Enrollment and Eligibility

Frequently asked questions about 2020 enrollment.

2020 Enrollment

What’s new for the Walmart medical plans?

A lot. This year, we’re taking exciting new steps to deliver on helping associates and their families live better, healthier lives.

You’ll see updated medical plans, simpler plan names, and in many areas, innovative new programs where associates can access top-rated doctors, virtual primary care physicians, and online personal health assistants. Here’s a breakdown of the changes.

Plan names are changing.
We’ve renamed our plans to make them simpler to understand and easier to choose:

Old medical plan name New medical plan name in 2020
HRA Plan Replaced by Premier Plan
HRA High Plan Renamed Contribution Plan
HSA Plan Renamed Saver Plan
ACP and Select Network Plans Renamed Local Plans

Plan features are changing.
  • The new Premier Plan replaces the Walmart dollars in the current HRA Plan with simple and affordable copays, and there’s no need to meet your deductible first. You’ll pay $35 for primary care office visits, and $75 for specialist and urgent care visits. You’ll still be able to use any Walmart dollars you have left to cover copays through 2021.
  • Walmart dollars will still be available in the Contribution Plan (the current HRA High Plan). You’ll get $250 each year for associates or $500 for families.
  • The Saver Plan (the current HSA Plan) will stay the same, except for an increase to the maximum annual contribution allowed by the IRS to $3,550 for individual coverage and $7,100 for family coverage.
  • In all plans, you’ll pay a $300 copay for emergency room services. In the Saver Plan you’ll have to meet your deductible and then pay the copay. After that the plan covers 100% in-network.
We’re leading with quality.

For associates in most areas, we’re making Grand Rounds the go-to resource to connect with the best network doctors for your needs, in-network and close to home.

We’ll also be rolling out several new programs in select areas that will deliver higher-quality care and save associates time and money.

What changes are happening only in certain areas?
We’re rolling out two exciting new programs, all focused on quality.

Introducing the Personal Online Doctor with Doctor On Demand.
In parts of Colorado, Minnesota, and Wisconsin, we are introducing a Personal Online Doctor program.
• You’ll get an online primary care doctor who can see you anytime, order lab work, write prescriptions, and coordinate
care with other doctors covered by your plan.
• Each video virtual visit will start at just $4, including physicians, psychologists, and psychiatrists. If you’re in the Saver
Plan, you’ll need to meet your deductible first. There’s no additional cost to sign up.
• Associates will also get access to a Doctor On Demand Care Team that can help manage long-term illness and
connect them to helpful resources.

Introducing the Personal Healthcare Assistant with Grand Rounds.
In some areas of North Carolina and South Carolina, you’ll have access to a Personal Healthcare Assistant at no cost
to you.
• Your assistant offers online and phone support to help make the most of your health benefits, from setting
appointments and collecting records to making sense of medical bills.
• They can even coordinate services like daycare and transportation to help you get to appointments.
• If you have an ongoing medical issue, you’ll also get special care management services.
Why are some programs being introduced only in a few areas?
Before we consider launching these programs nationwide for all associates, we want to learn from these new offerings
and see how associates respond.
What’s changing with plan networks?
We’re making changes in specific markets to optimize savings and network coverage.
Location (where you work) What's changing Which plans are affected What this means to you
Chicago, IL
San Antonio, TX
Austin, TX
El Paso, TX
Changing plan administrators and networks to Blue Cross Blue Shield Premier Plan and Saver Plan You may want to check that your doctors are still network providers
Dallas/Fort Worth, TX
  1. Moving the area to Blue Cross Blue Shield
  2. Eliminating the Select Network Plan
Premier Plan and Saver Plan
Select Network Plan
If you're in the Select Network Plan, you'll get the new Premier Plan for 2020
Oklahoma Moving to Blue Cross Blue Shield's alternate network All plans, except HMOs Check that your doctors are still network providers
Albuquerque & Santa Fe, New Mexico Discontinuing the Presbyterian ACP Plan Presbyterian ACP Plan If you're in the ACP, you'll get the new Premier Plan
What else is changing?
Expanded Centers of Excellence care.
We’re expanding our Centers of Excellence program by covering kidney transplants only at Centers of Excellence
facilities. We’re also offering an expert medical record for anyone who is recommended to begin outpatient
dialysis treatment.

