Company-paidlifeinsurance
121
Company-paidlifeinsurance
Whetheryouaresingleormarried,yourlovedoneswillhaveexpensesasaresultofyourdeath.
That’swhyWalmartautomaticallyprovidesyouwithlifeinsuranceatnocosttoyou.Yourcompany-
paidlifeinsurancebenetcanhelppayforyourfuneral,anycreditcardbalances,orotherdebtsand
expensesyoumayleavebehind.
COMPANYPAID LIFE INSURANCE RESOURCES
Find What You Need Online OtherResources
Changeyourbeneciarydesignation GototheWIREorWalmartOne.com Beneciarychangescannotbemade
overthephone
• Getmoredetailsaboutcompany-paid
lifeinsurance
• Requestanacceleratedbenet
• Getdetailsaboutcontinuing
yourinsurance
CallPrudentialat 877-74 0 -2116
Fileaclaim CallPrudentialat 877-74 0 -2116
Whatyouneedtoknowaboutcompany-paidlifeinsurance
• Wal-MartStores,Inc.providesallfull-timeassociates(includingfull-timehourlypharmacists,eldLogisticsassociates,
full-timetruckdrivers,eldsupervisorpositionsinstoresandclubs,managementtrainees,Californiapharmacists,
full-timehourlyVisionCentermanagersandwalmart.comfunctionalnon-exemptassociates)andmanagementassociates
withcompany-paidlifeinsurance—thereisnocosttoyou.
• Noenrollmentisnecessary.Coveragewillbecomeeectiveafteranyapplicablewaitingperiod.SeetheEligibility and
Enrollmentchapterfordetails.
• Yourcoverageamountisequaltoyourpay,includingovertimeandbonuses,duringtheprevious26payperiodsof
activestatus(52payperiodsifpaidweekly)priortoyourdeath,roundedtothenearest$1,000,uptoamaximumof
$50,000.Thiscompany-paidinsuranceisprovidedthroughThePrudentialInsuranceCompanyofAmerica(Prudential).
• Anearlypayoutduetoterminalillnessisavailable.
• Inaddition,ifyourdeathoccursoutsideofa100-mileradiusofyourhome,thereisabenetforexpensesthatare
incurredtoreturnyourbodytoeitherapreferredlocationwithintheUnitedStatesortoyourresidenceatthetime
ofdeath.Thebenetincludesexpensesforembalming,cremation,aconandtransportationoftheremains.
Thebenetisthelesserofthecosttoreturnyourremainsor$10,000.
• Thispolicyhasnocashvalue.
122
Naming a beneciary under your
company-paidlifeinsurance
Inordertoensureyourcompany-paidlifeinsurance
benetispaidaccordingtoyourwishes,youmustnamea
beneciary(ies).YoumaydothisbygoingtotheWIREor
WalmartOne.com.
Youcannameanyoneyouwish.Ifthebeneciary(ies)you
havelistedwiththecompanydiersfromthosenamedin
yourwill,thelistthatthecompanyhasprevails.
Thefollowinginformationisneededwhennamingyour
beneciary(ies):
• Beneciary(ies)name
• Beneciary(ies)currentaddress
• Beneciary(ies)phonenumber
• Beneciary(ies)relationshiptoyou
• Beneciary(ies)SocialSecuritynumber
• Beneciary(ies)dateofbirth
• Thepercentageyouwishtodesignateperbeneciaryupto
100%.
Iftwoormorebeneciariesaredesignatedandtheirshares
arenotspecied,theywillsharetheinsurancebenetequally.
Ifanamedbeneciarydiesbeforeyou,thatbeneciary’s
interestwillend,andwillbesharedequallybyanyremaining
beneciary(ies)unlessyourbeneciaryformstatesotherwise.
Youcannameaminorasabeneciary;however,Prudential
maynotbelegallypermittedtopaytheminoruntiltheminor
reacheslegalage.Youmaywanttoconsultwithanattorney
oranestateplannerbeforenamingaminorasabeneciary.
Ifyounameaminorasabeneciary,funeralexpensescannot
bepaidfromtheminor’sbeneciaryproceeds.
IF YOU DO NOT NAME A BENEFICIARY
Ifnobeneciaryisnamed,paymentwillbemadetoyour
survivingfamilymember(s)inthefollowingorder:
1. Widoworwidowerorpartnerofthedeceased;
ifnotsurviving,then
2. Childreninequalshares;ifnotsurviving,then
3. Parentsinequalshares;ifnotsurviving,then
4. Siblingsinequalshares;ifnotsurviving,then
5. Executororadministratorofyourestate.
Whenyourcompany-paidlife
insurancecoveragebegins
Youmustbeactively-at-workinorderforyourcoverageto
becomeeective.Youwillbeconsideredactively-at-work
onadaythatisoneofyourscheduledworkdaysifyouare
performingintheusualwayalloftheregulardutiesofyour
job.SeetheEligibility and enrollmentchapterfordetails.
