay for eligible health care expenses at the point of service and deducts funds directly from your health care account. This allows you to avoid waiting for reimbursement. Once you incur an eligible dependent care expense, submit a claim form along with the required documentation. If you have questions about a reimbursement, SASI s contact information can be found at the end of this Benefits Guide. S H I N O L A 11 D E T R O I T

13 DEPENDENT CARE REIMBURSEMENT ACCOUNT Reimbursement for dependent care claims is limited to the total amount that is deposited in your account at that time. Allows you to set aside up to $5,000 to pay for child or elder care expenses on a pre-tax basis. Eligible dependents would include children under the age of 13 and dependentsof any age who are incapable of caring for themselves. Dependent care expenses are reimbursable as long as the provider is not anyoneconsidered your dependent for income tax purposes. In order to be reimbursed, you must provide the tax identification number or Social Security number of the party providing care. ELIGIBLE DEPENDENT CARE REIMBURSEMENT ACCOUNT EXPENSES This account covers dependent day care expenses that are necessary for you and your spouse to work or attend school fulltime. The dependent must be a child under age 13 and claimed as a dependent on your federal income tax return, or a disabled dependent who spends at least eight hours a day in your home. Examples of eligible dependent care expenses include: In-home baby-sitting services (not by an individual you claim as a dependent) Care of a preschool child by a licensed nursery or day care provider Before- and after-school care Day camp In-house dependent care provider FSA DEBIT CARD: HEALTH CARE REIMBURSEMENT ACCOUNT You may use your FSA Debit Card at locations such as doctor and dentist offices, pharmacies, and vision service providers. The card cannot be used at locations that do not offer services under the plan, unless the provider has also complied with IRS regulations. Should you attempt to use the card at an ineligible location the swiped transaction will be denied. Should you need to submit a receipt, you will receive an or mailed Receipt Notification from SASI but you should always retain a receipt for your records. GENERAL FSA RULES AND RESTRICTIONS In exchange for the tax advantages FSAs offer, the IRS has imposed the following rules and restrictions for both Health Care and Dependent Care FSAs: Your expenses must be incurred during the plan year of Your dollars cannot be transferred from one FSA to another. You cannot participate in Dependent Care FSA and claim a tax deduction at the same time. You must use it or lose it any unused funds will be forfeited. You cannot change FSA election in the middle of the plan year unless you have a qualified life status change such as a marriage, divorce, or birth of a child. 2 1/2 MONTH GRACE PERIOD The 2½-month grace period allows participants an additional period of time to incur expenses after the plan year end (12/31/2014). If an expense is incurred between 1/1/2015 and 3/15/2015 AND submitted for reimbursement on or before 6/31/2015, any remaining balance in the previous plan year that ended 12/31/2014 will be paid out from the claim, even though the service was provided in the NEW plan year The 2½ month grace period applies to the Dependent Day Care and Health Care FSA. S H I N O L A 12 D E T R O I T

14 FSA SCENARIOS SCENARIO ONE ASSOCIATE PROFILE: Name: Jean Smith Age: 40 Marital status: married Children: 2 Annual income: $35,000 BI-WEEKLY SALARY: $961 Child requires braces, expense to associate: $2,000 Family visits physician 6 times annually, expense to associate: $150 Spouse wears contact lenses, expense to associate: $350 Estimated annualhealth care expense: $2,500 Estimated weekly health care expense: $48 SCENARIO TWO ASSOCIATE PROFILE: Name: Michelle Jones Age: 38 Marital status: married Children: 2 Annual income: $50,000 BI-WEEKLY SALARY: $961 Associate is expecting a baby, out-of-pocket for the delivery to associate: $2,000 Six newborn physician visits, expense to associate: $150 Monthly maintenancemedication: $150 Children in day care, expense to associate: $4,500 Associate can elect to participate in Health Care and Dependent Care Spending Accounts Estimated annual health care expense: $6,800 Estimated weekly health care expense: $ COMPARE SCENARIOS SCENARIO ONE SCENARIO TWO WITHOUT FSA WITH FSA WITHOUT FSA WITH FSA Weekly Salary $ $ $ $ Weekly Pre-Tax Contributions $0.00 $48.00 $0.00 $ Taxable Income $ $ $ $ Federal Income Tax $ $ $ $ Take-Home Pay $ $ $ $ After-Tax Expenses $48.00 $0.00 $ $0.00 Net Take-Home Pay $ $ $ $ Increase in Weekly Income $0.00 $17.11 $0.00 $46.62 Increase in Annual Spendable Income* $0.00 $ $0.00 $2, * This is a rough estimate only, since this example does not use actual multi-level tax structure. Your savings may be higher or lower than indicated. S H I N O L A 13 D E T R O I T

