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Click here or scroll down to respond to this candidate23AE-Standard-Medical-Rates 111422AConfidential Internal Use Only Street Address Walmar! Inc. 1Candidate's Name
Cost per biweekly pay periodTobacco-freeOnetobaccouserTwotobaccousersAssociate only $33.00 $66.00
Associate + spouse/par!ner $167.00 $200.00 $233.00 Associate + child(ren) $52.90 $85.90
Associate + family $195.90 $228.90 $261.90Saver PlanCost per biweekly pay periodTobacco-freeOnetobaccouserTwotobaccousersAssociate only $36.80 $73.60
Associate + spouse/par!ner $174.80 $211.60 $248.40 Associate + child(ren) $57.80 $94.60
Associate + family $201.80 $238.60 $275.40Contribution PlanCost per biweekly pay periodTobacco-freeOnetobaccouserTwotobaccousersAssociate only $93.30 $186.60
Associate + spouse/par!ner $315.60 $408.90 $502.20 Associate + child(ren) $131.60 $224.90
Associate + family $338.00 $431.30 $524.60Local Plans available in select locationsMedical plans available in most locationsBanner: ArizonaCost per biweekly pay periodTobacco-freeOnetobaccouserTwotobaccousersAssociate only $26.90 $53.80
Associate + spouse/par!ner $148.90 $175.80 $202.70 Associate + child(ren) $44.10 $71.00
Associate + family $174.50 $201.40 $228.30Mercy Arkansas: NW ArkansasCost per biweekly pay periodTobacco-freeOnetobaccouserTwotobaccousersAssociate only $53.00 $106.00
Associate + spouse/par!ner $221.20 $274.20 $327.20 Associate + child(ren) $82.90 $135.90
Associate + family $261.60 $314.60 $367.602023 Benefits rates23AE-Standard-Medical-Rates 111422A 2Confidential Internal Use Only 2022 Walmar! Inc. Health Net ExcelCareHigh Option: CaliforniaCost per biweekly pay periodTobacco-freeOnetobaccouserTwotobaccousersAssociate only $59.70 $119.40
Associate + spouse/par!ner $244.80 $304.50 $364.20 Associate + child(ren) $122.50 $182.20
Associate + family $286.60 $346.30 $406.00Health Net Salud Y Mas:CaliforniaCost per biweekly pay periodTobacco-freeOnetobaccouserTwotobaccousersAssociate only $56.30 $112.60
Associate + spouse/par!ner $226.70 $283.00 $339.30 Associate + child(ren) $79.60 $135.90
Associate + family $265.70 $322.00 $378.30Kaiser CaliforniaHigh Option:Nor!h and SouthCost per biweekly pay periodTobacco-freeOnetobaccouserTwotobaccousersAssociate only $60.40 $120.80
Associate + spouse/par!ner $249.00 $309.40 $369.80 Associate + child(ren) $97.90 $158.30
Associate + family $295.00 $355.40 $415.80Kaiser CaliforniaLow Option:Nor!h and SouthCost per biweekly pay periodTobacco-freeOnetobaccouserTwotobaccousersAssociate only $36.70 $73.40
Associate + spouse/par!ner $141.30 $178.00 $214.70 Associate + child(ren) $54.50 $91.20
Associate + family $160.90 $197.60 $234.30Kaiser of ColoradoLow OptionCost per biweekly pay periodTobacco-freeOnetobaccouserTwotobaccousersAssociate only $47.90 $95.80
Associate + spouse/par!ner $181.00 $228.90 $276.80 Associate + child(ren) $70.20 $118.10