Additional benets
Benetsarepayableunderthefollowingcircumstances:
• Ifadependentchildisbornaliveanddieswithin60days
ofbirthandwasnotenrolledinoptionaldependentlife
insurancepriortotheloss—withalivebirthcerticate
andadeathcerticate—Prudentialwillpaya$2,000
benetonly.
• Ifadependentchildisstillborn,Prudentialwillpaya$2,000
benet.Astillbornchildisdenedasaneligibleassociate’s
natural-bornchildwhosedeathoccursbeforeexpulsion,
extractionordeliveryandwhosefetalweightis350grams
ormore;or,iffetalweightisunknown,whosedurationin
uterowas20ormorecompleteweeksofgestation.Ifboth
themotherandfatherofthestillbornchildworkatWalmart,
eachassociateiseligibletosubmitaclaimforthisbenet
separately,foratotalof$4,000.
An early payout due to terminal illness
Ifyouareterminallyill,youmayelecttoreceiveupto50%
oftheamountyourbeneciary(ies)wouldhavereceived
uponyourdeath,whileyouarestillliving.Paymentmaybe
madeinalumpsumor12equalmonthlyinstallments.Upon
yourdeath,yourbeneciary(ies)willreceivetheremaining
50%(plusanyamountoftheearlypayoutnotyetreceived
atthetimeofyourdeath).Thisbenetisreferredtoasthe
“acceleratedbenet.”
Ifyouterminatefromthecompanyafteryouhavereceived
(orbeguntoreceive)theaccelerateddeathbenet,youwill
needtoconvertthepolicyinorderforyourbeneciary(ies)
toreceivetheremainingbalanceuponyourdeath.If
youdonotconvertthepolicyuponterminationofyour
employment,therewillbenobenetpayoutforyour
beneciary(ies).SeetheContinuing your company-paid
life insurance after you leave Walmartsectioninthis
chapterfordetailsonconversion.
Youareterminallyillif:
• Thereisnoreasonableprospectofrecovery;
• Deathisexpectedwithin12months;and
• Adoctorcancertifytheillnessorinjuryasterminal.
2014AssociateBenetsBook | Questions?LogontoWalmartOne.comortheWIRE,orcallBenetsCustomerServiceat800-421-1362
Company-paidlifeinsurance
123
Theremaybesomecircumstanceswhentheaccelerated
benetwillnotbepaid.ContactPrudentialat877-74 0 -2116
fordetails.
Taxlawsarecomplex.Pleaseconsultwithataxprofessionalto
assesstheimpactofthisbenet.
Filing a claim
Within12monthsofthecoveredassociate’sdeath,contact
Prudentialat877-740 -2116andprovidethefollowing
informationregardingthedeceasedassociate:
• Name;
• SocialSecuritynumber;
• Dateofdeath;and
• Causeofdeath(ifknown).
Anoriginalorcertiedcopyofthedeathcerticatemaybe
requiredasproofofdeath.Mailthedeathcerticateto:
The Prudential Insurance Company of America
Group Life Claim Division
P.O. Box 8517
Philadelphia, PA 19176
Theclaimwillnotbenalizeduntilthedeathcerticate
isreceived.Acceptanceofthedeathcerticateisnota
guaranteeofpayment.
Claimswillbedeterminedunderthetimeframesand
requirementssetoutintheClaims and appealschapter.
Yourbeneciary(ies)hastherighttoappealaclaimdenial.
Benetsarepaidaccordingtothetermsoftheinsurance
policy.Formoredetails,contactPrudentialat877-74 0 -2116.
When benets are not paid
Benetswillnotbepaidtoanybeneciary(ies)whoengaged
inanillegalactthatresultedinthedeathoftheassociate.
Instead,thebenetwouldgotoanothereligiblebeneciary
ortoyourestate.
Whencoverageends
Yourcompany-paidlifeinsurancecoverageends:
• Atterminationofyouremployment;
• Onthelastdayofthepayperiodwhenyourjobstatus
changestopart-time;
• Onthedateofyourdeath;
• Onthedatethatyouloseeligibility;
• Onthelastdayofanapprovedleaveofabsence(unlessyou
returntowork);or
• Whenthebenetisnolongeroeredbythecompany.
Thispolicyhasnocashvalue.
EstateGuidance®
EstateGuidanceoersyoutheconvenienceofonlinewill
preparationfromyourpersonalcomputeratnocostto
you.Willsensurethatyourassetswillbedistributedin
accordancewithyourwishesandallowyoutonamea
guardiantotakecareofyourminorchildren.Tocomplete
theonlinewillquestionnaire,logontowillguidance.com,
password:WMTWILL.
NOTE:Ifthebeneciary(ies)youhavelistedwiththe
companydiersfromthosenamedinyourwill,thelist
thatthecompanyhasprevails.
