2020 Associate Benefits Book

Transcription

2020 AssociateBenefits BookSummary Plan Descriptions with2021 Summaries of MaterialModificationsWhat’s insideMedical planLife insurance and disability plansPharmacy benefitAssociate Stock Purchase PlanDental planWalmart 401(k) PlanVision plan2021 Summaries of MaterialModificationsEffective January 1, 2020Walmart 401(k) Plan effective February 1, 2020Version 4.5 Nov. 2020

Table of contentsEligibility and enrollment4Eligibility and benefits for associates in Hawaii38The medical plan44The pharmacy benefit92Health savings account (HSA)98The dental plan106The vision plan116COBRA122Resources for Living 130Critical illness insurance134Accident insurance140Company‑paid life insurance148Optional associate life insurance154Optional dependent life insurance160Information obtained during communications with Walmart Inc. or anyPlan service provider does not waive any provision or limitation ofthe Plan. Information given or statements made through any form ofcommunication do not guarantee payment of benefits. In addition,benefits quotes that are given by phone are based wholly on theinformation supplied at the time. If additional relevant information isdiscovered, it may affect payment of your claim. All benefits are subjectto eligibility, payment of premiums, limitations, and all exclusions outlinedin the applicable Plan documents, including any insurance policies. Youcan request a copy of the documents governing these plans by writing to:Custodian of Records, People Services, 508 SW 8th Street, Bentonville,Arkansas 72716‑3500.Accidental death and dismemberment(AD&D) insurance166Business travel accident insurance174Short‑term disability for full-time hourly associates 180Salaried short-term disability plan190Truck driver short‑term disability plan198Long‑term disability206Truck driver long‑term disability214The Associate Stock Purchase Plan (ASPP)222The Walmart 401(k) Plan234Claims and appeals260Legal information280Glossary2942021 Summaries of Material Modifications296For more information338Atención Asociados Hispanos: Este folleto contiene un resumenen inglés de los derechos y beneficios para todos losasociados bajo elplan de beneficios de Walmart. Si Ud tienedificultades para entendercualquier parte de este folletopuede dirigirse a la siguiente dirección:People Services, 508 SW 8th Street, Bentonville, Arkansas 72716‑3500.O puede llamar para cualquier pregunta al 800‑421‑1362. Tenemosasociados quienes hablan Español y pueden ayudarles a Ud comprendersus beneficios de Walmart. El Libro de beneficios para asociados estadisponible en Español. Si usted desea una copia en Español, favor dever su Representante de Personal.2020 Associate Benefits Book Questions? Log on to One.Walmart.com or call People Services at 800-421-1362

This is where you’ll find the Summary Plan Descriptions (SPDs) for theAssociates’ Health and Welfare Plan (the Plan), and the Walmart 401(k) Plan.The prospectus for the Associate Stock Purchase Plan is here, too.Check out the table of contents for a complete list of what you’ll find inthis book. It’s a great resource to help you understand your benefits.This is also where you’ll find the 2021 Summary of Material Modifications to theAssociates’ Health and Welfare Plan and the 2021 Summary of Material Modificationsto the Walmart 401(k) Plan. The addition of these “SMMs” brings the 2020 AssociateBenefits Book up to date for another year. You’ll find the SMMs on page 296, alongwith several important legal notices.Throughout this book you’ll also see many spots where we have alerted you to detailsthat have been updated in one of the SMMs—look for the page icon like the one to theleft. When you see that, you’ll know where to turn to find the most current information.Lots of information.So easy to find.When you download the 2020 Associate Benefits Book from One.Walmart.com, you’llhave answers to your benefit questions at your fingertips.Just launch the PDF with Adobe Reader and click “Edit” on the toolbar. Then click “Find,”and enter a word or phrase that describes what you’re looking for, like “preventive”or “copay.” Easy!Key wordsMany of the terms used throughout the 2020 Associate Benefits Book maybe unfamiliar to you, or have specific meanings within the context of the Plans.You’ll find many of them defined in the Glossary on page 294, and we have alsoincluded important definitions at critical points throughout the text. Welcome to your 2020Associate Benefits Book3

