The time period when you can choose your benefits for the next year. This happens in the fall of each year.

A health and welfare employee benefit plan sponsored by Walmart Inc., and governed under the Employee Retirement Income Security Act of 1974, as amended (ERISA). This is the overall program covering many of the benefits offered by Walmart.

An overall name for the medical plans offered by Walmart. It includes the Premier Plan, Contribution Plan, Saver Plan, Local Plans, and the PPO Plan.

A drug that’s made by only a single manufacturer. It might or might not have a generic version. You can find all brand-name drugs covered by most Walmart plans on the plan formulary.

If you’re 50 or older, the IRS will let you make extra contributions to your 401(k) plan. If you’re 55 or older and enrolled in the Saver Plan, the IRS will let you make a $1,000 catch-up contribution to your health savings account.

COBRA lets you and your eligible dependents continue medical, dental, vision, and mental health benefits if you lose coverage because of a qualifying event—for example, if you lose your job.

The amount you pay for eligible medical and dental expenses after you’ve met your deductible. For example, if you pay 25% coinsurance, the plan pays the other 75% of eligible costs. See the Associate Benefits Book for details.

Walmart Inc., and its participating subsidiaries.

If you’re covered by two benefit plans for the same thing, this is the behind-the-scenes process of deciding which plan will pay first and how much each plan will pay. This means you might not receive the entire benefit from both plans.

A fixed amount of money you may need to pay for certain covered services or supplies, like doctor visits, prescriptions, or vision care.

Charges for procedures, supplies, equipment, or services that are covered by your medical plan. To be covered, they must be:

• medically necessary;
• not more than the maximum allowable charge;
• not more than any other plan limits; and
• not excluded under the plan.

People who can be legally considered as the following:

• Your spouse, as long as you are not legally separated.
• Your domestic partner (or "partner"), as defined by the plan.                              
• 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 (also referred to as "partner").
• Your dependent children, through the end of the month in which the child reaches age 26 (or older, if incapable of self-support) who are:
  • 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.     

If a court order requires you to provide medical, dental, or vision coverage for children, the children must meet the plan's eligibility requirements for dependent coverage.

For details, see the Associate Benefits Book.

NOTE: If you are a part-time or temporary associate, you may not enroll your spouse/partner in benefits. For most benefits, you may enroll your dependent children only.

The time between the date you’re hired and the date you can enroll for benefits.

A document sent to you that explains how a medical plan claim was paid or applied.

The list of generic and brand-name medications that are covered by most of Walmart’s medical plans. The plan formulary is maintained by OptumRx.

If you’re enrolled in a medical plan, your health care advisor is an actual person who is your single point of contact for all questions and communication with your plan’s third-party administrator. Your health care advisor can answer questions about your health care benefits, help you with claims, and resolve administrative questions and concerns.

The Contribution Plan includes an HRA, to which the company credits a specific amount of money to help pay your eligible medical expenses before you have to pay (excluding prescriptions). Each year Walmart will contribute $250 if you choose associate-only coverage, or $500 if you cover your dependents.

If you’re enrolled in the Saver Plan, you can open an HSA, which allows you to save money, then use it to pay for qualified medical expenses (as defined by the IRS). Walmart will match your contributions dollar for dollar up to $350 if you choose associate-only coverage, or $700 if you cover your dependents. You must contribute through payroll deductions to receive the company match.

The Health Insurance Portability and Accountability Act of 1996, which protects the privacy of your personal health information.

The first time you’re eligible to enroll for benefits under the plan. Initial enrollment periods are different for different jobs, and you might also have a waiting period. See the charts in the Eligibility and Enrollment chapter in the Associate Benefits Book.

If you need time away from work, a leave of absence is typically unpaid but lets you continue to use your benefits and keep your job during your time away. Walmart provides three types of leave:

• Family and Medical Leave Act (FMLA)
• Personal
• Military

See the leave of absence pages for a description of the leave of absence options that may be available to you.