Continuingyourcompany-paidlife
insuranceafteryouleaveWalmart
Inmostcircumstances,youwillhavetwooptionstocontinue
yourcompany-paidlifeinsuranceifyourgrouplifecoverage
ends.Therstoption,calledportability,allowsyouto
continuealloraportionofyourcurrentcoveragethrougha
grouptermpolicywithPrudential.Thesecondoption,called
conversion,allowsyoutoconvertalloraportionofyour
coveragetoaPrudentialindividualpolicy.
Youmustapplyforportabilityorconversionwithin31daysof
thedateyourcompany-paidcoverageends.Ifyoudiewithin
31daysofaqualifyinglossofcoverageandbeforeelecting
portabilityorconversionofyourlifeinsurancecoverage,
Prudentialwillpayadeathbenettoyourbeneciary.The
benetwillbepaidbasedontheamountofcoveragein
eectpriortothequalifyinglossofcoverage,evenifyoudid
notapplyforportabilityorconversionofyourcoverage.
It’simportanttoupdateyour
beneciary information annually.
Keepinmind,proceedswillgoto
whoeverislistedonyourbeneciary
form with the company, regardless
of your current relationship with
that person. You can change your
beneciary(ies)atanytimeonthe
WIRE or WalmartOne.com.
124
Portabilityenablesyoutomaintainsimilartermlifeinsurance
withPrudentialafteryouremploymentendsifcertain
conditionsaremet.ProofofGoodHealthisrequiredtoport
yourcoverage.IfyoudonotpassorsubmitproofofGood
Health,youwillbeeligibletoconvertyourcompany-paidlife
insurancetoanindividualpolicy,asdescribedbelow.
Youwillbeabletoapplyfortermlifecoverageunderthe
portabilityfeatureifyoumeetalloftheseconditions:
1. Yourcompany-paidlifecoverageendsforanyreason
otherthan:
a. yourfailuretopaypremiumswhileyouwerean
activeassociate;or
b.youleavethecompanyduetoadisability;or
c. Walmartchangesgrouplifeinsurancecarriersand
youare,orbecomeeligible,withinthenext31days.
2. Youmeettheactively-at-workrequirementontheday
yourcompany-paidinsuranceends.
3. Youarelessthanage80.
4. Youramountofinsuranceisatleast$20,000ontheday
yourcompany-paidinsuranceends.
Ifyoumeettheseconditions,youwillhave31daysfromyour
terminationdatetocontactPrudentialandenroll.
ConversionisarequiredPlanprovisionthatallowsyouto
convertyourlifeinsurancecoveragetoanindividualpolicy.
Ratesarebasedonanindividual’sageandamountconverted.
Youhave31daysfromtheterminationdateofcoverageto
requesttoconvertyourcoveragetoanindividualpolicy.If
yourdeathoccursduringthe31-dayconversionperiod,the
deathbenetwillbepayableuptotheamountthatcould
havebeenconverted.
ForresidentsofMinnesota,youmayelecttocontinue
coverageatyourexpenseifyouremploymentisterminated
eithervoluntarilyorinvoluntarily,orifyouarelaido,as
longasthegrouppolicyisstillinforcewiththeemployer.
Coveragemaybecontinueduntilyouobtaincoverage
underanothergrouppolicyoryoureturntoworkfrom
layo;however,themaximumperiodthatcoveragemaybe
continuedis18months.
Torequestinformationonportabilityorconversion,call
Prudentialat877-740 -2116.
Ifyouleavethecompanyand
are rehired
Ifyoureturntoworkwithin30days,youwillautomaticallybe
re-enrolled(orenrolledinthemostsimilarcoverageoered
underthePlan).
Ifyoureturntoworkafter30days,youwillbeconsidered
newlyeligibleandwillberequiredtocompletetheapplicable
eligibilitywaitingperiod.SeetheEligibility and enrollment
chapterfordetails.
2014AssociateBenetsBook | Questions?LogontoWalmartOne.comortheWIRE,orcallBenetsCustomerServiceat800-421-1362
Company-paidlifeinsurance
125
Optionalassociatelifeinsurance
127
Optionalassociatelifeinsurance
Youprotectyourfamilyeveryday—yourpaycheckkeepsaroofovertheirheadsandfoodon
thetable,youuseseatbeltsandchildsafetyseatsandyouplanforyourfamily’scollegeand
retirementexpenses.Whatwouldhappentoyourfamilyifyoudied?Wouldtheybeforcedto
dealwithadesperatenancialsituationalongwithemotionaldevastation?Inadditiontoyour
Walmart-providedlifeinsurance,optionalassociatelifeinsuranceprotectsyourfamilynancially
duringadiculttime.
OPTIONAL ASSOCIATE LIFE INSURANCE RESOURCES
Find What You Need Online OtherResources
Changeyourbeneciarydesignation GototheWIREorWalmartOne.com Beneciarychangescannotbemade
overthephone
• Getmoredetailsaboutlifeinsurance
• Requestanacceleratedbenet
• Getdetailsaboutcontinuingyour
insurance
CallPrudentialat 877-74 0 -2116
Fileaclaim CallPrudentialat 877-74 0 -2116
What you need to know about optional associate life insurance
• Allfull-timehourlyassociates(includingfull-timehourlypharmacists,eldLogisticsassociates,full-timetruckdrivers,
eldsupervisorpositionsinstoresandclubs,managementtrainees,Californiapharmacists,full-timehourlyVisionCenter
managersandwalmart.comfunctionalnon-exemptassociates)andmanagementassociatescanenrollinoptional
associatelifeinsurance.