New pharmacy benefit manager.
Our pharmacy manager will be OptumRx in 2020. You’ll still fill prescriptions at any Walmart or Sam’s Club pharmacy
as usual. The formulary—the list of covered drugs—is also changing, so it’s a good idea to double-check any medications
you take regularly.

Plan ID cards getting a refresh.
All enrolled associates will get new plan ID cards for 2020. Be sure to replace your old card with the new version before
you see the doctor or go to the pharmacy.

$9 fitness access.
To help associates and their families stay well, we’re offering a nationwide Walton Life Fitness Pass program starting at
just $9 per pay period.
I have questions about my benefits and would like to talk to someone. Who can help me?
Your People Partner and facility leadership are great resources for you. In addition, you are welcome to call our People
Services team at 800-421-1362
• Monday–Friday: 7:30 a.m.–6 p.m. CT
• Saturday: 9 a.m.–1 p.m. CT
What is ALEX®?

Walmart offers lots of programs besides the medical plans that can help you live better—but which ones are right for you? ALEX, your virtual benefits ambassador, can help you find out. ALEX will ask a series of simple questions about your needs, concerns, and goals about health and well-being. Then he’ll recommend the options that best meet your personal situation, and briefly explain how each program works. He’ll even wrap up with a printable summary page with more info and quick links.


When you’re ready to start living better, visit ALEX.

2020 Dependent Eligibility

Is the dependent audit for everyone, or just if I’m enrolling a dependent during Annual Enrollment?

Yes. We’re beginning the dependent verification process during Annual Enrollment and over the next year we’ll be expanding it to all associates covering dependents. This dependent audit will continue through 2020.

Are there any exceptions to the dependent verification audit?

Yes, there are exceptions. Here are a few examples:

• You covering dependents through a Qualified Medical Child Support Order under your medical plan will not need to prove that those dependents are eligible. 

• Participants enrolled in Walmart’s COBRA coverage will not receive information requesting verification of covered dependents. 

What is the timeline of when the dependent verification process will happen?

Beginning during 2020 Annual Enrollment, here’s what to expect depending on your current benefits status:

Who What to expect
Current associates covering dependents on a medical plan Making dependent changes during Annual Enrollment? Look for a letter in the mail at home with information on how to verify your covered dependent’s eligibility. These will be mailed throughout 2020 as the program is rolled out over time.
You newly eligible for benefits as of Jan. 1, 2020, covering dependents on a medical plan Once you’ve enrolled in a medical plan, look for a letter in the mail at home with information on how to verify your covered dependent’s eligibility.
You with a family status change Making a change to who you’ve enrolled on your medical plan? Then look for a letter in the mail at home with information on how to verify your covered dependent’s eligibility.

Beginning in 2020, we’ll start reaching out to all you across the U.S. with family members enrolled to request you provide proof that your covered family members are eligible.

Do I need to have these documents ready when I enroll a dependent?

No. Verifying dependents happens after you enroll. You’ll get instructions mailed to your home after you make any enrollment changes to who is covered under your benefits.

Who is eligible to be covered under Walmart’s benefits?

Here is how benefits eligibility works for benefits:

Eligible dependent Eligibility requirements
(same or opposite gender)
Legally married spouses of associates may be covered, if not legally separated
Domestic partner
(same or opposite gender)
Domestic partners of associates are eligible for Walmart benefits if all of these requirements are met:
  • Are in an exclusive and committed relationship similar to marriage and have been for at least 12 months and intend to continue indefinitely
  • 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 the rights of marriage in the state or country in which the relationship was created.
Children, stepchildren, foster children We understand families take many forms. Associates may cover:
  • Your natural children
  • Your adopted children or children placed with you for adoption
  • Your stepchildren
  • Your foster children
  • The children of your partner, provided your relationship qualifies under the definition of spouse/partner, or
  • Someone for whom you have legal custody or legal guardianship, provided he or she is living as a member of your household and you provide more than half of his or her support.
Why can’t I cover anyone I feel is my family member under my Walmart benefits? Why are there restrictions on eligibility?