Associate + family $208.40 $256.30 $304.20Health Net ExcelCareLow Option: CaliforniaCost per biweekly pay periodTobacco-freeOnetobaccouserTwotobaccousersAssociate only $39.00 $78.00
Associate + spouse/par!ner $169.20 $208.20 $247.20 Associate + child(ren) $77.90 $116.90
Associate + family $198.70 $237.70 $276.70Geisinger Extra HealthPlan: PennsylvaniaGeisinger Extra HealthPlan: eastern regionPennsylvaniaGeisinger Health Plan:PennsylvaniaGeisinger HealthPlan: eastern regionPennsylvaniaCost per biweekly pay periodTobacco-freeOnetobaccouserTwotobaccousersAssociate only $80.60 $161.20
Associate + spouse/par!ner $289.20 $369.80 $450.40 Associate + child(ren) $120.10 $200.70
Associate + family $354.60 $435.20 $515.80HMO Plans available in select locationsKaiser of GeorgiaLow OptionCost per biweekly pay periodTobacco-freeOnetobaccouserTwotobaccousersAssociate only $45.30 $90.60
Associate + spouse/par!ner $199.50 $244.80 $290.10 Associate + child(ren) $67.60 $112.90
Associate + family $234.00 $279.30 $324.6023AE-Standard-Medical-Rates 111422A 3Confidential Internal Use Only 2022 Walmar! Inc. Kaiser of the Mid-AtlanticLow Option: MarylandKaiser of the Mid-AtlanticLow Option: VirginiaCost per biweekly pay periodTobacco-freeOnetobaccouserTwotobaccousersAssociate only $63.80 $127.60
Associate + spouse/par!ner $203.40 $267.20 $331.00 Associate + child(ren) $86.40 $150.20
Associate + family $242.50 $306.30 $370.10Kaiser of OregonHigh OptionCost per biweekly pay periodTobacco-freeOnetobaccouserTwotobaccousersAssociate only $65.90 $131.80
Associate + spouse/par!ner $259.20 $325.10 $391.00 Associate + child(ren) $96.60 $162.50
Associate + family $311.60 $377.50 $443.40Kaiser of Washington stateCost per biweekly pay periodTobacco-freeOnetobaccouserTwotobaccousersAssociate only $29.50 $59.00
Associate + spouse/par!ner $141.70 $171.20 $200.70 Associate + child(ren) $44.50 $74.00
Associate + family $170.30 $199.80 $229.30Kaiser of OregonLow OptionCost per biweekly pay periodTobacco-freeOnetobaccouserTwotobaccousersAssociate only $51.40 $102.80
Associate + spouse/par!ner $195.30 $246.70 $298.10 Associate + child(ren) $71.70 $123.10
Associate + family $234.50 $285.90 $337.30HMO Plans (cont.)PPO PlanPlans for U.S.-based Global Tech associatesAvailable in select locations.PPO PlanCost per biweekly pay periodTobacco-freeOnetobaccouserTwotobaccousersAssociate only $40.70 $81.40
Associate + spouse/par!ner $177.20 $217.90 $258.60 Associate + child(ren) $69.00 $109.70
Associate + family $205.50 $246.20 $286.90HMO PlansKaiser of OregonCost per biweekly pay periodTobacco-freeOnetobaccouserTwotobaccousersAssociate only $35.60 $71.20
Associate + spouse/par!ner $153.80 $189.40 $225.00 Associate + child(ren) $60.30 $95.90
Associate + family $178.40 $214.00 $249.60Kaiser California:Nor!h and SouthCost per biweekly pay periodTobacco-freeOnetobaccouserTwotobaccousersAssociate only $35.00 $70.00
Associate + spouse/par!ner $150.50 $185.50 $220.50 Associate + child(ren) $59.00 $94.00