• Dependingonthecoverageamountyouchooseandwhenyouenroll,youmayberequiredtoprovideProof
ofGoodHealth.
• Youcanenrollin,changeordroplifeinsuranceatanytime,butifyouenrollatanytimeotherthanyourinitial
enrollmentperiod,youwillhavetoprovideProofofGoodHealth.
• Anearlypayoutduetoterminalillnessisavailable.
• Thispolicyistermlifeinsurance.Therefore,ithasnocashvalue.
128
Enrolling in optional associate
life insurance
Allfull-timehourlyassociatesandmanagementassociates
canenrollinoptionalassociatelifeinsuranceinaddition
tothecompany-paidlifeinsuranceprovidedbyWalmart.
Yourcoveragechoicesforoptionalassociatelifeinsurance
dependonwhetheryouareafull-timehourlyassociateora
managementassociate,asfollows:
Ifyouareafull-timehourlyassociate,yourcoveragechoices
foroptionalassociatelifeinsuranceare:
• $25,000
• $50,000
• $75,000
• $100,000
• $150,000
• $200,000
Ifyouareamanagementassociate,yourcoveragechoicesfor
optionalassociatelifeinsuranceare:
• $25,000
• $50,000
• $75,000
• $100,000
• $150,000
• $200,000
• $300,000
• $500,000
• $750,000
• $1,000,000
NOTE:Tobeeligibleforthisbenetasamanagement
associate,youmustbeclassiedinthecompany’spayroll
systemasamanagementassociate,managementtrainee,
Californiapharmacistorfull-timetruckdriver.
Forallassociates(full-timehourlyormanagement),Proofof
GoodHealthmayberequiredwhenyouenroll,dependingon
thecoverageamountyouchooseandwhenyouenroll.
Thispolicyhasnocashvalue.
Ifyoudie,yourbeneciary(ies)mayreceivealumpsum
paymentforthecoverageamountyouselect.Optional
associatelifeinsuranceisinsuredbyThePrudentialInsurance
CompanyofAmerica(Prudential).
Thecostofoptionalassociatelifeinsuranceisbasedonthe
coverageamountyouselect,yourageandwhetheryouare
eligiblefortobacco-freerates.
Allassociates(full-timehourlyormanagement)canenrollin
optionalassociatelifeinsuranceatanytime.ProofofGood
Healthisrequiredifyouenrollafteryourinitialenrollment
period.Also,youcanchangeordropcoverageatanytime.
However,ifyouwanttoincreaseyourcoverageorre-enroll
afterdroppingcoverage,youwillberequiredtoprovideProof
ofGoodHealth.
PROVIDING PROOF OF GOOD HEALTH
ProofofGoodHealthisrequiredforoptionalassociatelife
insuranceif:
• Thecoverageamountselectedisabove$25,000during
yourinitialenrollmentperiod;
• Youenrollafteryourinitialenrollmentperiodforany
amount;or
• Youincreaseyourcoverageafteryourinitialenrollment
period.
ProofofGoodHealthincludescompletingaquestionnaire
regardingyourmedicalhistoryandpossiblyhavingamedical
exam.TheProofofGoodHealthquestionnaireismade
availablewhenyouenroll.
Naming a beneciary
Inordertoensurethatyourlifeinsurancebenetispaid
accordingtoyourwishes,youmustnameabeneciary(ies)to
receiveyouroptionalassociatelifeinsurancebenetifyoudie.
YoumaydothisbygoingtotheWIREorWalmartOne.com.
Youcannameanyoneyouwish.Ifthebeneciary(ies)you
havelistedwiththecompanydiersfromthosenamedin
yourwill,thelistthatthecompanyhasprevails.
Thefollowinginformationisneededwhennamingyour
beneciary(ies):
• Beneciary(ies)name
• Beneciary(ies)currentaddress
• Beneciary(ies)phonenumber
• Beneciary(ies)relationshiptoyou
• Beneciary(ies)SocialSecuritynumber
• Beneciary(ies)dateofbirth
• Thepercentageyouwishtodesignateperbeneciary,
upto100%.
It’simportanttoupdateyour
beneciary information annually.
Keepinmind,proceedswillgoto
whoeverislistedonyourbeneciary
form with the company, regardless
of your current relationship with
that person. You can change your
beneciary(ies)atanytimeonthe
WIRE or WalmartOne.com.
2014AssociateBenetsBook | Questions?LogontoWalmartOne.comortheWIRE,orcallBenetsCustomerServiceat800-421-1362
Optionalassociatelifeinsurance
129
Iftwoormorebeneciariesaredesignatedandtheirshares
arenotspecied,theywillsharetheinsurancebenetequally.