Eligibility andenrollmentThe Associates’ Health and Welfare Plan6Associate eligibility6Part-time hourly and temporary associates: eligibility checks for medical benefits7Dependent eligibility9Legal documentation for dependent coverage10Dependents who are not eligible10When your dependent becomes ineligible10When you enroll for benefits10When coverage is effective11If you leave the company and are rehired12Effective dates for benefits under the Plan12Enrollment and effective dates by job classification13Paying for your benefits18Tobacco rates19Continuing benefit coverage if you go on a leave of absence19Continuing benefit coverage while disabled20Status change events21If your job classification changes24Transferring from one job classification to another24Qualified Medical Child Support Orders (QMCSO)36When your Plan coverage ends36If you have Medicare or will become eligible for Medicare in the next 12 months,you have more choices for your prescription drug coverage. See page 287 in theLegal information chapter for more details. See page 3322020 Associate Benefits Book Questions? Log on to One.Walmart.com or call People Services at 800-421-1362

5RESOURCESFind What You NeedOnlineOther Resources Enroll in Walmart benefits Notify People Services within 60days of a status change eventGo to One.Walmart.com orWorkday for Jet associatesCall People Services at 800-421-1362Notify People Services if you havequestions about the payroll deductionsfor your benefitsCall People Services at 800-421-1362Pay premiums for benefits while on aleave of absenceSee Continuing benefit coverage if you go on a leave ofabsence in this chapter for detailed information. If youare required to pay your premiums to keep coveragecurrent, you must pay the premiums to keep coveragecurrent. You may pay by credit or debit card with a Visa,MasterCard, American Express, or Discover card bycalling 800-421-1362 and saying “make a payment.”You may also send a check or money order payable tothe Associates’ Health and Welfare Trust to:Walmart People ServicesP.O. Box 1039Department 3001Lowell, Arkansas 72745To ensure timely posting of your payment, be sure toinclude your WIN (Walmart ID) number on the check.What you need to know about eligibility and enrollment You can enroll for benefits during your initial enrollment period as a newly eligible associate, during Annual Enrollment,or when you have a status change event. Your job classification (or changes to your job classification) determines when your initial enrollment period begins.If you are a Hawaii associate, see the Eligibility and benefits for associates in Hawaii chapter. Medical, dental, vision, critical illness, accident, and accidental death and dismemberment (AD&D) insurance benefitscannot be changed except during Annual Enrollment or after you have a status change event. If you choose to enroll in the short-term disability enhanced, long-term disability, or truck driver long-term disabilitybenefits options, you may drop your coverage at any time, but you will only be able to add this coverage again during aninitial enrollment period, Annual Enrollment, or when you have a status change event. You may enroll in, drop, or change optional life insurance benefits at any time but if you enroll after your initialenrollment period, you will have to provide Proof of Good Health.See page 298Eligibility and enrollmentEligibility and enrollment