15 C H A P T E R SURVIVOR BENEFITS TIP It is important that you name a primary and contingent beneficiary to receive your life insurance benefits BASIC LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT (AD&D) INSURANCE Basic Life and Accidental Death and Dismemberment (AD&D) is a part of the Company s benefits plan and is an essential part of your future financial security. It is important to understand how your plan works and what benefits you will receive. Just as you would keep track of money that you put into a bank or other financial institution, it is in your best interest to keep track of your survivor benefits. The Company automatically provides you with Basic Life and Accidental Death and Dismemberment (AD&D) insurance through Reliance Standard which guarantees that loved ones, such as a spouse or other designated survivors, will receive a survivor benefit after an employee s death. The Company provides life insurance equal to one times your annual base salary up to a maximum of $250,000 at no cost to you. If you are a full-time employee, you automatically receive Life insurance even if you elect to waive other benefit coverage. Your family could incur an unexpected financial hardship should an untimely death occur as a result of an accident. For this reason, the Company provides Accidental Death and Dismemberment (AD&D) coverage as part of your overall benefits program. AD&D benefits are included with the Basic Life coverage; therefore, your benefit amount is equal to your Basic Life insurance amount. S H I N O L A 14 D E T R O I T

16 BENEFICIARY DESIGNATION Your beneficiary is the person you name to receive your life insurance benefits in the event of your death. This includes any life insurance benefits payable under the Voluntary Life insurance plan available through the Company. Benefits payable for a dependent s death under the Voluntary Life insurance plan are payable to you if living; otherwise, benefits may, at the option of the insurance company, be payable to your surviving spouse or to the executors or administrators of your estate. It is important that your beneficiary designation be clear so that there will be no questions as to your intent. It is also important that you name a primary and contingent beneficiary. When naming your beneficiary(ies) please indicate their full name, address, Social Security number, relationship, date of birth and distribution percentage. If the beneficiary is not related either by blood or by marriage, insert the words Not Related next to their stated relationship. If you need assistance, contact the Human Resources Department or your own legal counsel. PRIMARY Mary J. Doe, Wife (not Mrs. John Doe) (100%) or Mary J. Doe, Wife (34%), Jane Doe, Daughter (33%) and John Doe, Son (33%) CONTINGENT Joseph W. Doe, Son and Jane Doe, Daughter, in equal shares (50%); or ESTATE OF THE INSURED If you name more than one beneficiary with unequal shares, please show the amount of insurance to be paid to each beneficiary in fractional parts, for example 33% to Mary Jones, Mother, and 67% to Edith Jones, Wife. If there is insufficient space for your beneficiary designations leave it blank and attach a separate sheet of paper indicating your designation and share %. VOLUNTARY SUPPLEMENTAL LIFE, VOLUNTARY DEPENDENT LIFE Employees may purchase Voluntary Supplemental Life for themselves and their family. Premiums are paid through post-tax payroll deductions. Your cost automatically adjusts each year at our annual renewal to reflect the age-graded rates. You must purchase Voluntary Life insurance for yourself to purchase Voluntary Life insurance for your spouse and child(ren). BASIC LIFE VOLUNTARY SUPPLEMENTAL LIFE VOLUNTARY DEPENDENT LIFE COVERAGE AMOUNT 1X Annual Salary Increments of $10,000 up to coverage maximum of $500,000 Spouse - increments of $10,000 up to a maximum of $500,000. (Employee or Spouse must have at least $10,000 in optional life insurance to elect child coverage) Children 14 days to 6 months $1,000. Children over 6 months - increments of $2,500 to a maximum of $10,000. WHO PAYS Company pays full cost You pay full cost You pay full cost WHEN BENEFITS ARE PAYABLE If you die while covered under the plan If you die while covered under the plan. This benefit is in addition to your Basic Life benefit. If your dependent dies while covered under the plan. MAXIMUM BENEFIT $250,000 $500,000 Spouse - $500,000 Child - $10,000 WHEN EVIDENCE OF INSURABILITY IS REQUIRED N/A For coverage amounts exceeding $50,000. Required on the entire coverage amount for late enrollees. Any election after original enrollment period. S H I N O L A 15 D E T R O I T