Ifanamedbeneciarydiesbeforeyou,thatbeneciary’s
interestwillend,andwillbesharedequallybyanyremaining
beneciary(ies),unlessyourbeneciaryformstatesotherwise.
Youcannameaminorasabeneciary;however,Prudential
maynotbelegallypermittedtopaytheminoruntiltheminor
reacheslegalage.Youmaywanttoconsultanattorneyoran
estateplannerbeforenamingaminorasabeneciary.Ifyou
nameaminorasabeneciary,funeralexpensescannotbe
paidfromtheminor’sbeneciaryproceeds.
IF YOU DO NOT NAME A BENEFICIARY
Ifnobeneciaryisnamed,paymentwillbemadetoyour
survivingfamilymember(s)inthefollowingorder:
1. Widoworwidowerorpartnerofthedeceased;ifnot
surviving,then
2. Childreninequalshares;ifnotsurviving,then
3. Parentsinequalshares;ifnotsurviving,then
4. Siblingsinequalshares;ifnotsurviving,then
5. Executororadministratorofyourestate.
When your optional associate life
insurancecoveragebegins
IfProofofGoodHealthisrequired,yourcoveragewill
generallybecomeeectivethedaythatthecompanyreceives
approvalfromPrudential.
IfyoushoulddiebeforePrudentialapprovescoverage,no
optionalassociatelifeinsurancebenetwillbepaidto
yourbeneciary(ies).
IfProofofGoodHealthisnotrequired,yourcoveragewillbe
eectiveonthedateyouenrollorattheendofyoureligibility
waitingperiod,whicheverislater.
Youmustbeactively-at-workinorderforyourcoverageto
becomeeective.Youwillbeconsideredactively-at-work
onadaythatisoneofyourscheduledworkdaysifyouare
performingintheusualwayalloftheregulardutiesofyour
job.SeetheEligibility and enrollmentchapterfordetails.
An early payout due to terminal illness
Ifyouareterminallyill,youmayreceiveupto50%ofthe
coverageamountyouhavechosenwhileyouarestillliving.
Paymentmaybemadeinalumpsumor12equalmonthly
installments.Uponyourdeath,yourbeneciary(ies)will
receivetheremaining50%(plusanyamountoftheearly
payoutnotyetreceivedatthetimeofyourdeath).Thisbenet
isreferredtoastheacceleratedbenet.
Ifyouterminatefromthecompanyafteryouhavereceived
(orbeguntoreceive)theaccelerateddeathbenet,youwill
needtoconvertthepolicytoanindividualpolicyinorderfor
yourbeneciary(ies)toreceivetheremainingbalanceupon
yourdeath.Ifyoudonotconvertthepolicyupontermination
ofyouremployment,therewillbenobenetpayoutforyour
beneciary(ies).SeetheContinuing your optional associate
life insurance after you leave Walmartsectionlaterinthis
chapterfordetailsonconversion.
Youareterminallyillif:
• Thereisnoreasonableprospectofrecovery;
• Deathisexpectedwithin12months;and
• Adoctorcancertifytheillnessorinjuryasterminal.
Theremaybesomecircumstanceswhentheaccelerated
benetwillnotbepaid.ContactPrudentialat877-74 0 -2116
fordetails.
Taxlawsarecomplex.Pleaseconsultataxprofessionalto
assesstheimpactofthisbenet.
Filing a claim
Within12monthsofthecoveredassociate’sdeath,contact
Prudentialat877-740 -2116andprovidethefollowing
informationregardingthedeceasedassociate:
• Name;
• SocialSecuritynumber;
• Dateofdeath;and
• Causeofdeath(ifknown).
Acopyofthedeathcerticateisrequiredasproofofdeath.
Mailthedeathcerticateto:
The Prudential Insurance Company of America
Group Life Claim Division
P.O. Box 8517
Philadelphia, PA 19176
Theclaimwillnotbenalizeduntilthedeathcerticate
isreceived.Acceptanceofthedeathcerticateisnota
guaranteeofpayment.
Claimswillbedeterminedunderthetimeframesand
requirementssetoutintheClaims and appealschapter.Your
beneciary(ies)hastherighttoappealaclaimdenial.
Benetsarepaidaccordingtothetermsoftheinsurance
policy.Formoredetails,contactPrudentialat877-74 0 -2116.
130
When benets are not paid
Benetswillnotbepaidtoanybeneciary(ies)whoengaged
inanillegalactthatresultedinthedeathoftheassociate.
Instead,thebenetwouldgotoanothereligiblebeneciary
ortoyourestate.
Nobenetswillbepaidtoyourbeneciary(ies)ifyoudie
asaresultofaself-inictedinjuryorsuicidewhilesaneor
insaneduringthersttwoyearsofcoverage.Ifyouincrease
yourcoverageandyoudieasaresultofaself-inictedinjury
orsuicidewithintwoyearsofthedateyouincreaseyour
coverage,yourbeneciary(ies)willreceivetheprior
coverageamount.