Associate + family $174.40 $209.40 $244.4023AE-Standard-Medical-Rates 111422A 4Confidential Internal Use Only 2022 Walmar! Inc. HMSA HawaiiCost per biweekly pay periodTobacco-freeOnetobaccouserTwotobaccousersAssociate only $59.20 $118.40
Associate + spouse/par!ner $290.90 $350.10 $409.30 Associate + child(ren) $140.60 $199.80
Associate + family $341.20 $400.40 $459.60Hawaii PlansVisionDentalVision and Dental PlansCost per biweekly pay periodCoverage RateAssociate only $2.76Associate + spouse/par!ner $5.52Associate + child(ren) $5.52Associate + family $8.26Note: If you have an HMO medical plan available, the HMO may offer its own vision coverage, so consider whether those benefits meet your needs before you make your enrollment decision.Cost per biweekly pay periodCoverage RateAssociate only $8.30Associate + spouse/par!ner $20.00Associate + child(ren) $19.40Associate + family $33.90Kaiser HawaiiCost per biweekly pay periodTobacco-freeOnetobaccouserTwotobaccousersAssociate only $54.60 $109.20
Associate + spouse/par!ner $284.80 $339.40 $394.00 Associate + child(ren) $126.50 $181.10
Associate + family $332.30 $386.90 $441.5023AE-Standard-Medical-Rates 111422A 5Confidential Internal Use Only 2022 Walmar! Inc. Optional associate life insuranceIncome protections and extra insuranceCost per biweekly pay periodAssociatesageAll eligible associates Management/truck drivers only$25,000 $50,000 $75,000 $100,000 $150,000 $200,000 $300,000 $500,000 $750,000 $1,000,000 under 25$0.36 $0.71 $1.07 $1.43 $2.14 $2.85 $4.28 $7.13 $10.70 $14.27$0.39 $0.78 $1.17 $1.56 $2.35 $3.13 $4.69 $7.82 $11.74 $15.65 2529$0.39 $0.78 $1.17 $1.56 $2.35 $3.13 $4.69 $7.82 $11.74 $15.65$0.43 $0.85 $1.28 $1.70 $2.55 $3.41 $5.11 $8.52 $12.77 $17.03 3034$0.53 $1.06 $1.59 $2.12 $3.18 $4.23 $6.35 $10.59 $15.88 $21.17$0.60 $1.20 $1.80 $2.39 $3.59 $4.79 $7.18 $11.97 $17.95 $23.93 3539$0.64 $1.29 $1.93 $2.58 $3.87 $5.16 $7.73 $12.89 $19.33 $25.78$0.72 $1.45 $2.17 $2.90 $4.35 $5.80 $8.70 $14.50 $21.75 $29.00 4044$0.74 $1.47 $2.21 $2.95 $4.42 $5.89 $8.84 $14.73 $22.09 $29.46$0.84 $1.68 $2.52 $3.36 $5.04 $6.72 $10.08 $16.80 $25.20 $33.60 4549$1.14 $2.28 $3.42 $4.56 $6.84 $9.11 $13.67 $22.78 $34.18 $45.57$1.29 $2.58 $3.87 $5.16 $7.73 $10.31 $15.47 $25.78 $38.66 $51.55 5054$1.73 $3.45 $5.18 $6.90 $10.36 $13.81 $20.71 $34.52 $51.78 $69.04$1.98 $3.96 $5.94 $7.92 $11.88 $15.83 $23.75 $39.58 $59.38 $79.17 5559$3.21 $6.42 $9.63 $12.84 $19.26 $25.68 $38.52 $64.21 $96.31 $128.42$3.67 $7.34 $11.01 $14.68 $22.02 $29.37 $44.05 $73.41 $110.12 $146.83 6064$4.78 $9.55 $14.33 $19.10 $28.65 $38.20 $57.30 $95.51 $143.26 $191.01$5.45 $10.91 $16.36 $21.82 $32.73 $43.63 $65.45 $109.08 $163.63 $218.17 6569$8.94 $17.88 $26.82 $35.76 $53.64 $71.53 $107.29 $178.82 $268.22 $357.63$11.93 $23.87 $35.80 $47.73 $71.60 $95.46 $143.19 $238.65 $357.98 $477.30 70+$13.90 $27.80 $41.70 $55.60 $83.40 $111.20 $166.80 $278.01 $417.01 $556.01$18.54 $37.08 $55.61 $74.15 $111.23 $148.30 $222.45 $370.75 $556.13 $741.50 Tobacco-free