1 2023 Employee Benefits Guide Questions? Contact Nemak Human Resources This guide is not a contract, but a summary of your benefits. Please refer to your Summary Plan Description or Certificate of Coverage(s) for more detailed information. In case of conflict, your Summary Plan Description will prevail for all claim adjudication. Salaried Employees 2 In this guide… A Guide to Your 2023 Employee Benefits..................... 3 Disability Insurance................................................ 20 Health and Wellness Benefits....................................... 4 Vehicle Discount Program..................................... 21 Provider Directory.................................................... 4 Dependent Scholarship Program.......................... 23 Medical, Dental & Vision Plan Summary...................... 5 Employee Tuition Assistance Program................. 23 Cost of Coverage..................................................... 5 Employee Referral Program.................................. 27 Eligibility.................................................................... 5 Time Off Benefits......................................................... 28 Medical Plan............................................................. 7 Vacation Policy....................................................... 28 Dental Plan............................................................... 9 Illness/Injury Leave Policy..................................... 28 Vision Plan.............................................................. 11 Personal Time Off Policy....................................... 29 Flexible Spending Account (FSA).......................... 13 Holidays.................................................................. 29 Other Wellness Programs...................................... 14 Parental Leave........................................................ 29 The All-New Wellness Incentive Program....... 14 Additional Benefits....................................................... 30 Employee Assistance Program (EAP).............. 15 Employee Recognition Programs......................... 30 Teladoc™ Health.............................................. 16 Nemak Choice Awards..................................... 30 Hinge Health Back & Join Pain Support.......... 16 BRAVO!............................................................. 30 Financial Benefits........................................................ 17 Appendix....................................................................... 31 401(k) Plan.............................................................. 17 Life Insurance......................................................... 18 Basic Life Insurance and AD&D....................... 18 Voluntary Life Insurance.................................. 19 3 A GU IDE TO YOUR 2023 EMPLOYEE BENEFITS At Nemak, we value our employees’ efforts to help drive the success of our business. We are committed to ensuring a responsible, respectful and positive experience for our employees—including a comprehensive and competitive benefits package. We encourage you to take the time to read through this guide and explore the benefit options available to you. This guide includes the benefits and enrollment material offered to full-time salaried employees for the January 1 through December 31, 2023 plan year. The elections you make during your initial enrollment period will become effective: • • On January 1 of the plan year for current employees activating or renewing their benefits The first day of the month following the date of employment for new employees Exceptions: » If the date of employment falls on the first day of the month, most coverage is effective upon your first day of employment. » Flexible Spending Account contributions can be made beginning on the first of the month following 60 days of employment. » Nemak 401(k) Plan participation may begin on the first day of the month following three months of employment. If you have any questions or require additional information on Nemak’s benefits, please contact Human Resources. Legal notices are also available at the end of this guide. 4 HEALT H & WELLNESS BENEFITS COVERAGE PHONE WEB / EMAIL COVERAGE Benefits Resource Center (BRC) 855-874-0742 [email protected] 401(k) Retirement Savings Plan Medical and Prescription Drug Plan Blue Cross Blue Shield of Tennessee CVS Caremark (Pharmacy) Dental Plan Delta Dental of Wisconsin Vision Plan NVA Flexible Spending Account (FSA) Employee Benefits Corporation (EBC) Employee Assistance Program (EAP) EmployeeConnect Plus bcbst.com 800-236-3712 deltadentalwi.com 800-672-7723 e-nva.com Back & Joint Pain Support Hinge Health Short Term & Long Term Disability [email protected] Business Travel Accident, Assistance & Concierge Services AIG - in the event of travel inconveniences, travel security issues, or travel medical emergencies during business travel guidanceresources.com Telemedicine Teladoc Health Voluntary Life Insurance Lincoln Financial Group Lincoln Financial Group ebcflex.com 855-327-4463 800-835-2362 855-902-2777 WEB / EMAIL 888-762-6088 qtweb.sentinelbenefits.com 888-787-2129 mylincolnportal.com 888-408-7300 mylincolnportal.com Basic Life and AD&D 800-565-9140 800-364-6331 800-346-2126 Sentinel Benefits Group PHONE Web ID: Lincoln bcbst.com/teladoc Select Talk with a Doctor Now hingehealth.com/nemak Travel Policy (outside the U.S.) GeoBlue (aka BCBS Global Traveler) – medical coverage during business travel 877-244-6871 or 715-346-0859 (outside the U.S. collect aig.com/us/travelassistance [email protected] reverse charge) 888-412-6403 or 610-254-5830 (outside the U.S. collect reverse charge) geo-blue.com 5 M ED ICAL , D ENTA L & V ISION PLAN SUMMARY MEDICAL PLAN Blue Cross Blue Shield of Tennessee (BCBS TN) PPO DENTAL PLAN Delta Dental PPO & Delta Dental Premium VISION PLAN National Vision Administrators, LLC (NVA) C O ST O F COVERAGE By enrolling in Nemak’s medical coverage, you are also electing dental and vision coverage. Opting out of dental and vision is not an option. Discount Eligible employees who participated in the 2022 biometric screening event will receive a credit of $150 toward the above costs in 2023. Eligibility Dependent children, as defined by the plan are eligible for coverage until the date on which they attain age 26. Single $61.75 Employee +1 $132.19 Family $171.31 The following life events may allow adjustments to your coverage outside of the normal Open Enrollment period: • Marriage or divorce • Birth or adoption of a child • Death of a spouse or family member • Reaching a certain age, such as turning 65 and becoming eligible for Medicare Should you need to make changes to your benefit plans outside of the normal Open Enrollment period, please contact Human Resources. 6 QUESTIONS? Reach out to the Benefits Resource Center (BRC)! Benefit Specialists are available to help you navigate available benefit plan and policy questions, eligibility and claim issues, coordination of benefits, finding in-network providers and much more. The BRC is staffed by subject matter experts familiar with Nemak’s offered employee benefits who have a track record of finding solutions to your benefit issues and questions. Contact the BRC Monday through Friday between 8 a.m. and 5 p.m. CST, toll free at 855874-0742 or email anytime at [email protected]. 7 MED ICAL PLAN Effective January 1, 2023, Nemak will offer a PPO medical and prescription drug plan administered through Blue Cross Blue Shield of Tennessee (BCBS TN) for all benefit-eligible employees. The semi-monthly cost of coverage includes medical, dental, and vision plan coverages. Preventive care is covered at 100% and no deductible applies. For other services, the plan requires a deductible to be satisfied before eligible services are paid. SUMMARY IN-NETWORK OUT-OF-NETWORK Deductible per calendar year $500 / Single $1,000 / Employee +1 $1,000 / Family $1,000 / Single $2,000 / Employee +1 $2,000 / Family Out of Pocket Max per calendar year (includes deductible and nonRx copays $1,500 / Single $3,000 / Employee +1 $3,000 / Family $3,000 / Single $6,000 / Employee +1 $6,000 / Family Physician Services Office visits, Urgent Care Clinic, Retail Health Clinics For $0 cost back and joint health, see Hinge Health information found on pg.16. Preventive Services Well Care child and adult exams and screenings, Immunizations, Prenatal, Screening You pay 20% after deductible NOTE: Teladoc-BCBS TN virtual or telephonic visits are available at $0 cost! See pg. 16 for more information. You pay 50% after deductible You pay 0% Not Covered Inpatient Hospital You pay 20% after deductible You pay 50% after deductible Outpatient Hospital You pay 20% after deductible You pay 50% after deductible 8 IN-NETWORK Emergency Room OUT-OF-NETWORK $150 copay, then 20% after deductible Prescription Drug/Rx Out-of-Pocket Max $1,800 Single $3,600 Family Prescription Drugs Retail Pharmacy (30-day supply) - Generic - Preferred Brand - Non-Preferred Brand Specialty Drugs* Retail90 Network or Mail Order (90 days) - Generic - Preferred Brand - Non-Preferred Brand $10 copay per script $30 copay per script $45 copay per script 20% to a maximum of $150 Not covered $20 copay per script $75 copay per script $112.50 copay per script *If covered, specialty medications are arranged through BCBS TN / CVS Caremark. For the PrudentRx Copay Program, $0 out-of-pocket costs will apply. Please refer to any mailings or phone outreach you may receive from PrudentRx for more information. Blue Network Providers To identify participating (in-network) providers, call the BCBS TN Customer Service number on the back of your medical ID card, or visit bcbst.com. The amount the plan pays for covered services is based on the allowed amount. If an out-of-network provider charges more than the allowed amount, you may have to pay the difference. Always use an in-network provider for the highest coverage of services. Questions? Refer to your Summary of Benefit Coverage (SBC) for a more detailed explanation about your health plan benefits, including mail order prescriptions and other health services. 