17 TO CALCULATE HOW MUCH YOUR VOLUNTARY SUPPLEMENTAL LIFE COVERAGE WILL COST: $ 10,000 = $ x Age Based Rate = $ Benefit Elected Premium VOLUNTARY LIFE RATES PER $10,000 (SPOUSE RATE BASED ON SPOUSE S AGE) EMPLOYEE AGE COST PER PAYCHECK PER $10,000 OF COVERAGE Under 30 $ $ $ $ $ $ $ $ $7.20 CHILD(REN) VOLUNTARY LIFE RATES COVERAGE AMOUNT COST PER PAYCHECK $1,000 (14 days to 6 months of age) $0.15 $2,500 $0.18 $5,000 $0.34 $7,500 $0.51 $10,000 $0.67 S H I N O L A 16 D E T R O I T

18 C H A P T E R INCOME PROTECTION TIP It is against the law to elect coverage for an ineligible person. Violations may result in prosecution and/or expulsion from the plan for up to five years. SHORT TERM DISABILITY INSURANCE Short Term Disability insurance is provided at no cost to you and protects a portion of your income if you become partially or totally disabled for a short period of time. Short Term Disability insurance replaces 60% of your income, up to a maximum of $1,500 per week. You must be disabled for at least 8 calendar days before you can receive your Short Term Disability insurance benefit payment and payments will last up to 12 weeks. Certain exclusions as well as pre-existing condition limitations may apply. Please refer to your Summary Plan Description for details or contact the Human Resources Department for specific benefits. LONG TERM DISABILITY INSURANCE Long Term Disability insurance protects a portion of your income if you become partially or totally disabled for a long period of time. Long Term Disability insurance replaces 60% of your income, up to a maximum of $6,000 per month, depending on your current annual earnings. You must be disabled for at least 90 days before you can receive an employer-paid Long Term Disability insurance benefit payment. Payments will last for as long as you are disabled or until you reach your Social Security Normal Retirement Age, whichever is sooner. Certain exclusions as well as pre-existing condition limitations may apply. Please refer to your Summary Plan Description for details or contact the Human Resources Department for specific benefits. S H I N O L A 17 D E T R O I T

19 C H A P T E R PLANNING FOR RETIREMENT TIP Open Enrollment is a good time to enroll in the Company 401(k) plan or to evaluate increasing your contribution if you are already enrolled. A consistent savings plan throughout your career is the foundation for security during your retirement years. According to financial experts, company-sponsored plans may provide approximately two-thirds of your necessary retirement income. HOW THE 401(K) PLAN WORKS SALARY DEFERRAL CONTRIBUTIONS Currently, the Company has a discretionary match of 50 cents on every dollar for the first 3% of your contribution. You may opt out of the plan at any time. You may choose to contribute up to 85% of your pay per pay period. You may make one deferral change per month. Your taxable income is reduced by the amount you contribute through salary deferral. This lets you reduce your current income taxes. Your maximum deferral percentage and/or dollar amount may be limited by IRS regulations. If you are 50 years old or older during the plan year and have met the annual IRS Deferral Limit, you may contribute a catch-up deferral. If you think you qualify and are interested in contributing catch-up deferrals, contact Fidelity s Client Contact Center at for more details. SALARY DEFERRAL CHANGES You may stop making salary deferral contributions at any time. You may change your salary deferral amount monthly. VESTING You are vested in the Company s contributions based on years of services with your employer as shown below. You are 100% vested in your own deferral contributions. YEARS < > 4 VESTING % S H I N O L A 18 D E T R O I T

20 INVESTMENTS Your retirement benefit plan intends to qualify as an ERISA 404(c) plan. This means that the Plan Fiduciary has transferred some responsibility for investing the retirement account to you. You are able to direct the investment of the retirement account balance by choosing among several fund options. For the plan to qualify under ERISA 404(c), you must be given: The opportunity to diversify your investment; and The ability to make an informed decision. In order for you to make informed investment decisions, it is important that you read the investment material (including prospectuses if applicable) available from the Company. You may also obtain this information by calling Fidelity s Client Contact Center at Contributions will be automatically directed to the plan s investment default if you do not choose any investment options. You may invest your contributions and employer contributions in any of the investment options offered by the plan. For detailed information about your investment options, please visit Fidelity s website at or call Please review the 