We understand families take many forms. Laws require Walmart to define who is and is not eligible. Once we’ve defined benefit eligibility, we must follow these rules carefully in order to keep benefits available to our you. 

If you’re looking for health insurance coverage options for family members who are not eligible for Walmart’s benefits, please reach out to HealthCompare. You can call HealthCompare at 877-260-1824, Monday through Friday between 8 a.m. and 6 p.m. CT.

What documents are required to prove my covered family members are eligible for Walmart’s medical benefits?

Here are examples of documents you may be asked to provide as proof of eligibility:

• Spouse: marriage certificate and jointly filed federal tax return

• Domestic partner: domestic partner affidavit and joint mortgage statement or rental agreement

• Children: state or county issued birth certificate or signed court order

I’ve been covering dependents on my benefits and realized I am not eligible to be covered. How do I drop my coverage?

Please call the People Services team at 800-421-1362 for more information on how to drop coverage on dependents who are not eligible for Walmart’s benefits. Dropping coverage on ineligible dependents is the right thing to do and this will not impact your job with Walmart.

I’ve been covering ineligible dependents and wondered if I can get the cost from my paycheck back once I drop them from coverage?

Since we are dropping coverage going forward, we’re unable to refund the costs you’ve paid for covering ineligible dependents.

I have an ineligible dependent currently undergoing treatment on my Walmart benefits. While I understand I am not eligible to be covered under my benefits, what are my options?

Once they are no longer covered by Walmart’s benefits, they can still sign up for other types of individual coverage. Reach out to HealthCompare for possible options through the market place. In certain cases, COBRA coverage may be available, please call People Services at 800-421-1362 for more information.

I’m in the process of adopting a child. When may I enroll the child in my medical benefits? Will I need to show proof of the adoption process?

You may enroll the child on your medical benefits as soon as you are placed for adoption. To find more details on documents needed for proof of eligibility, please go to One.Walmart.com/FamilyCheck.

Even though I’m not making any changes to medical benefits for 2020, may I proactively submit proof my spouse/partner and children are eligible to be covered?

We appreciate your proactive approach! Please wait until you receive paperwork in the mail before sending us any documentation. This could take a few months as we roll out this process across the U.S.

I don’t agree with the decision made that I’m not able to cover someone I feel is a family member. What are my options?

You have the option of having your eligibility documents reviewed through an appeal process. You have 365 days from the date you receive your enrollment notification to appeal in writing to:

Walmart People Services
Attn: Internal Appeals
508 SW 8th Street
Bentonville, Arkansas 72716-3500

More information on appeals can be found on the U.S. Department of Labor’s website.

Will my documents be secure when I submit them? They contain a lot of sensitive info about my dependents.

Yes. You’ll have options to send both electronic and paper versions, and all of your information will be secure when submitted and reviewed. Consova has met our high standards and requirements for security.

I have questions about who is eligible for my Walmart benefits. Where do I get answers?

We have several resources to help you with your eligibility questions:

• 2020 Associate Benefits Book—this is a helpful guide containing all the eligibility details.

• People Partner—reach out to your local People Partner with your questions.

• People Services—our People Services team is happy to walk you through eligibility information and answer your questions. Call them at 800-421-1362.

While reviewing my covered dependents, I realized I need to add a family member to my benefits. May I do that now?

You’ll need to have a qualifying life event, such as getting married or having a baby, to add a dependent to your Walmart benefits outside of the Annual Enrollment window. To learn more, go to One.Walmart.com/LifeEventChanges.


Related Content

Ready to get started?
Head over to online enrollment