Ifyourbeneciary(ies)lesaclaimwithinthersttwoyears
ofyourapprovaldate,Prudentialhastherighttore-examine
yourProofofGoodHealthquestionnaire.Ifmaterialfacts
aboutyouwerestatedinaccurately,thetruefactswillbeused
todeterminewhatamountofcoverageshouldhavebeenin
eect,ifany,and:
• Theclaimmaybedenied;and
• Premiumspaidmayberefunded.
Ifyougoonaleaveofabsence
Youmaycontinueyourcoverageuptothelastdayofan
approvedleaveofabsence,providedthatyoupayyour
premiumseitherbeforetheleavebeginsorduringtheleave.
Forinformationaboutmakingpaymentswhileonaleaveof
absence,seetheEligibility and enrollment chapter.
BREAK IN COVERAGE
Ifyourcoveragehasbeencanceled(byyourchoiceordue
tononpaymentofpremiumswhileyouareonleave)and
youreturntoactively-at-workstatuswithinoneyearfrom
cancellation,youwillautomaticallybeenrolledforthesame
coverage(or,ifthiscoverageisnotavailable,thecoverage
thatismostsimilartoyourpriorcoverage).Yourcoveragewill
beeectivetherstdayofthepayperiodthatyoumeetthe
actively-at-workrequirement.
Ifyourcoveragehasbeencanceled(byyourchoiceordue
tononpaymentofpremiumswhileyouareonleave)and
youreturntoactively-at-workstatusafteroneyearfrom
cancellation,youwillbeconsiderednewlyeligible;you
mayenrollforcoveragewithintheapplicabletimeperiod
andundertheconditionsdescribedintheEligibility and
enrollmentchapter.
Whencoverageends
Youroptionalassociatelifeinsurancecoverageends:
• Atterminationofyouremployment;
• Onthelastdayofthepayperiodwhenyourjobstatus
changestopart-time;
• Uponfailuretopayyourpremiums;
• Onthedateofyourdeath;
• Onthedatethatyouloseeligibility;
• Onthelastdayofanapprovedleaveofabsence(unlessyou
returntowork);
• Whenthebenetisnolongeroeredbythecompany;or
• Onthedayafteryoudropcoverage.
Thispolicyhasnocashvalue.
EstateGuidance®
EstateGuidanceoersyoutheconvenienceofonlinewill
preparationfromyourpersonalcomputeratnocosttoyou.
Willsensurethatyourassetswillbedistributedinaccordance
withyourwishesandallowyoutonameaguardiantotakecare
ofyourminorchildren.Tocompletetheonlinewillquestionnaire,
logontowillguidance.com,password:WMTWILL.
NOTE: Ifthebeneciary(ies)youhavelistedwiththe
companydiersfromthosenamedinyourwill,thelistthat
thecompanyhasprevails.
Continuingyouroptionalassociatelife
insuranceafteryouleaveWalmart
Inmostcircumstances,youwillhavetwooptionstocontinue
youroptionalassociatelifeinsuranceifyourgrouplife
coverageends.Therstoption,calledportability,allowsyou
tocontinuealloraportionofyourcurrentcoveragethrough
agrouptermpolicywithPrudential.Thesecondoption,
called conversion,allowsyoutoconvertalloraportionof
yourcoveragetoaPrudentialindividualpolicy.
Youmustapplyforportabilityorconversionwithin31days
ofthedateyourcoverageends.Ifyoudiewithin31daysof
aqualifyinglossofcoverageandbeforeelectingportability
orconversionofyourlifeinsurancecoverage,Prudential
willpayadeathbenettoyourbeneciary.Thebenetwill
bepaidbasedontheamountofcoverageineectpriorto
thequalifyinglossofcoverage,evenifyoudidnotapplyfor
portabilityorconversionofyourcoverage.
2014AssociateBenetsBook | Questions?LogontoWalmartOne.comortheWIRE,orcallBenetsCustomerServiceat800-421-1362
Optionalassociatelifeinsurance
131
Portabilityenablesyoutomaintainsimilartermlife
insurancewithPrudentialafteryouremploymentends
ifcertainconditionsaremet.ProofofGoodHealthisnot
requiredtoportyourcoverage.Youcan,however,receive
preferredratessimilartotheratesyoupaidwhileanactive
associateifyousubmitandpassProofofGoodHealth.Ifyou
donotpassorsubmitProofofGoodHealth,yourrateswillbe
basedonPrudential’sstandardportrates.
Youwillbeabletoapplyfortermlifecoverageunderthe
portabilityfeatureifyoumeetalloftheseconditions:
1. Youroptionalassociatelifecoverageendsforanyreason
otherthan:
a.yourfailuretopaypremiumswhileyouwerean
activeassociate;or
b.youleavethecompanyduetoadisability;or
c. Walmartchangesgrouplifeinsurancecarriersandyou
areorbecomeeligiblewithinthenext31days.