user Tobacco user Tobacco-free user Tobacco user 23AE-Standard-Medical-Rates 111422A 6Confidential Internal Use Only 2022 Walmar! Inc. Cost per biweekly pay periodAssociates age $5,000 $15,000 $25,000 $50,000 $75,000 $100,000 $150,000 $200,000 under 25$0.18 $0.54 $0.90 $1.80 $2.69 $3.59 $5.39 $7.18$0.21 $0.62 $1.04 $2.07 $3.11 $4.14 $6.21 $8.282529$0.21 $0.64 $1.07 $2.14 $3.21 $4.28 $6.42 $8.56$0.24 $0.71 $1.19 $2.37 $3.56 $4.74 $7.11 $9.483034$0.29 $0.86 $1.43 $2.85 $4.28 $5.71 $8.56 $11.41$0.32 $0.95 $1.59 $3.18 $4.76 $6.35 $9.53 $12.703539$0.32 $0.96 $1.60 $3.20 $4.80 $6.40 $9.60 $12.80$0.35 $1.06 $1.77 $3.54 $5.32 $7.09 $10.63 $14.184044$0.35 $1.06 $1.77 $3.54 $5.32 $7.09 $10.63 $14.18$0.40 $1.19 $1.98 $3.96 $5.94 $7.92 $11.88 $15.834549$0.53 $1.59 $2.66 $5.32 $7.97 $10.63 $15.95 $21.26$0.62 $1.85 $3.08 $6.17 $9.25 $12.34 $18.50 $24.67 5054$0.82 $2.45 $4.08 $8.17 $12.25 $16.34 $24.51 $32.68$0.95 $2.84 $4.74 $9.48 $14.22 $18.96 $28.44 $37.93 5559$1.53 $4.58 $7.63 $15.26 $22.89 $30.52 $45.77 $61.03$1.85 $5.55 $9.25 $18.50 $27.75 $37.01 $55.51 $74.01 6064$2.34 $7.03 $11.71 $23.43 $35.14 $46.86 $70.28 $93.71$2.96 $8.87 $14.79 $29.57 $44.36 $59.15 $88.72 $118.29 6569$4.51 $13.53 $22.54 $45.08 $67.63 $90.17 $135.25 $180.34$5.92 $17.76 $29.60 $59.19 $88.79 $118.38 $177.57 $236.76 70+$7.31 $21.94 $36.57 $73.14 $109.71 $146.28 $219.41 $292.55$9.60 $28.81 $48.02 $96.04 $144.05 $192.07 $288.11 $384.14 Tobacco-free user Tobacco userOptional spouse/par!ner life insurance**Spouse/par!ner life insurance is based on associates age. Cost per biweekly pay periodCoverage Rate$5,000 per dependent $0.33$10,000 per dependent $0.66$20,000 per dependent $1.32Optional dependent life insurance child(ren)23AE-Standard-Medical-Rates 111422A 7Confidential Internal Use Only 2022 Walmar! Inc. Cost per biweekly pay period*Associate onlyAssociates age $5,000 $10,000 $15,000 $20,000under 25$0.40 $0.80 $1.18 $1.58$0.58 $1.16 $1.74 $2.322529$0.40 $0.80 $1.18 $1.58$0.58 $1.16 $1.74 $2.323034$0.40 $0.80 $1.18 $1.58$0.58 $1.16 $1.74 $2.323539$0.52 $1.02 $1.54 $2.04$0.68 $1.34 $2.02 $2.684044$0.80 $1.58 $2.36 $3.14$1.06 $2.14 $3.20 $4.264549$1.26 $2.50 $3.74 $5.00$1.72 $3.42 $5.14 $6.845054$2.08 $4.16 $6.24 $8.32$2.82 $5.64 $8.46 $11.265559$2.76 $5.50 $8.24 $11.00$3.72 $7.44 $11.16 $14.866064$3.52 $7.02 $10.54 $14.04$4.80 $9.60 $14.40 $19.206569$4.18 $8.36 $12.54 $16.72$5.74 $11.46 $17.18 $22.9070+$5.56 $11.14 $16.70 $22.26$7.60 $15.20 $22.78 $30.38Tobacco-free user Tobacco userCritical illness*If you are enrolled in the Saver Plan, your rates will be slightly lower because you are not eligible for the major organ transplant rider. 