800-565-9140 or call the number on the back of your ID card bcbst.com 9 DEN TAL PLAN Nemak offers all benefit-eligible employees the Delta Dental PPO and Delta Dental Premium dental plan. This comprehensive plan covers important preventive care at 100% for innetwork providers, with no deductible. You may use any dentist for your dental services; however, using an in-network dental provider will reduce your out-of-pocket costs. Individual Annual Maximum Annual Deductible Access your dental account information from your smartphone or mobile device with Dental Delta app. With this app, you can: » » » » View your summary of benefits or claims Access your ID card Find a network dentist Brush with Toothbrush Timer $2,000 $50/Single $100/Family Does not apply to preventive and diagnostics Diagnostic & Preventive (Cleanings available 4 times per yr.) You Pay 0% Basic Restorative Care Amalgam & Resin Fillings You Pay 20% Oral Surgery You Pay 50% Endodontic Therapy Root Canal You Pay 50% Periodontics Gum disease You Pay 50% Diagnostic & Preventive Resins, Crowns You Pay 50% Diagnostic & Preventive Prosthetics and Implants You Pay 50% Orthodontic Services Lifetime Maximum You Pay Adult Ortho Dependents eligible until age 19 $1,500 50% Not Covered 10 Note: Before scheduling an appointment for extensive dental care, you should request that your dentist send the treatment plan to Delta Dental for prior review and approval. When accessing care out-of-network, there are no provider discounts, and the member is responsible for the difference between what is charged/billed over the Usual and Customary percentile. Amplifon Hearing Health Care As a Delta Dental member, you receive discounts and savings on hearing diagnostic testing, along with the guaranteed lowest pricing on hearing aids. More info: 877-846-7074 amplifonusa.com Questions? 800-236-3712 or call the number on the back of your ID card deltadentalwi.com Delta Dental mobile app 11 V ISIO N PLAN Vision Benefits Nemak offers all benefit-eligible employees a comprehensive vision care plan administered by National Vision Administrators, LLC (NVA). Summary You may use any provider for your vision services; however, using an in-network NVA vision provider will reduce your out-of-pocket costs. When accessing care out-of-network, you receive an amount that the vision provider will pay up to. You are then responsible for the difference. Eligible members and dependents are entitled to receive a vision exam and one pair of lenses and a frame, or contact lenses every calendar year You are responsible for 100% of the cost at the time of the service at out-of-network providers Eye Exam Standard Glass or Plastic Lenses Single, Bifocal, Trifocal Lenticular Lens Options Tints, Standard Scratch Coating, UV Coating Frames Contact Lenses Once Every Calendar Year Elective Contact Lenese Fit/Follow-up Standard Dally Wear Standard Extended Wear Specialty Wear Medically Necessary** Lasik Procedures $15; 100% covered thereafter Single Vision – $15; $100 covered thereafter Bifocal, Trifocal, Lenticular - You pay $15, 100% thereafter Covered 100% Reimbursed up to $40 The amount reimbursed differs by lens type. Contact NVA for more information Not covered You receive up to $130 allowance and then a 20% discount* off the balance Reimbursed up to $45 In lieu of Lenses & Frame In lieu of Lenses & Frame Up to $105 Retail 15% discount (Conventional) or 10% discount (Disposable) off balance Up to $105 Covered 100% Covered 100% Covered 100% after $20 copay Up to $20 Up to$30 Up to $30 Covered 100% Up to $210 Via the National LASIK Network, members are entitled to significant discounts and free initial consultation. Attractive financing options may also be available. Call 877-295-8599 or visit NVA’s website for more information. NA *Discount may not apply to certain large chain vision providers. Contact NVA for more information. **Requires pre-approval from NVA Note: At the time of your appointment, simply present your NVA ID card. A claim form is not required. The vision provider will inform you of your eligibility status prior to rendering services. 12 Contact Fill Program NVA provides members with the convenience and savings of Contact Fill by mail-order, which can provide significant savings on contact lenses and includes the convenience of home delivery. More info: 866-234-1393 contactfill.com Eye-Essential Program After you have exhausted your available vision benefit you may be eligible to access the NVA Eye-Essential Plan. This plan is an in-network benefit only. Benefit frequencies are unlimited. Contact NVA for more information. Prescription Safety Glasses Nemak offers reimbursement up to $100 for one pair of prescription safety glasses per year. For reimbursement, itemized bills should be forwarded to your location’s Human Resources Department. Questions? 800-672-7723 e-nva.com 13 ( FSA) FLEXIBLE SPENDING ACCOUNT Nemak sponsors flexible spending accounts administered by Employee Benefits Corporation (EBC). This benefit helps you pay for everyday medical expenses on a pre-tax basis through: • Medical Care Account: Set aside pre-tax contributions for medical, dental and vision expenses not paid by your (or your spouse’s) insurance plans up to the annual maximum set by the IRS or your annual election. Why enroll in an FSA Account? » Contributions are payroll deducted throughout the year, and are contributed on a pre-tax basis, thereby lowering your taxable income. » Elected FSA contributions are available on the first day of the plan year (or mid-year if hired after January 1). » The FSA account can be used like a debit card at most doctors, retail stores, dental or vision offices. Funding Employee funds entire account. Enrollment Must re-enroll each year at Open Enrollment. The plan year is from January through December. Access To Your Money Prescriptions For qualified medical expenses, you can access the entire annual election amount any time during the year, even if all the money has not been deducted. You must obtain a prescription from a treating physician for over the counter (OTC) medications in order to use FSA dollars for reimbursement (one prescription per OTC med, per year needed). Use It Or Lose It Any money left in the account at the end of the plan year is forfeited. Note: Nemak offers a 2 months and 15 days grace period after the end of the plan year to use up any remaining funds. Substantiation You keep receipts, and submit to EBC as requested, to prove that the money spent was eligible. Option To Change Contributions You can change election amount within 30 days of a life qualifying event, (i.e., marriage, divorce, birth, etc.) or during an annual Open Enrollment period. Questions? 800-346-2126 ebcflex.com 14 OTHER WEL LNESS PROGRAMS The All-New Wellness Incentive Program Eligible employees can earn $300 toward their 2024 medical plan premium by visiting a Primary Care Physician (PCP) for an annual physical. Earn the incentive in three simple steps: 1. Schedule a preventive care exam/physical with a PCP between November 1, 2022, and October 31, 2023. Under Nemak’s BCBS TN insurance plan, all individuals receive one in-network preventive care visit per year at no cost. 2. Remind the doctor’s office to code the visit as a preventive care exam/annual physical. 3. BCBS TN will notify Nemak Human Resources of all employees who complete their visit and are eligible for the $300 credit. Eligibility & Out of Pocket Costs If you are enrolled in the Nemak medical plan, you must complete the PCP wellness program to be eligible for the 2024 premium discount. Physician offices have the right to charge your visit as non-preventive (medical in nature) if there were services provided during your office visit that are not considered routine. In those cases, you may incur certain out-of-pocket costs for the visit if your plan year deductible/annual out of pocket maximum has not been reached. 