6Eligibility and enrollmentThe Associates’ Health andWelfare PlanThe Associates’ Health and Welfare Plan (the Plan) isa comprehensive employee benefit plan that offersmedical, dental, vision, critical illness insurance, accidentinsurance, AD&D, business travel accident insurance, lifeinsurance, disability, and Resources for Living (employeeassistance and wellness) benefits to eligible associates andtheir eligible dependents. Eligibility for these benefits isdescribed in this chapter, and the terms and conditions forthese benefits are described in the applicable chapters ofthis 2020 Associate Benefits Book. The Plan is sponsored byWalmart Inc. (the company).You are automatically enrolled for certain benefits underthe Plan on your date of hire or a later date. For otherbenefits, however, you must enroll to have coverage. Referto the Enrollment and effective dates by job classificationsection in this chapter for details about initial enrollmentperiods and when coverage is effective, for all benefitsavailable under the Plan.Associate eligibilityThe benefits you are eligible for depend on a numberof factors, which may include your date of hire, averageweekly hours, and your job classification in the WalmartInc. payroll system. In addition, for most benefits, youmay be required to meet an eligibility waiting period. Seethe Enrollment and effective dates by job classificationsection in this chapter for a list of the benefits you areeligible for and for your eligibility waiting period based onyour job classification.Our expectation is that you will use correct and accurateinformation when applying for or enrolling in benefits.If you do not, you may be subject to the loss of benefitsand/or loss of employment. To review Walmart’s policyabout intentional dishonesty, refer to the Statement ofEthics, which can be found on One.Walmart.com. SeeLegal documentation for dependent coverage later in thischapter for information about documents that may berequested of you to verify dependent eligibility.NOTE: Your eligibility for benefits is determined by theeligibility rules detailed in this Associate Benefits Book. Tothe extent that any information provided to you throughother sources conflicts with the Associate Benefits Book, theeligibility rules in the Associate Benefits Book will control.MANAGEMENT ASSOCIATE ELIGIBILITYTo be eligible for benefits as a management associate, youmust be classified in the company’s payroll system as amanagement associate, management trainee, Californiapharmacist, or full-time truck driver.FULL-TIME HOURLY ASSOCIATE ELIGIBILITYTo be eligible for benefits as a full-time hourly associate,you must be classified in the company’s payroll system as afull-time hourly associate.PART-TIME HOURLY ASSOCIATE ELIGIBILITYTo be eligible for benefits as a part-time hourly associate,you must be classified in the company’s payroll system as apart-time hourly associate.To be eligible to enroll in medical benefits, you mustwork an average of at least 30 hours per week, with thefollowing exceptions: Part-time hourly pharmacists hired prior toFebruary 1, 2012, do not need to work a minimumnumber of hours per week. Part-time hourly pharmacists hired on or afterFebruary 1, 2012, must work an average of at least24 hours per week. Part-time hourly associates in the field supply chainmust work an average of at least 24 hours per week. Part-time hourly nurse practitioners must work anaverage of at least 24 hours per week.Part-time hourly associates are subject to the annualeligibility check process described later in this chapter, withthe exception of part-time hourly pharmacists hired prior toFebruary 1, 2012. The annual eligibility check determines youreligibility for medical benefits based on the number of hoursyou work on average in the 52-week period preceding thedate of the annual eligibility check. For more information, seethe section titled Part-time hourly and temporary associates:eligibility checks for medical benefits.PART-TIME TRUCK DRIVER ELIGIBILITYTo be eligible for benefits as a part-time truck driver, youmust be classified in the company’s payroll system as apart-time truck driver. You do not need to work a minimumnumbers of hours per week to be eligible to enroll inmedical benefits as a part-time truck driver.2020 Associate Benefits Book Questions? Log on to One.Walmart.com or call People Services at 800-421-1362

7To be eligible for benefits as a temporary associate, youmust be classified in the company’s payroll system as atemporary associate.To be eligible to enroll in medical benefits, you must workan average of at least 30 hours per week, with the exceptionof temporary associates in the field supply chain, who mustwork an average of at least 24 hours per week.Temporary associates are subject to the annual eligibilitycheck process described later in this chapter. The annualeligibility check determines your eligibility for medicalbenefits based on the number of hours you work on averagein the 52-week period preceding the date of the annualbenefits eligibility check. For more information, see thesection titled Part-time hourly and temporary associates:eligibility checks for medical benefits.ASSOCIATES WHO ARE NOT ELIGIBLEYou are not eligible for the Plan if you fall in any of thefollowing categories, even if you are reclassified by a court,the IRS, or the Department of Labor as a common-lawemployee of the company or any participating affiliate: A leased employee A nonresident alien (except for optional associate lifeinsurance, optional dependent life insurance, accidentaldeath and disability insurance, and business travel accidentinsurance, and unless covered under a specific insurancepolicy for expatriates or third-country nationals who areemployed by the company) An independent contractor A consultant An associate residing outside the United States Not classified as an associate of the company or itsparticipating affiliates An associate who is enrolled in Medicare Part D (applicableonly to eligibility for medical plan options, including HMOsand the eComm PPO Plan), or An associate covered by a collective bargaining agreement,to the extent that the agreement does not provide forparticipation in the Plan.ELIGIBILITY INFORMATION FOR ADDITIONALASSOCIATE CATEGORIESAssociates in HMOs and eComm PPO Plans: HMO andeComm PPO Plans are available for some work locations.The policies and enrollment materials for the HMO andeComm PPO Plans may describe different eligibilityrequirements and waiting periods than those described inthis chapter. If there is any difference between the HMO’sor eComm PPO Plan’s eligibility terms and the eligibilityterms of the Associates’ Medical Plan (AMP) as described inthis chapter, eligibility terms in this chapter will control.In addition, some HMOs require participants to accept anarbitration agreement, where permitted by law, beforecoverage under the HMO will become effective. Youragreement must be received by the HMO within 60 days ofyour initial enrollment or your HMO coverage will not takeeffect. If the HMO does not receive your agreement, you willnot have medical coverage under the Plan unless you have avalid status change event, as described later in this chapter.Hawaii associates: Special rules govern benefits eligibilityand enrollment in the state of Hawaii. If you are a full-timehourly, part-time hourly, or temporary associate in Hawaii,please refer to the chapter titled Eligibility and benefitsfor associates in Hawaii. For management associates inHawaii, the eligibility and enrollment terms described in thisEligibility and enrollment chapter apply.Localized associates: If you have been approved by thecompany as having localized status, you and your dependentsresiding in the United States are eligible for the samebenefits under the Plan as associates who are United Statescitizens residing and working in the United States. Anyapplicable waiting period is waived. You are not eligible forexpatriate coverage under the Plan. If you are a localizedassociate and an eligible dependent resides outside theUnited States, medical claims will be processed as networkbenefits regardless of the provider’s network status and paidat the applicable copay or coinsurance rate for networkcharges, subject to applicable limitations and exclusionsunder the Plan. You or your enrolled dependents must file aclaim for reimbursement under the Plan’s claims procedures.See page 298 for important information for part-timehourly and temporary associates about eligibility checks.Part-time hourly and temporaryassociates: eligibility checks formedical benefitsINITIAL ELIGIBILITY CHECK FORMEDICAL BENEFITSIf you are a part-time hourly or temporary associate(other than a part-time truck driver), your initial eligibilityfor medical benefits is determined during your initialmeasurement period. Your initial measurement period is the52 consecutive weeks beginning on your date of hire, duringwhich your average hours worked per week are reviewed.Eligibility and enrollmentTEMPORARY ASSOCIATE ELIGIBILITY