23AE-Standard-Medical-Rates 111422A 8Confidential Internal Use Only 2022 Walmar! Inc. Cost per biweekly pay period*Associate + spouse/par!nerAssociates age $5,000 $10,000 $15,000 $20,000under 25$0.86 $1.72 $2.56 $3.42$1.04 $2.08 $3.12 $4.16$1.06 $2.14 $3.20 $4.26$1.26 $2.50 $3.74 $5.002529$0.86 $1.72 $2.56 $3.42$1.04 $2.08 $3.12 $4.16$1.06 $2.14 $3.20 $4.26$1.26 $2.50 $3.74 $5.003034$0.86 $1.72 $2.56 $3.42$1.04 $2.08 $3.12 $4.16$1.06 $2.14 $3.20 $4.26$1.26 $2.50 $3.74 $5.003539$1.12 $2.22 $3.34 $4.44$1.28 $2.54 $3.82 $5.08$1.32 $2.64 $3.96 $5.26$1.48 $2.96 $4.44 $5.924044$1.74 $3.46 $5.20 $6.94$2.02 $4.02 $6.04 $8.04$2.06 $4.12 $6.16 $8.22$2.34 $4.66 $7.00 $9.344549$2.76 $5.50 $8.24 $11.00$3.22 $6.42 $9.64 $12.84$3.34 $6.66 $9.98 $13.30$3.80 $7.58 $11.36 $15.145054$4.64 $9.28 $13.92 $18.56$5.38 $10.76 $16.14 $21.52$5.56 $11.14 $16.70 $22.26$6.30 $12.60 $18.90 $25.205559$6.22 $12.42 $18.64 $24.84$7.18 $14.36 $21.54 $28.72$7.44 $14.86 $22.30 $29.74$8.40 $16.80 $25.20 $33.606064$7.94 $15.88 $23.82 $31.76$9.24 $18.46 $27.70 $36.94$9.58 $19.16 $28.74 $38.32$10.88 $21.74 $32.62 $43.486569$9.44 $18.88 $28.32 $37.76$11.00 $21.98 $32.96 $43.94$11.40 $22.80 $34.20 $45.60$12.96 $25.90 $38.84 $51.8070+$12.58 $25.16 $37.74 $50.32$14.62 $29.22 $43.84 $58.44$15.16 $30.34 $45.50 $60.66$17.20 $34.40 $51.58 $68.78Tobacco-free users One tobacco user (associate) One tobacco user (spouse/par!ner) Two tobacco users*If you are enrolled in the Saver Plan, your rates will be slightly lower because you are not eligible for the major organ transplant rider. Critical illness23AE-Standard-Medical-Rates 111422A 9Confidential Internal Use Only 2022 Walmar! Inc. Cost per biweekly pay period*Associate + dependent child(ren)Associates age $5,000 $10,000 $15,000 $20,000under 25$0.58 $1.16 $1.74 $2.32$0.76 $1.54 $2.30 $3.062529$0.58 $1.16 $1.74 $2.32$0.76 $1.54 $2.30 $3.063034$0.58 $1.16 $1.74 $2.32$0.76 $1.54 $2.30 $3.063539$0.70 $1.40 $2.08 $2.78$0.86 $1.72 $2.56 $3.424044$0.98 $1.94 $2.92 $3.88$1.26 $2.50 $3.74 $5.004549$1.44 $2.86 $4.30 $5.74$1.90 $3.80 $5.68 $7.585054$2.26 $4.54 $6.80 $9.06$3.00 $6.00 $9.00 $12.005559$2.94 $5.86 $8.80 $11.74$3.90 $7.80 $11.70 $15.606064$3.70 $7.40 $11.08 $14.78$5.00 $9.98 $14.96 $19.946569$4.36 $8.74 $13.10 $17.46$5.92 $11.82 $17.74 $23.6470+$5.76 $11.50 $17.24 $23.00$7.78 $15.56 $23.34 $31.12Tobacco-free user Tobacco user*If you are enrolled in the Saver Plan, your rates will be slightly lower because you are not eligible for the major organ transplant rider. Critical illness23AE-Standard-Medical-Rates 111422A 10Confidential Internal Use Only 2022 Walmar! Inc.*If you are enrolled in the Saver Plan, your rates will be slightly lower because you are not eligible for the major organ transplant rider. Critical illnessCost per biweekly pay period*Associate + familyAssociates age $5,000 $10,000 $15,000 $20,000under 25$1.04 $2.08 $3.12 $4.16$1.24 $2.46 $3.68 $4.90$1.26 $2.50 $3.74 $5.00$1.44 $2.86 $4.30 $5.742529$1.04 $2.08 $3.12 $4.16$1.24 $2.46 $3.68 $4.90$1.26 $2.50 $3.74 $5.00$1.44 $2.86 $4.30 $5.743034$1.04 $2.08 $3.12 $4.16$1.24 $2.46 $3.68 $4.90$1.26 $2.50 $3.74 $5.00$1.44 $2.86 $4.30 $5.743539$1.30 $2.60 $3.88 $5.18$1.46 $2.92 $4.36 $5.82$1.50 $3.00 $4.50 $6.00$1.66 $3.34 $5.00 $6.664044$1.92 $3.84 $5.76 $7.66$2.20 $4.40 $6.58 $8.78$2.24 $4.48 $6.72 $8.96$2.52 $5.04 $7.56 $10.064549$2.94 $5.86 $8.80 $11.74$3.40 $6.80 $10.18 $13.58$3.52 $7.02 $10.54 $14.04$3.98 $7.94 $11.92 $15.885054$4.84 $9.66 $14.48 $19.30$5.56 $11.14 $16.70 $22.26$5.76 $11.50 $17.24 $23.00$6.50 $12.98 $19.46 $25.945559$6.40 $12.80 $19.18 $25.58$7.36 $14.74 $22.10 $29.46$7.62 $15.24 $22.86 $30.46$8.60 $17.18 $25.76 $34.346064$8.14 $16.26 $24.38 $32.50$9.42 $18.84 $28.26 $37.66$9.76 $19.54 $29.30 $39.06$11.06 $22.12 $33.16 $44.226569$9.64 $19.26 $28.88 $38.50$11.18 $22.34 $33.52 $44.68$11.60 $23.18 $34.76 $46.34$13.14 $26.26 $39.40 $52.5470+$12.76 $25.54 $38.30 $51.06$14.80 $29.60 $44.38 $59.18$15.36 $30.70 $46.04 $61.40$17.38 $34.76 $52.14 $69.52Tobacco-free users One tobacco user (associate) One tobacco user (spouse/par!ner) Two tobacco users 23AE-Standard-Medical-Rates 111422A 11Confidential Internal Use Only 2022 Walmar! Inc. Cost per biweekly pay periodCoverageAll eligible associates Management only$25,000 $50,000 $75,000 $100,000 $150,000 $200,000 $300k $500k $750k $1M Associate only $0.16 $0.32 $0.48 $0.64 $0.97 $1.29 $1.93 $3.22 $4.83 $6.44 Associate +family $0.31 $0.62 $0.93 $1.24 $1.86 $2.49 $3.73 $6.21 $9.32 $12.43 Accidental death and dismemberment insurance (AD&D) Cost per biweekly pay periodCoverage RateAssociate only $0.68Associate + spouse/par!ner $1.28Associate + child(ren) $1.34Associate + family $1.80Accident insuranceShor!-term disability enhanced insuranceCost per biweekly pay period*Age Rate CT only rate DC only rate MA only rate NY only rate WA only rate under 25 $0.19 $0.10 $0.10 $0.03 $0.33 $0.062529 $0.19 $0.10 $0.10 $0.03 $0.43 $0.063034 $0.19 $0.10 $0.10 $0.03 $0.46 $0.063539 $0.19 $0.10 $0.10 $0.03 $0.51 $0.064044 $0.20 $0.11 $0.11 $0.03 $0.43 $0.074549 $0.24 $0.13 $0.13 $0.03 $0.43 $0.085054 $0.31 $0.16 $0.17 $0.04 $0.63 $0.105559 $0.35 $0.18 $0.19 $0.05 $0.72 $0.126064 $0.42 $0.22 $0.23 $0.06 $1.04 $0.146569 $0.52 $0.27 $0.28 $0.07 $1.50 $0.1770+ $0.67 $0.35 $0.36 $0.09 $1.51 $0.22*Disability costs are based on your age and earnings. To find your cost, divide your pretax earnings by 100 and multiply by the rate above. 23AE-Standard-Medical-Rates 111422A 12Confidential Internal Use Only 2022 Walmar! Inc. Long-term and long-term enhanced disability insurance Truck driver long-term disability insuranceCost per biweekly pay period*Age LTD rate LTD enhanced rateunder 25 $0.05 $0.082529 $0.09 $0.143034 $0.13 $0.213539 $0.25 $0.374044 $0.37 $0.574549 $0.56 $0.855054 $0.80 $1.175559 $0.95 $1.376064 $1.02 $1.546569 $0.91 $1.4070+ $0.89 $1.36Cost per biweekly pay period*Plan duration option Driver LTD rate** Driver LTD enhanced rate** Five-year duration coverage $1.73 $2.59Full-duration coverage $2.34 $3.52*Disability costs are based on your age and earnings. To find your cost, divide your pretax earnings by 100 and multiply by the rate above.**Truck driver LTD coverage premiums are based on earnings and the type of truck driver LTD coverage. |