404(c) information included in your enrollment kit. If you have any questions about the investment options under the plan, your 404(c) contact can assist you. WHEN DO YOU RECEIVE BENEFITS? Benefits are payable at: Retirement (age 65) Age 59 ½ and still working Death Disability Termination of Employment FINANCIAL HARDSHIP You may withdraw all or part of your salary deferral contributions (not earnings) if you can prove financial hardship and are unable to meet your financial needs another way. The plan defines hardship as an immediate and severe financial need along with establishing the allowable reasons to receive such a withdrawal. Please see your Summary Plan Description for more details regarding hardship withdrawals. Salary deferral contributions will be suspended for six months after your withdrawal. LOANS You may borrow up to 50% of the vested account balance or $50,000 (whichever is less). The minimum loan amount is $1,000. One loan can be approved in a 12-month period. You may have one loan outstanding at any time. The interest rate will be determined when you apply for your loan. You may pay back both the principal and interest directly to the account held for you in the plan through payroll deduction. You will also pay a loan set-up and recordkeeping fee. Loans must be repaid within a five-year period. See your Loan Administrator for additional details. OTHER INFORMATION Your salary deferral contributions are included in the wages used to determine your Social Security tax. This summary includes a brief description of the Company s Retirement plan. If there are any discrepancies between this summary and the Plan Document, the Plan Document will govern. Most withdrawals/distributions are subject to taxation and required withholding. Check with your financial/tax advisor on how this may affect you. Fidelity is required by the IRS to withhold 20% of any distribution eligible for rollover if it is not directly rolled over to another eligible retirement plan, including an IRA, or used to purchase an annuity to be paid over a minimum period of the lesser of 10 years or the participant s life expectancy. This withholding will offset a portion of federal income taxes you owe on the distribution. The retirement account may be affected differently by individual state taxation rules. Contact your tax advisor with questions. The Retirement and Investor Services Client Contact Center at Fidelity is available to answer questions about the retirement plan, too. Please call Monday through Friday, 7:30 am 7:30 pm (Central Time), to speak with a counselor. To find out more information about Fidelity, visit ROTH If your retirement plan allows it, anyone who can save through a traditional 401(k) can fund a Roth 401(k). And unlike a Roth IRA, there are no income limits on Roth401(k) eligibility. Unlike a traditional 401(k), with a Roth account you invest after-tax dollars. Those dollars grow tax deferred, and if you hold the account for at least five years and don t withdraw the money until at least age 59½, you will not owe any taxes on your earnings. The trade-off: Because contributions are after tax, your take-home pay will be reduced by the amount you save. You may contribute up to the IRS annual limit (currently $17,500, though other plan limits may apply) to your entire retirement plan traditional, Roth or a combination of both. Also, if you re age 50 or older at any time during 2014, and your plan allows, you can make up to $5,500 more in catch-up instead of contributions to your accounts. S H I N O L A 19 D E T R O I T

21 C H A P T E R ADDITIONAL BENEFITS EMPLOYEE ASSISTANCE PROGRAM (EAP) The Company cares about your total health management both physical as well as emotional. For that reason, the Company offers an Employee Assistance Program through HMSA. This service connects you with the best mental health and counseling services to fit your individual needs. With just one phone call, at any hour of the day or night, you can reach a compassionate ear and connect to helpful resources. All services provided are confidential, and will not be shared with the Company. There is also online access to information, benefits, educational materials and more at The program is available to all employees and their eligible dependents and provides referrals for: Emotional problems Alcohol or drug dependency Marriage or family relationship problems Parenting advice Stress, anxiety and depression Inpatient referrals Financial or legal advice Dependent, elder and pet care HMSA provides over-the-phone assistance and can refer individuals to a local counselor. Simply call and a HMSA representative will guide you through the process. With HMSA services, you are eligible for five free in-person counseling sessions, per issue, for each family member if appropriate for your