8Eligibility and enrollmentIf you work an average of at least 30 hours a week (24 hoursa week for part-time nurse practitioners, part-time hourlypharmacists, part-time hourly and temporary associatesin the field supply chain) over the 52-week review periodwithout a break in employment greater than 13 weeks, youwill become eligible for medical benefits at the close ofyour initial measurement period. Specifically, your eligibilityfor medical benefits will begin on the first day of thesecond calendar month following your one-year anniversarydate. For example, if your date of hire is April 16, 2019, youraverage hours worked from that day through April 15, 2020will be calculated. If you meet the average-hours-workedrequirement over this initial measurement period, yourcoverage would begin June 1, 2020 (assuming you enroll in atimely manner).Initial medical coverage for associates who meet theaverage-hours-worked requirement continues throughthe end of the second calendar year following date of hire.In the example above, your coverage (if you enroll in atimely manner) would continue through the end of 2021.You would then be subject to annual eligibility checks, asdescribed below.ANNUAL ELIGIBILITY CHECK FORMEDICAL BENEFITSIf you are classified as a part-time hourly or temporaryassociate (other than a part-time truck driver or a part‑timehourly pharmacist hired before Feb. 1, 2012), you will besubject to an annual eligibility check to establish youreligibility for medical benefits for the next calendar year.You will also be subject to the annual eligibility check if youwere originally hired as a management or full-time hourlyassociate and were employed one year or more beforechanging to part-time hourly or temporary status.The measurement period for the annual eligibility checkwill be the 52 weeks preceding an annually designateddate in early October prior to each calendar year’sAnnual Enrollment. For example, the annual eligibilitycheck occurring in fall 2020 (for the 2021 calendar year)will review your hours worked from October 5, 2019,through October 4, 2020. If you meet the average hoursrequirement (24 or 30 hours per week, depending on jobclassification) over the 52-week period, you will be eligibleto enroll in medical benefits during Annual Enrollment forcoverage during 2021.If you do not meet the average weekly hours requirementin the annual eligibility check, your medical coverage maycontinue for a period of time, as described below under If youdo not meet the annual eligibility check for medical benefits.IF YOU MEET THE ANNUAL ELIGIBILITY CHECKFOR MEDICAL BENEFITSIf you are currently a part-time hourly or temporary associatewho is enrolled for medical coverage and you meet theannual eligibility check in October, you will remain enrolledfor medical coverage for the remainder of the current year.You will receive Annual Enrollment materials and be eligibleto enroll for medical benefits for the following year.You will be subject to the annual eligibility check each yearto determine your eligibility for medical benefits for thefollowing year.IF YOU DO NOT MEET THE ANNUALELIGIBILITY CHECK FOR MEDICAL BENEFITSIf you are currently a part-time hourly or temporaryassociate who is enrolled for medical coverage, but you donot meet the annual eligibility check in October, you willremain enrolled for medical coverage for the remainder ofthe current calendar year. You will not be eligible for medicalbenefits for the following year unless your job classificationchanges and you meet the eligibility requirements based onyour new classification. You will receive a letter describingyour options under the Consolidated Omnibus BudgetReconciliation Act (COBRA) to continue your medicalcoverage when the current calendar year ends. (See theCOBRA chapter for more information.)You will be subject to the annual eligibility check each yearto determine your eligibility for medical benefits for thefollowing year.IF YOU TAKE TIME OFF DURING THEANNUAL MEASUREMENT PERIOD FOR THEELIGIBILITY CHECKIf you take any type of unpaid time off that is not anapproved leave of absence, as described below, yournumber of actual service hours will still be used in thecalculation of your average hours for the annual eligibilitycheck (even if it is zero).If your absence is an approved leave (including for juryduty, Family and Medical Leave Act of 1993 [FMLA] leave,or military leave), your average-hours-worked calculationwill be based on the number of weeks during the 52-weekmeasurement period that you worked. For example, if youtake an approved leave during two weeks of the 52-weekmeasurement period, your average hours worked will becalculated over 50 weeks rather than 52.If you have questions about the annual eligibility check, callPeople Services at 800-421-1362.2020 Associate Benefits Book Questions? Log on to One.Walmart.com or call People Services at 800-421-1362