15 ( E AP) EMPLOYEE ASSISTANCE PROGRAM Benefit-eligible employees have access to a free and confidential Employee Assistance Program (EAP) provided 24/7 by EmployeeConnect Plus™. You, your spouse and your dependents are entitled to: • Unlimited phone access to legal, financial and work-life services • In-person help with short-term issues • Up to six (6) sessions per individual, per issue, per year Services include: CONFIDENTIAL COUNSELING ONLINE GUIDANCE RESOURCES FINANCIAL SERVICES Stress, anxiety and depression Articles, videos and self-assessments Managing personal financial challenges Relationship/marital conflicts “Ask the Expert” personal responses to your questions Credit card and debt management Child care, elder care, attorney and financial planner searches Tax questions Parenting questions Job pressures Grief and loss Substances abuse Pet insurance discounts and care locator Budgeting Financing for college Estate planning Investment options Mortgages, loans and refinancing Retirement planning LEGAL SERVICES WORK-LIFE SERVICES Family law Child care and before- and after-school care Bankruptcy and credit issues Elder care and assisted living services Landlord/tenant issues Relocation information Civil actions and small claims Event planning and home improvement DUI/DWI Wills, living wills and trusts Name changes Contracts Probate matters Immigration More info 855-327-4463 guidanceresources.com Organization Web ID: Lincoln GuidanceNow mobile app 16 T EL AD O C ™ HEALTH Nemak offers telehealth visits to benefit-eligible employees and your family members at no cost under the BCBS TN medical plan. Talk to Teladoc when it’s not an emergency and you can’t get to a doctor’s office. It’s available 24/7 and can be used for things like: allergies, cold, fever and flu, constipation or diarrhea, sinus or respiratory issues, earaches, mental health support, urinary infections, nausea and vomiting, pink eye, and skin conditions. How to Use Teladoc Health Get started using Teladoc’s online video chat or the free BCBS TN app: • Register by logging in to the BCBS TN app or at bcbst.com/Teladoc and choosing Talk with a Doctor Now. You can also call 1-800-TELADOC. • The first time you use Teladoc Health, you’ll need to fill out a short medical history survey and create an account. • The next time you use it, you can just log in through the app and talk to a doctor in minutes. H I N G E HE ALTH BACK & JOINT PAIN SUPPORT Hinge Health is available to employees and their family members (age 18 or older) covered under Nemak’s BCBS TN medical plan, at no cost. Hinge Health provides a variety of tools, including personalized exercise, unlimited 1-on-1 health coaching and wearable sensors for live feedback, to help individuals conquer back, knee, hip, shoulder or neck pain without drugs or surgery. • Conquer pain or limited movement • Recover from a recent or past injury • Prepare for and recover from surgery • Keep joints healthy and pain free The average Hinge Health participant reduced pain by over 60%. Sign up 855-902-2777 hingehealth.com/nemak A simple online assessment of your condition is rendered at the time of enrollment. 17 F I NANC IAL BENEFITS 401(k) Plan Your Nemak 401(k) plan—administered through Sentinel—is a defined contribution savings plan designed to help you build retirement savings. Employee Contributions: You contribute to the 401(k) through automatic payroll deductions either on a pre-tax or post-tax (Roth) basis, or a combination of pre-tax and Roth. • On the first day of the month following three months of employment, eligible employees are automatically enrolled into the Nemak 401(k) plan at a 3% contribution (pre-tax), unless they specify a different contribution percentage. • Every January, your contribution is increased by 1% (until a 15% contribution is reached) unless you opt out. • You may contribute up to 100% of eligible pay up to the IRS annual maximum limit and you decide how to invest your account balance among available investment funds. • In addition, if you are age 50 or over, you are eligible to contribute an additional amount through a catch-up contribution. Company (Safe Harbor) Contributions: As soon as you become eligible, Nemak will also contribute 3% of your base salary to your account. Company contributions are made on a per pay period basis. Access to More Information: Once in the Sentinel system, you can access your account information, change investment selections and contribution percentages (deferrals), request fund prospectuses, designate a beneficiary and much more. Performance Bonus Plan: The Company provides a competitive performance bonus plan to eligible employees once per year. Questions? 888-762-6088 sentinelgroup.com 18 LIFE INSURANCE All benefit-eligible employees are enrolled in Basic Life Insurance, insured through Lincoln Financial Group. Accidental Death and Dismemberment (AD&D) insurance provides an additional benefit if you lose your life, sight, hearing, speech or your limbs in an accident. COST OF COVERAGE Basic Life Insurance and AD&D Paid 100% by Nemak on behalf of employees Voluntary Life Insurance Paid 100% by employee Accelerated Death Benefit Both basic life and voluntary life insurance (if enrolled) include an accelerated death benefit should you or your insured spouse become terminally ill. If requested, Lincoln will pay life insurance as allowed for under the policy before death occurs. Basic Life Insurance and AD&D You are enrolled for basic life insurance for three times your base annual earnings, rounded to the next highest $1,000. The minimum basic life benefit is $10,000 up to a maximum basic life benefit of $750,000. You are also enrolled for AD&D insurance at an amount equal to your basic life insurance amount. The value of basic life insurance in excess of $50,000 is considered imputable taxable income that is reported on your W-2 at the end of the year. Note: The original amount of the basic life and AD&D benefits will reduce as you age and will terminate upon employee’s retirement or the termination of employment. In addition, it is important to ensure you complete your beneficiary information at the time you enroll. To update your beneficiary information, see your location’s Human Resources Department. 19 Voluntary Life Insurance In addition to the basic life insurance provided by Nemak, you may purchase supplemental life insurance for yourself, your spouse, or your children through Lincoln. These plans are paid 100% by you and are intended to supplement the provided Basic Life and AD&D Insurance described above. You must enroll in Employee Voluntary Life Insurance in order to enroll Spouse and Child(ren), and Spouse coverage amount is limited to 50% of the Employee election (not to exceed $30K). VOLUNTARY LIFE INSURANCE BENEFITS Employee benefit You are eligible to enroll in supplemental life benefits to the lesser of three times your base annual earnings (sold in $10,000 increments) or $250,000. Spouse benefit Maximum benefit is $30,000. Sold in $10,000 increments. You must have Employee Voluntary Life Insurance in order to have Spouse and/or Child(ren) coverage. Spouse coverage amount is limited to 50% of the Employee election (not to exceed $30K) Child(ren) benefit $10,000 (only option). Note: live birth, but under 25 years old. Voluntary Life Insurance Rates The employee and spouse monthly premiums shown above are per $1,000 increments. 20 Disability Insurance Both Short-Term Disability and Long-Term Disability benefits are provided through Lincoln for all employees at no cost. DISABILITY INSURANCE BENEFITS Short-Term Disability Long-Term Disability 100% of pay for up to 90 days of continuous disability Benefits made available through Nemak payroll process 60% of pre-disability earnings (as outlined in the Long-Term Disability policy) after 90 days of continued disability Not to exceed a $12,000 monthly benefit maximum 21 V E HIC L E D IS COU NT PROGRAM Stellantis (formerly Fiat-Chrysler) The Stellantis Affiliates Rewards plan offers employees and their spouses to receive a Preferred Price (1% below factory invoice), which is the maximum you’ll be charged. A $75 administration fee applies. Employees and their spouses may purchase or lease a combined total of two vehicles per calendar year. 1. Visit FCAUSAffiliates.com to receive a unique Control Number, or call 888-444-4321 (use Company Code: S55020) 2. Take the Control Number, along with a company photo ID or recent pay stub, to any participating U.S. Fiat, Chrysler, Dodge, or Jeep dealership to receive the Preferred Price Ford 1. Visit fordpartner.com or call 1-877-XPLAN-00 (1-877-975-2600) to obtain a PIN 2. Provide Partner Code: N570C to obtain your PIN GM Eligible Nemak employees qualify for the GM Supplier Discount Program, which allows you to take advantage of savings on a wide range of new and unused GM vehicles from Chevrolet, Buick, GMC, and Cadillac. 1. Visit gmsupplierdiscount.com, enter Company Code 468048 or 895868 and sign in 2. Follow the prompts to obtain your personal Authorization Number 3. Take it to a participating GM Dealer to receive your discount 22 Hyundai Purchase or lease a new Hyundai vehicle at a special discounted price. 