situation. This benefit is available for all employees, if the employee is currently enrolled in the Medical insurance plan. PAID TIME OFF (PTO) AND HOLIDAYS It is important that all hard working employees take time for themselves. As difficult as it may seem to schedule a vacation, it is highly encouraged; if for no other reason than to avoid burnout and provide a break in the work routine. Hopefully you will return to work revitalized and productive. Beginning on the first day you are hired, vacation days accrue according to the following schedule: VACATION DAYS 1st year through 3rd year...10 days (80 hours) or 3.08 hours per pay period 4th year through 7th year...15 days (120 hours) or 4.62 hours per pay period 8th year and beyond...20 days (160 hours) or 6.15 hours per pay period. The Company offers a total of 10 paid holidays per year to all eligible employees. The actual Holidays to be observed each year may vary by location. Please consult with the Human Resources Department or your supervisor. Generally the holiday schedule is announced prior to the new calendar year. If a Company-designated holiday falls on a Saturday, it will be observed on the preceding Friday. If a Company-designated holiday fall on a Sunday, it will be observed on the following Monday. TYPICAL HOLIDAY SCHEDULE* New Year s Day...January 1st President s Day...Third Monday in February Memorial Day...Last Monday in May Independence Day...July 4th Labor Day...First Monday In September Thanksgiving Day...Last Thursday in November Friday after Thanksgiving Day...Last Friday in November Christmas Eve...December 24th Christmas Day...December 25th New Years Eve...December 31st * Subject to change S H I N O L A 20 D E T R O I T

22 EMPLOYEE DISCOUNT Shinola employees can now place orders directly on and receive 50% off the full retail price on all items, except bikes where you will receive a 38% discount. Additionally, you will be responsible for the cost of shipping. To place an order, first create an account on Shinola.com using your Shinola.com address. The system will recognize your information and apply the discount after the item is added to your shopping cart. If you do not have a Shinola.com address please visit shinola.com/employee to register with an alternate address. You will need to provide your ADP File Number located on your paystub (see attached for an example). If you experience any problems, please contact customer service at Note that the employee discount only applies to purchases made online, not at the retail stores. We only ask that you use the discount for yourself or immediate family members. Enjoy! EMPLOYEE WATCH PROGRAM All regular full-time Shinola employees are eligible to receive a free Shinola watch as an appreciation gift. Who is eligible to receive a free watch? All active full-time Shinola employee who completed 90 days of employment. This is a one-time only gift. Re-hires are not eligible to receive a 2nd free watch. Where can I place the order? Online via our Shinola website ( How can I place the order? Easy, simply follow these steps: 1. Go to 2. Access the Employee Watches section of the site. This section is located on the left side of the category navigation while browsing the Shinola.com store. 3. Select the watch you like from the pre-selected group of watches and add it to the shopping cart. 4. Use the promotional code of ARGONITE During checkout, select Detroit Factory Pickup if you are a Detroit employee or select Ground Shipping if you work in any other location or State. Whatever shipping option you select is delivering the watch won t cost you anything. 6. The Shinola shipping department will send you the watch through customer service (for Detroit employees) or ship to the appropriate office/store, as indicated by the shipping address provided during checkout. For those employees who don t have a Shinola store/office close by to pick up, the watch will be delivered to the shipping address provided during checkout. I haven t received my watch yet, who should I contact? Please allow the team to process your order. This may take approximately 2 to 5 days. If you haven t received your watch or is not ready for pick up after 2 weeks of placing the order online, please contact our Customer Service Group at You may also want to check our Customer Care section of our website at S H I N O L A 21 D E T R O I T

