2014 EMPLOYEE BENEFITS GUIDE
`
`Non—Union
`
`|||inois & Wisconsin
`
`Jiawei et al. Exhibit 1022 Page 1
`
`'2
`Meswow Financia|®
`
`Independent Minds.
`Innovative Solutions.
`
`Jiawei et al. Exhibit 1022 Page 1
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`

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`Medical benefits are insured by:
`
`Cigna
`
`ChoiceFund HSA Open Access Plus
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`
`
`‘
`
`Plan Deductible
`$1,500 per individual
`$3,000 per individual
`$3.000 per family
`$6.000 per family
`coinsurance
`
`90%
`
`60%
`
`
`
`.'PIanDeducibieV
`$300 per individual
`$600 per family
`coinsurance
`90%
`
`W"
`
`7
`Plan Deductible
`6’
`‘V
`$400 per individual
`$600 per individual
`$800 per family
`$1,200 per family
`
`coinsurance
`
`90%
`
`70%
`
`Out-of-Pocket Maximum
`includes deducbble, coinsurance 6. copayments
`
`COMBINED Out-of-Pocket Maximum
`includes deductible A‘. coinsurance
`
`
`
`
`$6,000 per individual
`$3,000 per individual
`$12,000 per family
`$6,000 per family
`Doctor Office ifisit
`applies to consultation only
`10% after
`40% after
`plan deductible
`plan deductible
`Prescription Drug Card
`Retail
`
`10% after
`plan deductible
`
`no coverage
`
`Mail Order
`90 day-supply
`Preventive Maintenance Generic: 0%, deductible waived
`Other: 10% after
`no coverage
`plan deductible
`
`
`
`Specialty lnjectables: 10%
`after plan deductible
`Prescription Out-oi-Pocket
`Prescription Drug expenses apply towards
`a COMBINED Out-of-Pocket Maximum
`
`
`
`
`
`
`Out-of-Pocket Maximum
`includes deductible, coinsurance & copayments
`
`$3,000 per individual
`$6,000 per family
`Doctor Office Visit
`applies to consultation only
`$30 copay Primary Care (PCP)
`$40 copay Specialist
`Prescription Drug Card
`Retail
`Generic: $10 copay
`Preferred Brand: $40 copay
`Non-preferred Brand: $60 copay
`Specialty lnjectabies: greater of $75 copay
`or 20% coinsurance
`
`Mail Order
`90 day-supply
`Preventive Maintenance Generic: $0 copay
`Generic: $20 copay
`Preferred Brand: $80 copay
`Non-preferred Brand: $120 copay
`Specialty lnjectables: greater of $150 copay
`or 20% coinsurance
`Prescription Out-of-Pocket
`$2,000 per individual
`$4,000 per individual
`
`$8,700 per individual
`$4,350 per individual
`$17,400 per family
`$8,700 per family
`Doctor Office Visit
`applies to consultation only
`$30 copay (PCP)
`30% after
`$40 copay Specialist
`plan deductible
`Prescription Drug Card
`Retail
`
`Generic: $10 copay
`Preferred Brand: $40 copay
`Non-preferred Brand: $60 copay
`Specialty lnjectabies: greater of $75 copay
`or 20% coinsurance
`
`no coverage
`
`Mail Order
`90 day-supply
`Preventive Maintenance Generic: $0 copay
`Generic: $20 copay
`no coverage
`Preferred Brand: $80 copay
`Non-preferred Brand: $120 copay
`Specialty lnjectabies: greater of $150 copay
`or 20% coinsurance
`Prescription Out-of-Pocket
`$2,000 per individual
`$4,000 per individual
`
`not available
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`
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`
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`
`
`
`
`available hrough Chase Bank
`Annual Employer contribution:
`3500
`$1,000
`$1,000
`
`
`
`
`
`Single
`Employee + One Dependent
`Family
`
`
`important Phone Numbers
`
`
`
`
`
`
`
`Log on:
`
`CIGNA Access for Members: www.mycigna.com
`CIGNA Provider Finden www.mycigna.com
`
`
`
`
`CIGNA Member Customer Service: 800-C|GNA24
`(800) 244-6224
`
`
`
`Payroll Deductions /Medical contributions
`Cost Per Paycheck (26 pay periods)
`OAP In-Network
`OAP
`$54.19
`$69.31
`$170.13
`$207.92
`$119.71
`$159.93
`$182.73
`$226.83
`'.-_,.‘
`_.,.