1. Visit hyundaicircle.com, select “Vendors/Dealers/All Others” and enter Supplier Discount ID (CID): 0148652. 2. Select your vehicle and browse the inventory results to find exactly what you are looking for. 3. Print your Plan A Certificate and take it to your Hyundai dealer to purchase your new vehicle. Jaguar Land Rover Private offer available to Nemak employees in North America. This program includes attractive lease or purchase opportunities on select Jaguar Land Rover models. 1. Visit jlrprivateoffer.com 2. Submit your personal information 3. Complete the online form to request your unique Offer PIN Code 4. Upon submission of the form, you will be able to download your PIN Code certificate on the confirmation page as well as from a link in your confirmation email 5. Present your PIN Code certificate to your preferred local authorized Jaguar Land Rover Retailer to redeem offer (note: PIN’s are valid for 10 days from date of issue) Nissan & Infiniti Special pricing on Nissan and Infinity vehicle purchases. Note: Two claims allowed per calendar year. Claim ID’s cannot be transferred and can only be used by the person they are issued to. Claim ID’s are good for 45 days. Dealerships are not required to participate in this program. 1. Visit insidenissan.com, and click on the link for Business Associate 2. Enter your first name, last name and Nemak’s VPP Company Code: VPP003255 3. Employees may create their own claim form number from this website by selecting “Get VPP Claim Number” 4. Take claim number and proof of employment (photo ID badge, paycheck stub or a business card) to the dealership for purchase of vehicle 23 DEPEN D EN T SCHOLA RS HIP PROGRAM $500 per dependent Eligible employee’s dependent children who graduate from high school and are accepted by an accredited college or university, or other recognized and established educational institution, will be entitled to receive $500 to defray tuition costs in the first year of study. EM PLOYE E TUITION PROGRAM Purpose & Scope The purpose of the Tuition Assistance Policy is to encourage Nemak full time hourly and salaried employees (“employees”) in the United States and Canada to further their personal development. Under this program, Nemak refunds limited tuition and compulsory fees to full time employees on the active employment roll, who satisfactorily complete after-hours courses approved by the Company, at accredited and approved universities or colleges, business schools, high schools, and trade or vocational schools. The courses may be either jobrelated or for the employee’s advancement within the Company. The tuition assistance program is intended to encourage employee participation in formal courses of study that relate to the acquisition of job-related skills and knowledge. Courses of study under this program are those which enable employees to maintain or improve their performance in their current positions or those which may prepare them for future positions at Nemak. Participation is voluntary and class attendance and homework assignments must be completed on the employee’s personal time. The hours an employee spends in attending classes and completing assignments under the program will not be considered as hours of work and the employee will not receive any pay from the Company for these hours. Special shift accommodations will not be made to enable an employee to attend class. Where available, employees can voluntarily change shifts with another employee. The tuition assistance program is a training and development tool that enables the Company and the employee to jointly direct professional development in accordance with the needs of the Company and the needs of the individual. Therefore, a tuition assistance application will be approved only if the course or courses meet the needs of the Company and management’s assessment of an employee’s capability and potential. Wisconsin hourly employees may refer to the Wisconsin Labor Agreement 2020-2022 for information pertaining to tuition eligibility. 24 General Guidelines Eligibility All full-time employees are eligible to apply for tuition assistance. However, the Company cannot guarantee that all applications for tuition assistance will be granted. The availability of tuition assistance will depend on the number of applications for assistance and the dollars available for the program. Employees receiving assistance from sources outside of the Company (G.I. bill or scholarships) may apply for limited tuition assistance only to the extent of the difference between the total cost of tuition and registration fees and any reimbursement from other sources. Prior to submitting tuition assistance applications, employees must review with their supervisor the nature of their educational plan and its relationship to department and Company objectives. All courses must be related to a specific skill or knowledge required to maintain or improve the employee’s capability to perform the current responsibilities. Requests for reimbursement for courses that may prepare an employee for future positions will be considered based on the future availability of the position (s) and the employee’s potential of attaining the position(s). To be eligible for reimbursement, an employee must start and complete course work while in full-time active employment status and perform at an acceptable performance level (minimum Meets Expectations). Employees who are laid off or separated, through no fault of their own, while participating in the Tuition Assistance Program will be reimbursed for the approved course(s) that is underway at the time in which they were laid off or separated, providing they complete it satisfactorily and within the guidelines of this Policy. Employees who leave the Company voluntarily, prior to course completion, will not be reimbursed. Employees who are forced to withdraw from a course(s) due to an interor intra-company transfer will be reimbursed for tuition charges that they are not able to recover. 25 Institutions & Courses To qualify for tuition assistance, courses must be conducted by an accredited college or university as noted below. Consideration may also be given to courses offered by other recognized and established institutions. Seminars are considered outside the scope of this policy. Accreditation - In order to be approved under the program, the proposed USA educational institution will generally be required to be accredited by one of the following six regional associations: The New England Association of Schools and Colleges; The Middle States Association of Colleges and Schools; the North Central Association of Colleges and Schools; the Northwest Commission on Colleges and Universities; the Southern Association of Colleges and Schools; or the Western Association of Schools and Colleges. Accredited schools in the US must be included in the list of accredited schools found at the following link: US Database of Institutions. Accredited schools in Canada must be included in the list of accredited schools found at the following link: CAN Database of Institutions Tuition Refund An eligible employee will receive a refund of the full amount of the tuition and compulsory fees as noted below: • There is a maximum tuition amount allowed of $2,000.00* during the calendar year that applies to all non-credit college or university courses. • There is a $5,250.00* limit per calendar year for approved university or college credit courses. • The tuition assistance program will reimburse 100% of the cost of tuition, laboratory fees and registration fees (up to the maximum). Expenses for books, supplies, parking, thesis expenses, entrance equivalency exams, graduation fees, certification fees, transportation and meals are excluded from reimbursement. • Nemak recommends that students be limited to no more than 2 courses per semester to support and encourage a positive work life balance. • Reimbursement will be made after satisfactory completion of an approved course. Satisfactory completion will be defined as a grade of “C” or better at the undergraduate level, “B” or better at the graduate level or “Pass” under a Pass/Fail grading system. (*Above limits cannot be combined) Prepayment Privilege In the event the payment of tuition costs by the employee is burdensome and a hardship, employees who must pay over $1000 per semester for tuition fees may submit a request to their local Human Resources that Nemak pay the tuition, not to exceed the maximum allowed, directly to the university/college at the start of the course. Human Resources has the right, at their discretion, to deny the request or allow a partial pre-payment privilege depending on the circumstances. Employees who receive advanced tuition payment must have at least one-year service and will be responsible to follow the Employee Obligation Agreement on the Tuition Application form. 26 Employee Retention Agreement Reimbursement will be made only to those employees who are on the