23 C H A P T E R REQUIRED NOTICES WOMEN S HEALTH AND CANCER RIGHTS ACT The Women s Health and Cancer Rights Act of 1998 was signed into law on October 21, The Act requires that all group health plans providing medical and surgical benefits with respect to a mastectomy must provide coverage for all of the following: Reconstruction of the breast on which a mastectomy has been performed Surgery and reconstruction of the other breast to produce a symmetrical appearance Prosthesis Treatment of physical complications of all stages of mastectomy, including lymphedema This coverage will be provided in consultation with the attending physician and the patient, and will be subject to the same annual deductibles and coinsurance provisions which apply for the mastectomy. For deductibles and coinsurance information applicable to the plan in which you enroll, please refer to the summary plan description or contact the Company Human Resources Department. HIPAA PRIVACY AND SECURITY The Health Insurance Portability and Accountability Act of 1996 deals with how an employer can enforce eligibility and enrollment for health care benefits, as well as ensuring that protected health information which identifies you is kept private. You have the right to inspect and copy protected health information that is maintained by and for the plan for enrollment, payment, claims and case management. If you feel that protected health information about you is incorrect or incomplete, you may ask your benefits administrator to amend the information. For a full copy of the Notice of Privacy Practices, describing how protected health information about you may be used and disclosed and how you can get access to the information, contact the Company Human Resources Department. HIPAA PRE-EXISTING CONDITION EXCLUSIONS Some group health plans restrict coverage for medical conditions present before an individual s enrollment. These restrictions are known as pre-existing condition exclusions. A pre-existing condition exclusion can apply only to conditions for which medical advice, diagnosis, care, or treatment was recommended or received within the 6 months before your enrollment date. Your enrollment date is your first day of coverage under the plan, or, if there is a waiting period, the first day of your waiting period (typically, your first day of work). In addition, a pre-existing condition exclusion cannot last for more than 12 months after your enrollment date (18 months if you are a late enrollee). Finally, a pre-existing condition exclusion cannot apply to pregnancy and cannot apply to a child who is under the age of 19. If a plan imposes a pre-existing condition exclusion, the length of the exclusion must be reduced by the amount of your prior creditable coverage. Most health coverage is creditable coverage, including group health plan coverage, COBRA continuation coverage, coverage under an individual health policy, Medicare, Medicaid, State Children s Health Insurance Program (SCHIP), and coverage through high-risk pools and the Peace Corps. Not all forms of creditable coverage are required to provide certificates of creditable coverage. If you do not receive a certificate for past coverage, talk to your new plan administrator. You can add up any creditable coverage you have. However, if at any time you went for 63 days or more without any coverage (called a lapse in coverage) a plan may not have to count the coverage you had before the lapse. Therefore, once your coverage ends, you should try to obtain alternative coverage as soon as possible to avoid a 63-day lapse. All questions about the pre-existing condition exclusion and creditable coverage should be directed to the Company Human Resources Department. HIPAA SPECIAL ENROLLMENT RIGHTS If you are declining enrollment for yourself or your dependents (including your spouse) because of other health insurance or group health plan coverage, you may be able to later enroll yourself and your dependents in this plan if you or your dependents lose eligibility for that other coverage (or if the employer stops contributing towards your or your dependents other coverage). Loss of eligibility includes but is not limited to: Loss of eligibility for coverage as a result of ceasing to meet the plan s eligibility requirements (i.e. legal separation, divorce, cessation of dependent status, death of an employee, termination of employment, reduction in the number of hours of employment); Loss of HMO coverage because the person no longer resides or works in the HMO service area and no other coverage option is available through the HMO plan sponsor; Elimination of the coverage option a person was enrolled in, and another option is not offered in its place; Reaching the plan s lifetime benefit maximum on all benefits, if the person is covered under a separate plan or a single plan with multiple options and the other option has a higher lifetime maximum, or the benefits paid under the first option were not integrated with the second option; Failing to return from an FMLA leave of absence; and Loss of coverage under Medicaid or the Children s Health Insurance Program (CHIP). Unless the event giving rise to your special enrollment right is a loss of coverage under Medicaid or CHIP, you must request enrollment within 30 days after your or your dependent s(s ) other coverage ends (or after the employer that sponsors that coverage stops contributing toward the coverage). If the event giving rise to your special enrollment right is a loss of coverage under Medicaid or the CHIP, you may request enrollment under this plan within 60 days of the date you or your dependent(s) lose such coverage under Medicaid or CHIP. Similarly, if you or S H I N O L A 22 D E T R O I T