9If you are a management or full-time hourly associate and are eligible for benefits under the Plan, you may also enroll all eligibledependents as described below. If you are a part-time hourly or temporary associate or a part-time truck driver, and you areeligible for benefits under the Plan, you may also enroll only your dependent child; you may not enroll any other dependent.EMPLOYMENT CLASSIFICATIONELIGIBLE DEPENDENTS (AS DEFINED BELOW) Management Full-time hourlyCan elect to cover: Spouse/partner Dependent child(ren) Part-time hourly Temporary Part-time truck driverCan elect to cover: Dependent child(ren)But not spouse/partnerDEFINITIONS: ELIGIBLE DEPENDENTSSPOUSE/PARTNER Your spouse, as long as you are not legally separated Your domestic partner (or “partner”), as long as you and your domestic partner:– Are in an exclusive and committed relationship similar to marriage and have been for at least 12 months– Are not married to each other or anyone else– Meet the age for marriage in your home state and are mentally competent to consent to contract– Are not related in a manner that would bar a legal marriage in the state in which you live, and– Are not in the relationship solely for the purpose of obtaining benefits coverage. Any other person to whom you are joined in a legal relationship recognized as creating some or all of therights of marriage in the state or country in which the relationship was created (also referred to as “partner”)DEPENDENTCHILD(REN) Your dependent children through the end of the month in which the child reaches age 26.Your dependent children are:– Your natural children– Your adopted children or children placed with you for adoption– Your stepchildren or children of your eligible partner, provided however: Eligibility will end upon divorce or change in partner status, even if the child is under age 26 Eligibility will end upon death of your spouse or partner, if the child is under age 18, or Eligibility will continue until age 26 in the event of the death of your spouse or partner, if at the timeof death: i) the child has attained age 18, and ii) the child is enrolled in the Plan.– Your foster children– Someone for whom you have legal custody or legal guardianship, provided he or she is living as a memberof your household and you provide more than half of his or her supportIf an individual is your eligible dependent and subsequentlyno longer satisfies the definition of eligible dependent, thatindividual will no longer be eligible for coverage under thePlan and you are required to report the change. See Whenyour dependent becomes ineligible later in this chapter forinformation. If you fail to report the change, you may besubject to the loss of benefits and/or loss of employment.plan, you may still enroll your eligible dependents, butthey will not have access to network providers in thegeographic area in which they live and may have access onlyto emergency coverage. If you are unsure if your eligibledependent lives outside your medical plan’s service area, callyour health care advisor at the number on your plan ID card.If a court order requires you to provide medical, dental,and/or vision coverage for your child, the child must be aneligible dependent as defined above. For more informationon how the Plan handles a Qualified Medical Child SupportOrder (QMCSO), see the Qualified Medical Child SupportOrders (QMCSO) section later in this chapter.IF YOUR CHILD IS INCAPABLE OFSELF‑SUPPORTIf you are enrolled in a medical plan option that does notoffer out-of-network coverage and you have an eligibledependent living outside the service area of your medicalIf your child is enrolled for coverage under the Plan, youmay continue the child’s coverage beyond the end of themonth in which your child reaches age 26 if: The child is physically or mentally incapable of self-supportand primarily dependent on you for legal support, and The child’s doctor provides written medical evidence ofthe child’s incapacity.Eligibility and enrollmentDependent eligibility