active payroll when payment is due and who execute an agreement to reimburse Nemak at 100% if the employee leaves the Company less than 12 months after reimbursement or at 50% if the employee leaves the Company 12 to 24 months after reimbursement. Approvals The tuition assistance application must be completed in advance of starting the first course outlining the requested Program and approvals attained from the Training Advisory Committee which is comprised of 3 or more members of management (including the HR Manager) at each location. Subsequent to initial approval of the Tuition Assistance Plan and in accordance with the Application, employees must submit a list of courses for pre-approval before each semester. Approval is based on the contribution to the general development and potential of the individual as an employee of the Company. The employee’s supervisor and HR department will be responsible for approving subsequent Applications. The Plant Human Resources Manager will be responsible for ensuring that all course registration and subsequent tuition reimbursement requests are in compliance with the Company’s applicable policies and within the initial coursework approval plan. Exceptions The HR Director will be responsible for any final interpretations or deviations of the Policy. The company retains the right to modify this policy and will review its effectiveness as needed. Revisions 0- September – 2014 1- September – 2018 2- October – 2020 3- October - 2022 Approved by HR Director Americas, USA/CAN, October 2022 Questions? For questions or comments about this policy, please contact BU Human Resources or Local HR. 27 E M PLOYEE REF ERRA L PROGRAM The Employee Referral Program provides an incentive award to any active full-time employee who brings new talent to Nemak by referring applicants who are selected and successfully employed in a full-time skilled trade or salaried position. Employees can earned up to $1,000 (less applicable taxes) payable in two increments: » $300 after the new hire’s 30th day of employment » $700 after the new hire’s 60th day of employment Note: Human Resource employees and employees involved in the hiring process are not eligible for this incentive. Candidates who are currently employed in any capacity by Nemak, have been previously referred by someone else or have previously applied for a position at Nemak are not eligible. See Human Resources to obtain the Employee Referral Form and additional information to make a referral. 28 T IM E O FF BENEFITS Vacation Policy Employees are entitled to paid vacation days each year. The amount of paid vacation time is based on the completed years of continuous employment with Nemak and is accrued on the number of full months worked during the calendar year. Salaried employees are eligible for vacation with pay at their individual base salary rates on the following basis: COMPLETED YEARS OF NEMAK SERVICE VACATION ENTITLEMENT 0-14 Years 20 Days (160 Hours) 15-19 Years 22.5 Days (180 Hours) 20+ Years 25 days (200 hours) Normally, vacation hours are taken in full day (8 hours) increments but may be scheduled and taken in increments of a half day (4 hours). Management will make every effort to accommodate the request for vacation time for the requesting employee. However, business conditions could require a change in scheduling. In the event that the operation of a work unit may be impaired by scheduled vacations, the manager may limit the number of employees who can take vacation at the same time. In such cases, the Manager, in their sole discretion, will approve vacations based on the operational needs of the department/unit. There is no carry-over of vacation from one calendar year to the next. Any unused vacation time at year-end will be forfeited. Illness/Injury Leave Policy In case of illness or accident occurring on or before the last working day before a scheduled vacation begins, arrangements may be made to postpone the vacation. Illness or accident during a vacation, however, does not entitle an employee to additional time off. A long-term illness or injury that prevents the employee from taking all their vacation entitlement at year-end may be paid out with written approval from the Human Resources Manager. 29 Personal Time Off Policy All salaried employees are entitled to two personal days per year, prorated for new hires, to manage these absences. Personal days are to be used for appointments and other dealings in their daily lives that prevent them from being at work, but generally do not fit the definition of vacation time or result in their own personal illness. If the days are not needed for personal reasons, the employee is free to use them at their discretion. If the employee routinely or occasionally has matters that prevent him/her from being at work outside of personal illness, the Company recommends that the employee keep them “on reserve” for these purposes. For the purposes of overtime calculation for entitled salaried employees, vacation days and personal days as outlined in this policy shall be included in the 40-hour calculation. Holidays Nemak provides nine (9) paid holidays each year. Those holidays are as follows: • New Year’s Day • Good Friday • Memorial Day • Independence Day • Labor Day • Thanksgiving Day • Friday after Thanksgiving Day • Christmas Eve • Christmas Day Parental Leave After one year of full-time employment, Nemak provides paid leave associated with the birth of an employee’s own child, or for the placement of a child with the employee in connection with adoption or foster care. Parental leave is paid for a maximum of two weeks and is not charged against the employee’s other paid leave credits. 30 A D D ITIO NAL BENEFITS EMPLOYEE RECOGNITION PROGRAMS Nemak Choice Awards Nemak USA participates annually in Nemak Choice Awards, a voluntary recognition program in which employees may receive additional monetary compensation for projects in which they have participated. BRAVO! Managers and supervisors can recognize colleagues who go above and beyond through the BRAVO! Dashboard (located in myNemak). COMMUNITY STEWARDSHIP Sustainability Nemak aims to be a pacesetter in the automotive industry’s shift toward sutainable, emission-fress mobility. We are committed to systematically enhancing our energy efficiency and increasingly embracing circular economy principles. Nemak’s vision of sustainability encompasses our people and nearby communities as well. We continuously look for new ways to enhance employee safety, wellbeing, and diversity. In addition, we strives to be an exemplary corporate citizen of communities in which we operate production facilities. 31 Appendix 32 I M P O RTAN T L EGAL NOTICES A F F ECTING YO U R HEALTH PLAN COVERAGE THE WOMEN’S HEALTH CANCER RIGHTS ACT OF 1998 (WHCRA) If you have had or are going to have a mastectomy, you may be entitled to certain benefits under the Women’s Health and Cancer Rights Act of 1998 (WHCRA). For individuals receiving mastectomy-related benefits, coverage will be provided in a manner determined in consultation with the attending physician and the patient, for: • All stages of reconstruction of the breast on which the mastectomy was performed; • Surgery and reconstruction of the other breast to produce a symmetrical appearance; • Prostheses; and • Treatment of physical complications of the mastectomy, including lymphedema. These benefits will be provided subject to the same deductibles and coinsurance applicable to other medical and surgical benefits provided under this plan. NOTICE OF 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 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 toward your or your dependents’ other coverage). However, you must request enrollment within 30 days after your or your dependents’ other coverage ends (or after the employer stops contributing toward the other coverage). 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. Further, if you decline enrollment for yourself or eligible dependents (including your spouse) while Medicaid coverage or coverage under a State CHIP program is in effect, you may be able to enroll yourself and your dependents in this plan if: • coverage is lost under Medicaid or a State CHIP program; or • you or your dependents become eligible for a premium assistance subsidy from the State. In either case, you must request enrollment within 60 days from the loss of coverage or the date you become eligible for premium assistance. To request special enrollment or obtain more information, contact the person listed at the end of this summary. 