`
`ChoiceFund HSA OAP
`$46.63
`$117.40
`$81.91
`$130.76
`
`
`
`
`
`
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`
`
`Tobco-ee
`V
`.00
`BMI or Body Fat %
`up to $7.50
`up to $7.50
`
`
`Glucose < 100
`$5.00
`$5.00
`
`
`Cholesterol < 5.0
`$3.75
`$3.75
`
`
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`BF’ < 130/85
`$3.75
`$3.75
`
`up to $25.00
`TOTAL BIOMETRIC CREDIT
`
`
`
`
`401(K) Plan
`Our 401K plan is administered by Great West. You are eligible to enroll in the 401K plan at the beginning of the month following 60 days of service. You are
`allowed to contribute up to the IRS maximum which changes annually (note: the 2014 contribution limit is $17,500).
`If you are age 50 or older, you are also entitled
`to make an additional "catch-up contribution". The catch-up contribution limit is also set by iRS annually and it equals $5,500 for 2014.
`individual contributions are
`always 100% vested. Coleman Cable may match a portion of your contributions through employer matching contributions, however, these contributions are
`discretionary and they may vary from year to year. There is a 2-year vesting period for discretionary contributions (including match), Le. 50% one year, 100% two
`years.
`
`up to $25.00
`
`You will be prompted to use your Social Security Number, PIN followed by the # sign
`
`Great West Access for Members: wvvw.gwrs.com
`
`Great West Phone number: 800-3384015
`
`Great West Contacts 401(K)
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`Jiawei et al. Exhibit 1022 Page 2
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`
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`
`
`Employee
`Employee + Spouse
`Employee + Chiid(ren)
`Family
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`
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`Jiawei et al. Exhibit 1022 Page 2
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`

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`Basic life/AD&D, supplemental life, voluntary
`AD&D and voluntary long term disability
`benefits are insured b :
`34'-INN“ STRNDHHD
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`Life/AD&D Insurance
`You must be regularly scheduled to work at least 32 hours per
`
`week. Basic group life/AD&D insurance equals 1 times your
`annual salary ($50,000 minimum / $400,000 maximum).
`Coleman Cable pays 100% of the premiums for basic
`life/AD&D insurance.
`
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`Supplemental Life and AD&D
`Supplemental Employee l Spouse l Dependent Life and AD&D
`are also available for purchase at your own cost
`
`
`
`Benefit Amount
`increments of $10,000
`
` Guarantee Issue
`$1 50,000
`
` Maximum Life Benefits
`$500,000
`
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`
`
`
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`
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`
`
`
` Spouse
`Benefit Amount
`Spouse cannot elect more than 100% of the employees coverage
`
`increments of $10,000
`Guarantee lssue
`$30,000
`
`
`Maximum Life Benefits
`$250,000
`
` Children
`Up to age 26
`
`Benefit Amount
`increments of $5,000
`Guarantee Issue
`$25,000
`Maximum Life Benefits
`$25,000
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` Optional Lil otl a_te r_$ 000 of Befit I
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`Dental benefits are insured by:
`
`Cigna
`
`Dental PPO Plan
`
`Calendar Year Maximum
`Preventive/Diagnostic Services Do Not Apply
`$1,000 per individual
`$1,000 per individual
`
`Calendar Year Deductible
`
`$50 per individual
`$150 per family
`
`$50 per individual
`$150 per family
`
`Preventive & Diagnostic Care (Deductible waived)
`Cleanings, Exams, Fluoride Treatment, Sealants, Space Maintainers
`100%
`100%
`
`Basic Restorative Care
`Fillings, Oral Surgery, Penbdontlcs, Endodontics
`80% after deductible
`80% after deductible
`