2. Youmeettheactively-at-workrequirementontheday
yourinsuranceends.
3. Youarelessthanage80.
4. Youramountofinsuranceisatleast$20,000ontheday
yourinsuranceends.
Ifyoumeettheseconditions,youwillhave31daysfromyour
terminationdatetocontactPrudentialandenroll.
ConversionisarequiredPlanprovisionthatallowsyouto
convertyourlifeinsurancecoveragetoanindividualpolicy.
Ratesarebasedonanindividual’sageandamountconverted.
Youhave31daysfromtheterminationdateofcoverageto
requesttoconvertyourcoveragetoanindividualpolicy.If
yourdeathoccursduringthe31-dayconversionperiod,the
deathbenetwillbepayableuptotheamountthatcould
havebeenconverted.
ForresidentsofMinnesota,youmayelecttocontinue
coverageatyourexpenseifyouremploymentisterminated
eithervoluntarilyorinvoluntarily,orifyouarelaido,as
longasthegrouppolicyisstillinforcewiththeemployer.
Coveragemaybecontinueduntilyouobtaincoverage
underanothergrouppolicyoryoureturntoworkfrom
layo;however,themaximumperiodthatcoveragemaybe
continuedis18months.
Torequestinformationonportabilityorconversion,call
Prudentialat877-740 -2116.
Ifyouleavethecompanyand
are rehired
Ifyoureturntoworkwithin30days,youwillautomatically
bere-enrolledforthesamecoverageineectpriortoleaving
thecompany(orthemostsimilarcoverageoeredunder
thePlan).
Ifyoureturntoworkafter30days,youwillbeconsidered
newlyeligibleandwillberequiredtocompletetheapplicable
eligibilitywaitingperiod.ProofofGoodHealthisrequired
forcoverageplansabove$25,000.SeetheEligibility and
enrollmentchapterfordetails.
Ifyoudropordecreaseyourcoverage
andre-enroll
Ifyoudropordecreaseyourcoverageandre-enrollwithin30
days,youmayre-enrollforthesamecoverageineectprior
todroppingordecreasingcoverage.
Ifyoure-enrollmorethan30daysafterdroppingor
decreasingyourcoverage,youmayenrollforcoverage
underthetimeperiodsandconditionsdescribedinthe
Eligibility and enrollmentchapter.ProofofGoodHealth
willberequired.
Optionaldependentlifeinsurance
133
Optionaldependentlifeinsurance
Thelossofyourspouse/partnercouldmeanthelossofanincomeoraneedforchildcare.Theloss
ofachildcouldmeanmedicalbillsandfuneralexpenses.Whileyouandyourfamilyaredealing
withtheemotionalburdenthatthelossofafamilymemberbrings,youcanreceivehelpforthe
nancialconsequencesthroughoptionaldependentlifeinsurance.Thinkabouttheexpensesyou
wouldhaveifyourspouse/partnerorchilddied.Optionaldependentlifeinsurancecouldeaseyour
nancialsituation,helpingyourfamilygetthroughadiculttime.
OPTIONAL DEPENDENT LIFE INSURANCE RESOURCES
Find What You Need Online OtherResources
Getmoredetailsaboutlifeinsurance GototheWIREorWalmartOne.com CallPrudentialat 877-74 0 -2116
Getdetailsaboutcontinuingyour
insurance
CallPrudentialat 877-74 0 -2116
Fileaclaim CallPrudentialat 877-74 0 -2116
What you need to know about optional dependent life insurance
• Allfull-timehourlyassociates(includingfull-timehourlypharmacists,eldLogisticsassociates,full-timetruckdrivers,
eldsupervisorpositionsinstoresandclubs,managementtrainees,Californiapharmacists,full-timehourlyVisionCenter
managersandwalmart.comfunctionalnon-exemptassociates)andmanagementassociatescanenrolltheirspouse/partner
and/orchildreninoptionaldependentlifeinsurance.
• ProofofGoodHealthforyourspouse/partnerisrequiredifyouenrollforacoverageamountabove$5,000duringyour
initialenrollmentperiodorforanycoverageamountifyouenrollatanyothertime.
134
Enrolling in optional dependent
life insurance
Allfull-timehourlyassociatesandmanagementassociates
canenrolltheirspouse/partnerand/orchild(ren)inoptional
dependentlifeinsurance.Ifyourspouse/partnerand/orlegal
dependentdies,youmayreceivealumpsumpaymentfor
thecoverageamountyouselect.Optionaldependentlife
insuranceisinsuredbyThePrudentialInsuranceCompanyof
America(Prudential).
Yourcoveragechoicesforoptionaldependentlifeinsuranceare:
• Spouse/partner:
– $5,000
– $15,000
– $25,000
– $50,000
– $75,000
– $100,000
• Child:
– $2,000perchild
– $5,000perchild
– $10,000perchild
Dependingonthecoverageamountyouchooseandwhen
youenroll,yourspouse/partnermayberequiredtoprovide
ProofofGoodHealth.YoudonothavetoprovideProofof
GoodHealthforyourchild(ren).