33 NOTICE REGARDING WELLNESS PROGRAMS Nemak makes available is a voluntary wellness program available to all employees. The program is administered according to federal rules permitting employer-sponsored wellness programs that seek to improve employee health or prevent disease, including the Americans with Disabilities Act of 1990, the Genetic Information Nondiscrimination Act of 2008, and the Health Insurance Portability and Accountability Act, as applicable, among others. If you choose to participate in the wellness program you will be asked to complete a voluntary annual physical/wellness exam with your chosen Primary Care Physician (PCP). You are not required to participate in the Nemak wellness program, however, employees who choose to participate in the wellness program will receive an incentive of a discount on medical plan premiums for the following plan year. The information from your annual voluntary physical/wellness exam with your PCP can be used to provide you with information to help you understand your current health and potential risks as discussed between yourself and your PCP. Protections from Disclosure of Medical Information We are required by law to maintain the privacy and security of your personally identifiable health information. Although the wellness program and Nemak may use aggregate information it collects to design a program based on identified health risks in the workplace, Nemak will never disclose any of your personal information either publicly or to the employer, except as necessary to respond to a request from you for a reasonable accommodation needed to participate in the wellness program, or as expressly permitted by law. Medical information that personally identifies you that is provided in connection with the wellness program will not be provided to your supervisors or managers and may never be used to make decisions regarding your employment. Your health information will not be sold, exchanged, transferred, or otherwise disclosed except to the extent permitted by law to carry out specific activities related to the wellness program, and you will not be asked or required to waive the confidentiality of your health information as a condition of participating in the wellness program or receiving an incentive. Anyone who receives your information for the purpose of providing you services as part of the wellness program will abide by the same confidentiality requirements. The only individual(s) who will receive your personally identifiable health information is Blue Cross Blue Shield of Tennessee (wellness exams are submitted by your PCP for claim processing under the Nemak medical plan) in order to provide proof of employee participation in the wellness program. In addition, all medical information obtained through the wellness program will be maintained separate from your personnel records, information stored electronically will be encrypted, and no information you provide as part of the wellness program will be used in making any employment decision. Appropriate precautions will be taken to avoid any data breach, and in the event a data breach occurs involving information you provide in connection with the wellness program, we will notify you immediately. 34 You may not be discriminated against in employment because of the medical information you provide as part of participating in the wellness program, nor may you be subjected to retaliation if you choose not to participate. If you have questions or concerns regarding this notice, or about protections against discrimination and retaliation, please contact the Nemak representative named to the right. CONTACT INFORMATION Questions regarding any of this information can be directed to: Laura Deschaine Nemak 2 Towne Square, Suite 300 Southfield, Michigan 48076 United States 248-229-5446 [email protected] 35 THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY. YOUR INFORMATION. YOUR RIGHTS. OUR RESPONSIBILITIES. Recipients of the notice are encouraged to read the entire notice. Contact information for questions or complaints is available at the end of the notice. YOUR RIGHTS OUR USES AND DISCLOSURES • You have the right to: We may use and share your information as we: • Get a copy of your health and claims records • Help manage the health care treatment you receive • Correct your health and claims records • Run our organization • Request confidential communication • Pay for your health services • Ask us to limit the information we share • Administer your health plan • Get a list of those with whom we’ve shared your information • Help with public health and safety issues • Get a copy of this privacy notice • Do research • Choose someone to act for you • Comply with the law • File a complaint if you believe your privacy rights have been violated • Respond to organ and tissue donation requests and work with a medical examiner or funeral director YOUR CHOICES • Address workers’ compensation, law enforcement, and other government requests You have some choices in the way that we use and share information as we: • Respond to lawsuits and legal actions • Answer coverage questions from your family and friends • Provide disaster relief YOUR RIGHTS • Market our services and sell your information When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you. 36 Get a copy of health and claims records • You can ask to see or get a copy of your health and claims records and other health information we have about you. Ask us how to do this. • We will provide a copy or a summary of your health and claims records, usually within 30 days of your request. We may charge a reasonable, cost-based fee. Ask us to correct health and claims records • You can ask us to correct your health and claims records if you think they are incorrect or incomplete. Ask us how to do this. • We may say “no” to your request, but we’ll tell you why in writing, usually within 60 days. Request confidential communications • You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. • We are not required to agree to your request. Get a list of those with whom we’ve shared information • You can ask for a list (accounting) of the times we’ve shared your health information for up to six years prior to the date you ask, who we shared it with, and why. • Choose someone to act for you • If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. • We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months. We will make sure the person has this authority and can act for you before we take any action. File a complaint if you feel your rights are violated • You can complain if you feel we have violated your rights by contacting us using the information at the end of this notice. • You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/. • We will not retaliate against you for filing a complaint. We will consider all reasonable requests and must say “yes” if you tell us you would be in danger if we do not. Ask us to limit what we use or share • You can ask us not to use or share certain health information for treatment, payment, or our operations. • Get a copy of this privacy notice You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly. For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions. In these cases, you have both the right and choice to tell us to: • Share information with your family, close friends, or others involved in payment for your care • Share information in a disaster relief situation If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety. 37 • In these cases we never share your information unless you give us written permission: • Marketing purposes • Sale of your information OUR USES AND DISCLOSURES How do we typically use or share your health information? We typically use or share your health information in the following ways. Help manage the health care treatment you receive We can use your health information and share it with professionals who are treating you. Example: A doctor sends us information about your diagnosis and treatment plan so we can arrange additional services. Pay for your health services We can use and disclose your health information as we pay for your health services. Example: We share information about you with your dental plan to coordinate payment for your dental work. Administer your plan We may disclose your health information to your health plan sponsor for plan administration. Example: Your company contracts with us to provide a health plan, and we provide your company with certain statistics to explain the premiums we charge. Run our organization • We can use and disclose your information to run our organization and contact you when necessary. • We are not allowed to use genetic information to decide whether we will give you coverage and the price of that coverage. This does not apply to long-term care plans. Example: We use health information about you to develop better services for you. How else can we use or share your health information? We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html. Help with public health and safety issues We can share health information about you for certain situations such as: • Preventing disease • Helping with product recalls • Reporting adverse reactions to medications • Reporting suspected abuse, neglect, or domestic violence • Preventing or reducing a serious threat to anyone’s health or safety Do research We can use or share your information for health research. Comply with the law We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law. Respond to organ and tissue donation requests and work with a medical examiner or funeral director • We can share health information about you with organ procurement organizations. 