Walmart provides health insurance options to its employees, referred to internally as associates, as part of a comprehensive benefits package. Offerings are structured to accommodate different needs and budgets, providing choices for medical, dental, and vision coverage. This article details the current health plan offerings, eligibility requirements, and associated costs.
Eligibility Requirements for Health Coverage
Eligibility for Walmart’s medical coverage is determined by the associate’s employment status and tenure. Full-time hourly associates are eligible to enroll in a medical plan sooner than part-time counterparts. Coverage typically becomes effective on the first day of the calendar month coinciding with or following the 89th day of continuous employment.
Part-time hourly associates must meet a specific minimum service requirement before becoming eligible for health coverage. They must complete one year of service and meet a minimum average of weekly hours to qualify. To maintain eligibility, associates are required to average a minimum of 34 working hours per week, which Walmart considers full-time status.
Types of Health Insurance Plans Offered
Walmart offers several distinct medical plan options, allowing associates to choose the structure that best fits their healthcare needs. These plans include options like the Premier PPO Plan, which offers lower costs per pay period and predictable co-pays for routine care. The Premier PPO plan is a popular choice, providing a network structure that does not require a referral to see a specialist.
Other options include a Contribution HRA Plan, a more traditional plan design, and a Saver HSA Plan, a High Deductible Health Plan (HDHP) paired with a Health Savings Account (HSA). Some regions offer specific Local Plans, tailored around local health systems to provide coordinated care and potentially feature the lowest cost or deductible options. The Premier Plan covers preventive care at 100% when using in-network providers, such as annual checkups and vaccinations.
Understanding Employee Costs and Premiums
The financial contribution required depends on the plan selected and whether the associate covers only themselves or their family. For associate-only coverage under a national plan like the Premier PPO Plan, the cost per pay period can be as low as $38.30. This premium is deducted from the associate’s paycheck before taxes, providing a tax advantage.
Beyond premiums, associates are responsible for other costs such as deductibles, co-pays, and co-insurance. For the Premier PPO Plan, in-network doctor visits have fixed co-pays, such as $35 for primary care or mental health visits and $75 for specialist or urgent care visits. The deductible is the amount paid out-of-pocket before the plan begins covering major medical expenses. For the Premier Plan, this deductible is $2,750 for an individual, after which the plan pays up to 75% of eligible in-network costs.
The Enrollment Process and Timing
New associates who meet eligibility requirements have a specific initial enrollment window to select medical coverage. This period begins after receiving the first paycheck and extends until the day before the first day of the calendar month coinciding with the 89th day of continuous employment. Enrollment must be completed during this window for coverage to begin on the scheduled effective date.
Once enrolled, associates must keep their plan selection for the entire calendar year. Changes can only be made during the annual Open Enrollment period, which usually takes place in the fall, or if the associate experiences a Qualifying Life Event (QLE). A QLE, such as marriage, divorce, birth or adoption of a child, or loss of other coverage, allows for a special 30-day window to make changes outside of standard enrollment periods.
Additional Health and Wellness Benefits
Walmart’s benefits extend beyond medical coverage to include other plans focused on health and wellness. These ancillary benefits are elected separately from the main medical plan and have their own distinct premiums and coverage rules.
Dental Coverage
Dental insurance is available to eligible associates and covers a range of services, from preventive care to significant procedures. The plan covers preventive care, such as regular cleanings and X-rays, at 100% when utilizing a network provider. Basic procedures like fillings are covered at 80%, while major services, such as crowns and dentures, receive 50% coverage after a deductible is met.
Vision Coverage
A separate vision plan is offered to cover the costs associated with routine eye care and corrective lenses. Vision coverage assists with expenses for annual eye exams and provides discounts or allowances for glasses or contact lenses. The plan operates through a network of eye doctors and optical retailers, including the Vision Centers located within many Walmart stores.
Ancillary Benefits (Life Insurance, Disability)
Associates have access to various forms of financial protection, including life insurance and disability coverage. Company-paid life insurance may be automatically provided to eligible full-time associates upon meeting the tenure requirement. Additional voluntary coverage, such as supplemental life insurance, long-term disability, and short-term disability insurance, is available for increased protection.