`Major Restorative Care
`Crowns, Bridges, Dentures
`
`50% after deductible
`
`50% after deductible
`
`Orthodontia
`For dependent children to age 19
`50% after deductible
`50% after deductible
`
`Lifetime Orthodontia Maximum
`$2,000 per individual
`
`Usual & Customary paid 80th percentile
`
`Payroll Deductions / Dental contributions
`
`
`Cost Per Paycheck (26 pay periods)
`
`Dental PPO
`
`$11 .99
`$23.62
`$29.98
`
`Employee
`Employee + Spouse
`Employee + Chi|d(ren)
`Family
`
`
`
`
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`Vision benefits are insured by:
`
`Vision Plan
`
`0 Eye Examevery 12\months
`
`$45 allowance
`Covered in full
`Lenses, Contact Lenses & Frames every 12 months
`$150 allowance
`$96 allowance
`
`Payroll Deductions / Vision Contributions
`Cost Per Paycheck (26 pay periods)
`
`Employee
`Employee 4- Spouse
`Employee + Chi|d(ren)
`Family
`
`Short - Term Disability
`Short term disability coverage provides financial protection in the event of illness or injury.
`STD benefits begin on the 6th consecutive day of sickness or injury, payable from the first
`day of absence, The benefit amount is based on your weekly earnings and your length of
`service with the company - please refer to the employee handbook for details. Benefits
`are paid up to a maximum period of 13 weeks. Coleman Cable sponsors the Short Term
`Disability benefits at no cost to you.
`
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`‘
`
`0.90
`0.90
`110
`1.60
`2.50
`430
`6.90
`10.90
`18.80
`28.70
`48.90
`79.90
`
`
`
`Less than 30
`Age 30 - 34
`Age 35 - 39
`Age 40 - 44
`Age 45 - 49
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`Age 50 - 54
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`Age 55 - 59
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`Age 60 — 64
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`Age 65 — 69
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`Age 70 - 74
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`Age 75 -79
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`80+
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`Ae0-26
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`
`
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`$0.60 er $55,000 of Benefit
`
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`Voluntary Long - Term Disability
` For periods of disability lasting longer than 90 days, voluntary
`long-term disability coverage is available at an affordable price.
`
`If you become disabled due to a non-work-related illness or
`injury, this benefit pays you up to 60% of your monthly
`earnings, to a maximum of $7,000 per month.
`
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`Jiawei et al. Exhibit 1022 Page 3
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`Jiawei et al. Exhibit 1022 Page 3
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`

`
`YOUR EMPLOYEE BENEFITS
`
` DENTAL
`
`90.0‘:
`
`Cigna.
`
`Choosing a Dental Plan
`Our dental plan is provided by Cigna.
`DENTAL PPO works in the same way as the medical PPO in
`that you will receive the maximum benefits if you receive care
`from a PPO in-network dentist. While you may still be covered
`if you choose an out-of—network dentist, those benefits are
`limited to “usual and customary” (U&C) rates prevailing in the
`geographic areas in which the expenses are incurred.
`
`
`w\wv.ci<_rna.com
`
`,-9.”
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`Cigna.
`
`choosing a Vision Plan
`Our vision plan is provided by Cigna and it allows you the
`choice to visit an in-network or out—of—network vision care
`
`provider, however, you will receive the maximum benefits if you
`receive care from a Cigna Vision provider. The Cigna Vision
`network consists of private practice providers and optical
`retailers such as Pearle Vision, Sears, Target, and jCPenney.
`Mr
`www.cigna.c0m
`-
`it-.~?
`,y(: Cigna.