38 • We can share health information with a coroner, medical examiner, or funeral director when an individual dies. Address workers’ compensation, law enforcement, and other government requests We can use or share health information about you: • For workers’ compensation claims • For law enforcement purposes or with a law enforcement official • With health oversight agencies for activities authorized by law • For special government functions such as military, national security, and presidential protective services Respond to lawsuits and legal actions We can share health information about you in response to a court or administrative order, or in response to a subpoena. Our Responsibilities • We are required by law to maintain the privacy and security of your protected health information. • We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information. • We must follow the duties and privacy practices described in this notice and give you a copy of it. • We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind. For more information see: www.hhs.gov/ocr/privacy/hipaa/ understanding/consumers/noticepp.html. CHANGES TO THE TERMS OF THIS NOTICE We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, on our web site (if applicable), and we will mail a copy to you. OTHER INSTRUCTIONS FOR NOTICE Effective Date of this Notice: October 1, 2022 Laura Deschaine Nemak 2 Towne Square, Suite 300 Southfield, Michigan 48076 United States 248-229-5446 [email protected] 39 I M P O RTAN T N OT IC E F ROM NEMA K USA IN C . ABOUT YOUR PRESCRIPTION DRUG COVERAGE & 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 Nemak USA Inc. 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. When Can You Join A Medicare Drug Plan? You can join a Medicare drug plan when you first become eligible for Medicare and each year from October 15thto December 7th. There are two important things you need to know about your current coverage and Medicare’s prescription drug coverage: If you do decide to join a Medicare drug plan and drop your current Nemak USA Inc. Medical plan coverage, be aware that you and your dependents will be able to get this coverage back. 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. Nemak USA Inc. has determined that the prescription drug coverage offered by the Nemak USA Inc. Medical 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. 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. 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 Nemak USA Inc Plan coverage will not be affected. 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 Nemak USA Inc. 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 October to join. 40 FOR MORE INFORMATION ABOUT THIS NOTICE OR YOUR CURRENT PRESCRIPTION DRUG COVERAGE… Contact the person listed below for further information NOTE: You’ll get this notice each year. You will also get it before the next period you can join a Medicare drug plan, and if this coverage through Nemak USA Inc. changes. You also may request a copy of this notice at any time. Date: October 1, 2022 Name of Entity/Sender: Nemak USA, Inc. Contact--Position/Office: Laura Deschaine Address: 2 Towne Square, Suite 300, Southfield, Michigan 48076 United States Phone Number: 248-229-5446 41 Form Approved OMBNo.1210-0149 (expires 6-30-2023) NEW HE ALTH INS U RA NCE MA RKETP L AC E COVERAGE OPTIONS AND YOUR HEALTH COVERAGE PART A: GENERAL INFORMATION When key parts of the health care law take effect in 2014, there will be a new way to buy health insurance: the Health Insurance Marketplace. To assist you as you evaluate options for you and your family, this notice provides some basic information about the new Marketplace and employment-based health coverage offered by your employer. What is the Health Insurance Marketplace? The Marketplace is designed to help you find health insurance that meets your needs and fits your budget. The Marketplace offers “onestop shopping” to find and compare private health insurance options. You may also be eligible for a new kind of tax credit that lowers your monthly premium right away. Open Enrollment for health insurance coverage through the Marketplace begins in October 2013 for coverage starting as early as January 1, 2014. Can I Save Money on my Health Insurance Premiums in the Marketplace? You may qualify to save money and lower your monthly premium, but only if your employer does not offer coverage, or offers coverage that doesn’t meet certain standards. The savings on your premium that you’re eligible for depends on your household income. Does Employer Health Coverage Affect Eligibility for Premium Savings through the Marketplace? Yes. If you have an offer of health coverage from your employer that meets certain standards, you will not be eligible for a tax credit through the Marketplace and may wish to enroll in your employer’s health plan. However, you may be eligible for a tax credit that lowers your monthly premium, or a reduction in certain cost-sharing if your employer does not offer coverage to you at all or does not offer coverage that meets certain standards. If the cost of a plan from your employer that would cover you (and not any other members of your family) is more than 9.5% of your household income for the year, or if the coverage your employer provides does not meet the “minimum value” standard set by the Affordable Care Act, you may be eligible for a tax credit.1 Note: If you purchase a health plan through the Marketplace instead of accepting health coverage offered by your employer, then you may lose the employer contribution (if any) to the employer-offered coverage. Also, this employer contribution -as well as your employee contribution to employer-offered coverage- is often excluded from income for Federal and State income tax purposes. Your payments for coverage through the Marketplace are made on an after-tax basis. How Can I Get More Information? For more information about your coverage offered by your employer, please check your summary plan description or contact. The Marketplace can help you evaluate your coverage options, including your eligibility for coverage through the Marketplace and its cost. Please visit HealthCare.gov for more information, including an online application for health insurance coverage and contact information for a Health Insurance Marketplace in your area. 1 An employer - sponsored health plan meets the “minimum value standard” if the plan’s share of the total allowed benefit costs covered by the plan is no less than 60 percent of such costs. 42 PART B: INFORMATION ABOUT HEALTH COVERAGE OFFERED BY YOUR EMPLOYER This section contains information about any health coverage offered by your employer. If you decide to complete an application for coverage in the Marketplace, you will be asked to provide this information. This information is numbered to correspond to the Marketplace application. 3. Employer name 4. Employer Identification Number (EIN) Nemak USA, Inc. 62-1298183 5. Employer address 7. City 1635 Old Columbia Rd Dickson 6. Employer phone number 8. State 248-304-4033 9. ZIP code TN 37055 10. Who can we contact about employee health coverage at this job? Laura Oatney 11. Phone number (if different from above) 12. Email address [email protected] Here is some basic information about health coverage offered by this employer: • As your employer, we offer a health plan to: � All employees. Eligible employees are: � Some employees. Eligible employees are: 43 • With respect to dependents: � We do offer coverage. Eligible dependents are: � We do not offer coverage. � If checked, this coverage meets the minimum value standard*, and the cost of this coverage to you is intended to be affordable, based on employee wages. ** Even if your employer intends your coverage to be affordable, you may still be eligible for a premium discount through the Marketplace. The Marketplace will use your household income, along with other factors, to determine whether you may be eligible for a premium discount. If, for example, your wages vary from week to week (perhaps you are an hourly employee or you work on a commission basis), if you are newly employed mid-year, or if you have other income losses, you may still qualify for a premium discount. If you decide to shop for coverage in the Marketplace, HealthCare.gov will guide you through the process. Here's the employer information you'll enter when you visit HealthCare.gov to find out if you can get a tax credit to lower your monthly premiums PREMIUM ASSISTANCE UNDER MEDICAID AND THE CHILDREN’S HEALTH INSURANCE PROGRAM (CHIP) If you or your children are eligible for Medicaid or CHIP and you’re eligible for health coverage from your employer, your state may have a premium If you or your children are eligible for Medicaid or CHIP and you’re eligible for health coverage from your employer, your state may have a premium assistance program that can help pay for coverage, using funds from their Medicaid or CHIP programs. If you or your children aren’t eligible for Medicaid or CHIP, you won’t be eligible for these premium assistance programs but you may be able to buy individual insurance coverage through the Health Insurance Marketplace. For more information, visit www.healthcare.gov. If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, contact your State Medicaid or CHIP office to find out if premium assistance is available. If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, contact your State Medicaid or CHIP office or dial 1-877-KIDS NOW or www.insurekidsnow.gov to find out how to apply. If you qualify, ask your state if it has a program that might help you pay the premiums for an employer-sponsored plan. 44 If you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your employer plan, your employer must allow you to enroll in your employer plan if you aren’t already enrolled. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance. If you have questions about enrolling in your employer plan, contact the Department of Labor at www.askebsa.dol.gov or call 1-866-444-EBSA (3272). If you live in one of the following states, you may be eligible for assistance paying your employer health plan premiums. The following list of states is current as of January 31, 2023. Contact your State for more information on eligibility – ALABAMA – Medicaid ALASKA – Medicaid The AK Health Insurance Premium Payment Program Website: http://myakhipp.com/ Phone: 1-866-251-4861 Email: [email protected] Medicaid Eligibility: https://health.alaska.gov/dpa/Pages/default.aspx Website: http://myalhipp.com Phone: 1-855-692-5447 ARKANSAS – Medicaid Website: http://myarhipp.com/ Phone: 1-855-MyARHIPP (855-692-7447) COLORADO Health First Colorado (Colorado’s Medicaid Program) & Child Health Plan Plus (CHP+) CALIFORNIA – Medicaid Website: Health Insurance Premium Payment (HIPP) Program http://dhcs.ca.gov/hipp Phone: 916-445-8322 Fax: 916-440-5676 Email: [email protected] FLORIDA – Medicaid Health First Colorado Website: https://www.healthfirstcolorado.com/ Health First Colorado Member Contact Center: 1-800-221-3943/ State Relay 711 Website: https://www.flmedicaidtplrecovery.com/flmedicaidtplrecovery. CHP+: https://www.colorado.gov/pacific/hcpf/child-health-plan-plus com/hipp/index.html CHP+ Customer Service: 1-800-359-1991/ State Phone: 1-877-357-3268 Relay 711 Health Insurance Buy-In Program (HIBI): https://www.colorado.gov/pacific/hcpf/health-insurance-buy-program HIBI Customer Service: 1-855-692-6442 45 GEORGIA – Medicaid GA HIPP Website: https://medicaid.georgia.gov/health-insurancepremium-payment-program-hipp Phone: 678-564-1162, Press 1 GA CHIPRA Website: https://medicaid.georgia.gov/programs/third-partyliability/childrens-health-insurance-program-reauthorization-act-2009-chipra Phone: (678) 564-1162, Press 2 IOWA – Medicaid and CHIP (Hawki) Medicaid Website: https://dhs.iowa.gov/ime/members Medicaid Phone: 1-800-338-8366 Hawki Website: http://dhs.iowa.gov/Hawki Hawki Phone: 1-800-257-8563 HIPP Website: https://dhs.iowa.gov/ime/members/medicaid-a-to-z/hipp HIPP Phone: 1-888-346-9562 KENTUCKY – Medicaid Kentucky Integrated Health Insurance Premium Payment Program (KI-HIPP) Website: https://chfs.ky.gov/agencies/dms/member/Pages/kihipp.aspx Phone: 1-855-459-6328 Email: [email protected] KCHIP Website: https://kidshealth.ky.gov/Pages/index.aspx Phone: 1-877-524-4718 Kentucky Medicaid Website: https://chfs.ky.gov MAINE – Medicaid Enrollment Website: https://www.maine.gov/dhhs/ofi/applications-forms Phone: 1-800-442-6003 TTY: Maine relay 711 Private Health Insurance Premium Webpage: https://www.maine.gov/dhhs/ofi/applications-forms Phone: -800-977-6740 TTY: Maine relay 711 INDIANA – Medicaid Healthy Indiana Plan for low-income adults 19-64 Website: http://www.in.gov/fssa/hip/ Phone: 1-877-438-4479 All other Medicaid Website: https://www.in.gov/medicaid/ Phone 1-800-457-4584 KANSAS – Medicaid Website: https://www.kancare.ks.gov/ Phone: 1-800-792-4884 LOUISIANA – Medicaid Website: www.medicaid.la.gov or www.ldh.la.gov/lahipp Phone: 1-888-342-6207 (Medicaid hotline) or 1-855-618-5488 (LaHIPP) MASSACHUSETTS – Medicaid and CHIP Website: https://www.mass.gov/masshealth/pa Phone: 1-800-862-4840 TTY: (617) 886-8102 46 MINNESOTA – Medicaid Website: https://mn.gov/dhs/people-we-serve/children-and-families/ health-care/health-care-programs/programs-and-services/otherinsurance.jsp Phone: 1-800-657-3739 MONTANA – Medicaid Website: http://dphhs.mt.gov/MontanaHealthcarePrograms/HIPP Phone: 1-800-694-3084 Email: [email protected] NEVADA – Medicaid Medicaid Website: http://dhcfp.nv.gov Medicaid Phone: 1-800-992-0900 NEW JERSEY – Medicaid and CHIP Medicaid Website: http://www.state.nj.us/humanservices/ dmahs/clients/ medicaid/ Medicaid Phone: 609-631-2392 CHIP Website: http://www.njfamilycare.org/index.html CHIP Phone: 1-800-701-0710 NORTH CAROLINA – Medicaid Website: https://medicaid.ncdhhs.gov/ Phone: 919-855-4100 OKLAHOMA – Medicaid and CHIP Website: http://www.insureoklahoma.org Phone: 1-888-365-3742 MISSOURI – Medicaid Website: http://www.dss.mo.gov/mhd/participants/pages/hipp.htm Phone: 573-751-2005 NEBRASKA – Medicaid Website: http://www.ACCESSNebraska.ne.gov Phone: 1-855-632-7633 Lincoln: 402-473-7000 Omaha: 402-595-1178 NEW HAMPSHIRE – Medicaid Website: https://www.dhhs.nh.gov/programs-services/medicaid/healthinsurance-premium-program Phone: 603-271-5218 Toll free number for the HIPP program: 1-800-852-3345, ext. 5218 NEW YORK – Medicaid Website: https://www.health.ny.gov/health_care/medicaid/ Phone: 1-800-541-2831 NORTH DAKOTA – Medicaid Website: http://www.nd.gov/dhs/services/medicalserv/medicaid/ Phone: 1-844-854-4825 OREGON – Medicaid Website: http://healthcare.oregon.gov/Pages/index.aspx http://www.oregonhealthcare.gov/index-es.html Phone: 1-800-699-9075 47 PENNSYLVANIA – Medicaid Website: https://www.dhs.pa.gov/Services/Assistance/Pages/HIPP-Program.aspx Phone: 1-800-692-7462 SOUTH CAROLINA – Medicaid Website: https://www.scdhhs.gov Phone: 1-888-549-0820 TEXAS – Medicaid Website: http://gethipptexas.com/ Phone: 1-800-440-0493 VERMONT– Medicaid Website: http://www.greenmountaincare.org/ Phone: 1-800-250-8427 WASHINGTON – Medicaid Website: https://www.hca.wa.gov/ Phone: 1-800-562-3022 WISCONSIN – Medicaid and CHIP Website: https://www.dhs.wisconsin.gov/badgercareplus/p-10095.htm Phone: 1-800-362-3002 RHODE ISLAND – Medicaid and CHIP Website: http://www.eohhs.ri.gov/ Phone: 1-855-697-4347, or 401-462-0311 (Direct RIte Share Line) SOUTH DAKOTA - Medicaid Website: http://dss.sd.gov Phone: 1-888-828-0059 UTAH – Medicaid and CHIP Medicaid Website: https://medicaid.utah.gov/ CHIP Website: http://health.utah.gov/chip Phone: 1-877-543-7669 VIRGINIA – Medicaid and CHIP Website: https://www.coverva.org/en/famis-select https://www.coverva.org/en/hipp Medicaid Phone: 1-800-432-5924 CHIP Phone: 1-800-432-5924 WEST VIRGINIA – Medicaid and CHIP Website: https://dhhr.wv.gov/bms/ http://mywvhipp.com/ Medicaid Phone: 304-558-1700 CHIP Toll-free phone: 1-855-MyWVHIPP (1-855-699-8447) WYOMING – Medicaid Website: https://health.wyo.gov/healthcarefin/medicaid/programs-and-eligibility/ Phone: 1-800-251-1269 48 To see if any other states have added a premium assistance program since January 31, 2023, or for more information on special enrollment rights, contact either: U.S. Department of Labor Employee Benefits Security Administration www.dol.gov/agencies/ebsa 1-866-444-EBSA (3272) U.S. Department of Health and Human Services Centers for Medicare & Medicaid Services www.cms.hhs.gov 1-877-267-2323, Menu Option 4, Ext. 61565 49 Paperwork Reduction Act Statement According to the Paperwork Reduction Act of 1995 (Pub. L. 104-13) (PRA), no persons are required to respond to a collection of information unless such collection displays a valid Office of Management and Budget (OMB) control number. The Department notes that a Federal agency cannot conduct or sponsor a collection of information unless it is approved by OMB under the PRA, and displays a currently valid OMB control number, and the public is not required to respond to a collection of information unless it displays a currently valid OMB control number. See 44 U.S.C. 3507. Also, notwithstanding any other provisions of law, no person shall be subject to penalty for failing to comply with a collection of information if the collection of information does not display a currently valid OMB control number. See 44 U.S.C. 3512. The public reporting burden for this collection of information is estimated to average approximately seven minutes per respondent. Interested parties are encouraged to send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the U.S. Department of Labor, Employee Benefits Security Administration, Office of Policy and Research, Attention: PRA Clearance Officer, 200 Constitution Avenue, N.W., Room N-5718, Washington, DC 20210 or email [email protected] and reference the OMB Control Number 1210-0137. 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92