24 your dependent(s) become eligible for a state-granted premium subsidy towards this plan, you may request enrollment under this plan within 60 days after the date Medicaid or CHIP determine that you or the dependent(s) qualify for the subsidy. In addition, if you have a new dependent as a result of marriage, birth, adoption, or placement for adoption, you may be able to enroll yourself and your dependents. However, you must request enrollment within 30 days after the marriage, birth, adoption, or placement for adoption. To request special enrollment or obtain more information, contact the Company Human Resources Department. IMPORTANT NOTICE FROM COMPANY ABOUT YOUR PRESCRIPTION DRUG COVERAGE AND MEDICARE Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage with the Company and about your options under Medicare s prescription drug coverage. This information can help you decide whether or not you want to join a Medicare drug plan. If you are considering joining, you should compare your current coverage, including which drugs are covered at what cost, with the coverage and costs of the plans offering Medicare prescription drug coverage in your area. Information about where you can get help to make decisions about your prescription drug coverage is at the end of this notice. There are two important things you need to know about your currentcoverage and Medicare s prescription drug coverage: 1. Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can get this coverage if you join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan (like an HMO or PPO) that offers prescription drug coverage. All Medicare drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium. 2. The Company has determined that the prescription drug coverage offered by the CIGNA plan is, on average for all plan participants, expected to pay out as much as standard Medicare prescription drug coverage pays and is therefore considered Creditable Coverage. Because your existing coverage is Creditable Coverage, you can keep this coverage and not pay a higher premium (a penalty) if you later decide to join a Medicare drug plan. WHAT HAPPENS TO YOUR CURRENT COVERAGE IF YOU DECIDE TO JOIN A MEDICARE DRUG PLAN? If you decide to join a Medicare drug plan, your current Company coverage will not be affected. For most persons covered under the Plan, the Plan will pay prescription drug benefits first, and Medicare will determine its payments second. For more information about this issue of what program pays first and what program pays second, see the Plan s Summary Plan Description or contact Medicare at the telephone number or web address listed herein. If you do decide to join a Medicare drug plan and drop your current Company coverage, be aware that you and your dependents will not be able to get this coverage back. WHEN WILL YOU PAY A HIGHER PREMIUM (PENALTY) TO JOIN A MEDICARE DRUG PLAN? You should also know that if you drop or lose your current coverage with the Company and don t join a Medicare drug plan within 63 continuous days after your current coverage ends, you may pay a higher premium (a penalty) to join a Medicare drug plan later. If you go 63 continuous days or longer without creditable prescription drug coverage, your monthly premium may go up by at least 1% of the Medicare base beneficiary premium per month for every month that you did not have that coverage. For example, if you go nineteen months without creditable coverage, your premium may consistently be at least 19% higher than the Medicare base beneficiary premium. You may have to pay this higher premium (a penalty) as long as you have Medicare prescription drug coverage. In addition, you may have to wait until the following November to join. WHEN CAN YOU JOIN A MEDICARE DRUG PLAN? You can join a Medicare drug plan when you first become eligible for Medicare during a seven-month initial enrollment period. That period begins three months prior to your 65th birthday, includes the month you turn 65, and continues for the ensuing three months. You may also enroll each year from October 15th through December 7th. However, if you lose your current creditable prescription drug coverage, through no fault of your own, you will also be eligible for a two (2) month Special Enrollment Period (SEP) to join a Medicare drug plan. S H I N O L A 23 D E T R O I T