`
`BASIC LIFE, VOLUNTARY LIFE and AD&D
`
`To assist your family financially in the unfortunate event of your
`loss of life, Coleman Cable provides you with basic term life
`insurance, generally in increments equal to your base annual
`salary, at no cost to you. An additional benefit may be payable
`for accidental death or non—work—related dismemberment.
`
`Should you desire more life insurance coverage for yourself
`and/ or your dependents, voluntary “buy—up” life/AD&D
`insurance is available at an affordable price. Life and AD&D
`coverage is carried through Reliance Standard.
`neunuce smunnno
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`FLEXIBLE SPENDING ACCOUNT (FSA)
`
`
`
`Coleman Cable is pleased to offer to you and your family our
`comprehensive benefits program. Our benefits program contains
`a variety of plans intended to enhance your life and those of
`your family members now and in the future. As part of this
`benefits program you will be asked to make choices about the
`benefits described in this booklet. Please study the information
`about each plan carefully, then, promptly complete the
`enrollment forms provided so that you can begin to enjoy the
`features of your benefits program as soon as they become
`effective.
`
`'
`
`Highlights of Your Benefils
`I
`Choice of health coverage
`-
`CIGNA Open Access Plus ln—Network, Open
`Access Plus, and ChoicePlus Health Savings Account
`— Open Access Plus medical plan
`CIGNA Dental PPO program
`-
`CIGNA Vision plan
`-
`Employer—paid Basic Life insurance and Accidental Death
`& Dismemberment (AD&D)
`'
`Voluntary Life insurance and AD&D
`I
`Employer-paid Short Term Disability
`'
`Voluntary Long Term Disability
`'
`Flexible Spending Accounts
`Eligibility
`All full-time employees regularly scheduled to work at least 30
`hours per week are eligible to participate in our benefits
`program. Most benefits begin the first of the month following
`your 30 days waiting period. In addition to covering yourself,
`you may also choose to cover eligible dependents including your
`eligible spouse and children until they reach age 26.
`
`MEDICAL
`
`choosing a Medical Plan
`The Company’s medical coverage is provided by CIGNA
`insurance company. All three medical plans offer the same
`extensive national network of physicians and hospitals, called
`Cigna Open Access Plus network (OAP).
`OAP In-Network has NO coverage out of network. For your
`health care to be covered by the plan, you must choose a health
`care professional who is part of the Cigna network. lt’s not
`required, but recommended that you select a primary care
`physician (PCP) as your personal doctor. However, you do not
`need a referral to see a Specialist.
`OAP offers you the convenience of referral—free access to
`medical care and the freedom to choose the providers you
`prefer, but you are covered at a higher level if you receive care
`from a provider in the Cigna network rather than outside of the
`network.
`
`Coleman Cable makes available to you flexible spending
`accounts for healthcare and dependent care.
`Healthcare FSA enables you to put aside pre—tax dollars to pay
`for out—of—pocket expenses you may incur for medical, dental,
`vision and pharmacy care (including over—the—counter medically-
`necessary healthcare products). The maximum contribution is
`limited to $2,500 as set by the ACA healthcare reform act.
`ChoiceFund HSA OAP plan combines traditional, high
`Dependent Care FSA enables you to put aside pre—tax dollars
`deductible health insurance coverage with a Health Savings
`to pay for child and elder care expenses. The maximum
`Account (HSA) and other investment options to help you pay
`contribution you may elect for your dependent care FSA is
`for your healthcare expenses. This plan also offers the
`$5,000.
`convenience of referral—free access to any doctor or hospital,
`FSA Contributions are made via pre—tax payroll deductions. As
`however, your benefits are the highest when you see
`expenses are incurred, you may submit receipts for services to
`“participating providers”.
`Jiawei et al. EXI‘1IbIIIA1IiEli22nF3a§®e146 for reimbursement.
`www.C1gna.com
`www. allicdbcncfmcom
`
`nu \IlVl \\\ll\C\ nu
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`Jiawei et al. Exhibit 1022 Page 4