10Eligibility and enrollmentAdditional coverage may be added if your child experiencesa valid status change event. For information regarding astatus change event, refer to the Status change eventssection of this chapter.Legal documentation fordependent coverageThe Plan reserves the right to conduct a verification audit ofdependent eligibility. You may be required to provide legaldocumentation to prove the eligibility of your dependent. Itis your responsibility to provide the written documentationif requested to do so by the Plan. If you do not providenecessary documentation in a timely manner, the Plan has theright to cancel your dependent’s coverage until the requesteddocumentation is received. It is your responsibility to notifythe Plan of any changes in your dependent’s eligibility.Examples of valid documentation are as follows: Spouse: marriage certificate and jointly filed federaltax return Domestic partner: domestic partner affidavit and jointmortgage statement or rental agreement Children: state- or county-issued birth certificate orsigned court orderDependents who are not eligibleYour dependent is not eligible for coverage under the Planif he or she is: Residing outside the U.S. (not applicable to optionaldependent life insurance, AD&D, critical illness, andaccident insurance, and not applicable if your dependentis attending college full-time outside the U.S.) Covered under an expatriate plan An undocumented immigrant Not an eligible dependent as defined under Dependenteligibility on the previous page A Walmart associate already enrolled in coverage underthe Plan (not applicable to optional dependent lifeinsurance, AD&D, critical illness, and accident insurance) A dependent of another Walmart associate and alreadyenrolled in coverage under the Plan (not applicable tooptional dependent life insurance, AD&D, critical illness,and accident insurance) Enrolled in Medicare Part D (applicable only to eligibilityfor medical plan options, including HMOs and the eCommPPO Plan)When your dependentbecomes ineligibleIf your dependent is enrolled in coverage under the Plan andbecomes ineligible for coverage, you must notify PeopleServices at 800-421-1362 within 60 days from the date yourdependent becomes ineligible. If you notify People Serviceswithin this time frame, the Plan will send an election notice,allowing you to elect Consolidated Omnibus BudgetReconciliation Act (COBRA) continuation coverage. Yourdependent’s election to enroll in COBRA coverage must bereceived within 60 days from the date your dependent losescoverage or the date of the election notice, if later. See theCOBRA chapter for more information.Failure to notify the Plan by calling People Services at800-421-1362 when your dependent becomes ineligible forcoverage may be considered an intentional misrepresentationof material facts, which may result in your coverage beingcanceled. If your dependent becomes ineligible for coverageand you fail to notify the Plan by calling People Services, youmay be responsible for any charges mistakenly paid by thePlan after the date that your dependent became ineligible.When you enroll for benefitsOnce you have completed any applicable eligibility waitingperiod, you can enroll for benefits during your initialenrollment period, which is the first time you are eligible toenroll. The timing of your initial enrollment period varies byjob classification and may change if your job classificationchanges. For more information, see Enrollment andeffective dates by job classification later in this chapter andrefer to the chart that applies to your job classification. Youmay also enroll for benefits at the following times: During Annual Enrollment, which generally occursin the fall of each year. Benefits you enroll in duringAnnual Enrollment are generally effective January 1 ofthe following year, but there are exceptions. See theappropriate chart in the Enrollment and effective dates byjob classification section for important details. If you choose to enroll in the

The Associates’ Health and Welfare Plan (the Plan) is a comprehensive employee benefit plan that offers medical, dental, vision, critical illness insurance, accident insurance, AD&D, business travel accident insurance, life insurance, disability, and Resources for Living (employee ass