These plans feature a network of doctors, clinics, hospitals, and other providers who work together to coordinate your care.

The most the plan will pay for any health care services, drugs, medical devices, equipment, supplies, or benefits. This applies to both covered in-network and covered out-of-network medical services. For details, see the Medical Plan chapter of the Associate Benefits Book.

The most the plan will pay for dental services. This applies to both covered in-network and covered out-of-network dental services. For details, see the Dental Plan chapter of the Associate Benefits Book.

Procedures, supplies, equipment, or services determined by the Plan to be:

• appropriate for the symptoms, diagnosis, or treatment of a medical condition;
• provided for the diagnosis or direct care and treatment of the medical condition;
• within the standards of good medical practice within the organized medical community;
• not primarily for the convenience of the patient or the patient's doctor or other provider; and
• the most appropriate procedure, supply, equipment, or service that can be safely provided.

Each of Walmart’s third-party administrators follows its own policies and procedures determining whether a procedure, supply, equipment, or service is medically necessary; the policies and procedures may vary by administrator. Your plan benefits are subject to the terms of such policies. For details, see the Medical Plan chapter in the Associate Benefits Book.

Walmart's benefits for mental/behavioral health and substance abuse, including alcohol and drug abuse. In addition to your medical plan’s coverage, which requires enrollment, Walmart also offers mental and emotional health services through My Mental Health Resources (powered by Lyra), AiRCare, and Supportiv.

Doctors and other providers that don’t have a written agreement to provide services to associates and their dependents enrolled in a Walmart plan. Getting care from these providers may cost you more or may not be covered by your plan.

Covered expenses that are provided by a non-network provider and don’t meet the standards outlined in the Medical Plan chapter of the Associate Benefits Book in the “What is covered by the Associates’ Medical Plan” section.

If you’re enrolled in a Local Plan, out-of-network expenses are not covered except in an emergency.

The most you’ll pay each year for eligible network services, including prescriptions. There is no maximum for out-of-network services.

"Partial Disability" or "Partially Disabled", with respect to Long Term Disability, means that, as a result of injury or sickness you are able to:

1. Perform one or more, but not all, of the material and substantial duties of your own occupation or any occupation on a full-time or part-time basis; or
2. Perform all of the material and substantial duties of yours own occupation or any occupation on a part-time basis; and
3. Earn between 20% and 80% of your indexed average monthly wage.”

A service that can help you find a doctor, get a second opinion, or figure out a medical bill for any associate or family member who is enrolled in most Walmart medical plans. Connect with them at IncludedHealth.com/Walmart.

A notification that may be required from your plan’s third-party before you can get coverage for certain services or get certain medications. See Preauthorization.

Precertification requirements name the conditions, medical setting, or other limits to the plan's coverage. Network providers and hospitals typically use the precertification process before inpatient admissions or some ambulatory procedures.

The amount you pay for the benefits you choose, generally out of each paycheck.

Proof of your health condition, which includes answering a questionnaire about your medical history and possibly having a medical exam. It’s also known as “evidence of insurability.” The Proof of Good Health questionnaire is available when you enroll.

A final court or administrative order requiring you to provide health care coverage for your eligible dependents under the plan, usually following a divorce or child custody proceeding.

Medications that target and treat specific chronic or genetic conditions. These include biopharmaceuticals (bioengineered proteins), blood-derived products, and complex molecules. They are available in oral, injectable, or infused forms. See Pharmacy.

A person who’s properly enrolled for coverage, as described in the Eligibility and Enrollment chapter of the Associate Benefits Book:

• 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 the rights of marriage in the state or country in which the relationship was created (also referred to as "partner").

An organization that handles claims and internal appeals for your medical plan. Third-party administrators also provide health care advisors to help you with claims and other issues. The Associates’ Medical Plan’s administrators include Aetna, Blue Advantage Administrators of Arkansas, and UMR.