You(theassociate)areautomaticallyassignedastheprimary
beneciaryofyourdependent’slifeinsurancecoverage.Ifyou
andyourcovereddependent(s)dieatthesametime,benets
willbepaidtoyourdependent’sestateor,atPrudential’s
option,toasurvivingrelativeofthedependent.
Thecostofoptionaldependentlifeinsuranceforyour
spouse/partnerisbasedonthecoverageamountyouselect,
your(theassociate’s)ageandwhetheryourspouse/partner
iseligibleforthetobacco-freerates.Thecostofcoveragefor
yourchild(ren)isbasedonthecoverageamountyouselect.
Thispolicyhasnocashvalue.
Youcanenrollinoptionaldependentlifeinsuranceatany
time.ProofofGoodHealthisrequiredforyourspouse/partner
ifyouenrollafteryourinitialenrollmentperiod.Also,youcan
changeordropcoverageatanytime.However,ifyouwant
toincreaseyourspouse’s/partner’scoverageorre-enrollafter
droppingcoverage,youwillberequiredtoprovideProofof
GoodHealthforyourspouse/partner.
PROOF OF GOOD HEALTH
ProofofGoodHealthisrequiredforyourspouse’s/partner’s
optionaldependentlifeinsurancecoverageif:
• Thecoverageamountselectedisabove$5,000duringyour
initialenrollmentperiod;
• Youenrollafteryourinitialenrollmentperiodforany
amount;or
• Youincreaseyourcoverageafteryourinitialenrollment
period.
ProofofGoodHealthincludescompletingaquestionnaire
regardingyourspouse’s/partner‘smedicalhistoryandpossibly
requiringyourspouse/partnertohaveamedicalexam.The
ProofofGoodHealthquestionnaireismadeavailablewhen
youenrollyourspouse/partner.ProofofGoodHealthisnot
requiredforchildren.
When your optional dependent life
insurancecoveragebegins
If Proof of Good Health is required,yourspouse’s/partner’s
coveragewillgenerallybecomeeectivethedaythatthe
companyreceivesapprovalfromPrudential.
Ifyourspouse/partnershoulddiebeforePrudentialapproves
coverage,nooptionaldependentlifeinsurancewillbepaid
toyou.
If Proof of Good Health is not required,yourspouse’s/
partner’scoveragewillbeeectiveonthedateyouenrollorat
theendofyoureligibilitywaitingperiod,whicheverislater.
If your spouse/partner or dependent child is conned
to a hospital or home,coveragewillbedelayeduntilthe
spouse/partnerorchildhasamedicalrelease(doesnotapply
toanewbornchild).
Additionalbenetsareavailableifadependentchildisborn
aliveanddieswithin60daysofbirth,orifadependentchildis
stillborn.SeeAdditional benets intheCompany-paid life
insurance chapterformoreinformation.
Youmustbeactively-at-workinorderforyourdependent
coveragetobeeective.Youwillbeconsideredactively-at-
workonadaythatisoneofyourscheduledworkdaysifyou
areperformingintheusualwayalloftheregulardutiesofyour
job.SeetheEligibility and enrollmentchapterfordetails.
2014AssociateBenetsBook | Questions?LogontoWalmartOne.comortheWIRE,orcallBenetsCustomerServiceat800-421-1362
Optionaldependentlifeinsurance
135
Filing a claim
Within12monthsofthecovereddependent’sdeath,contact
Prudentialat877-740 -2116andprovidethefollowing
informationregardingthedeceased:
• Name;
• SocialSecuritynumber;
• Dateofdeath;and
• Causeofdeath(ifknown).
Anoriginalorcertiedcopyofthedeathcerticatemaybe
requiredasproofofdeath.Mailthedeathcerticateto:
The Prudential Insurance Company of America
Group Life Claim Division
P.O. Box 8517
Philadelphia, PA 19176
Theclaimwillnotbenalizeduntilthedeathcerticate
isreceived.Acceptanceofthedeathcerticateisnota
guaranteeofpayment.
Claimswillbedeterminedunderthetimeframesand
requirementssetoutintheClaims and appealschapter.
Youhavetherighttoappealaclaimdenial.
Benetsarepaidaccordingtothetermsoftheinsurance
policy.Formoredetails,contactPrudentialat877-74 0 -2116.
When benets are not paid
Benetswillnotbepaidtoyouifyouengageinanillegal
actthatresultedinthedeathoftheinsured.Instead,the
benetmaygotoanothereligiblebeneciaryortothe
insured’sestate.
Nobenetswillbepaidtoyouifyourspouse/partneror
dependentdiesasaresultofaself-inictedinjuryorsuicide
whilesaneorinsaneduringthersttwoyearsofcoverage.
Ifyouincreaseyourdependent’scoverageandyour
spouse/partnerordependentchilddiesasaresultofaself-
inictedinjuryorsuicidewithintwoyearsoftheincreasein
coverage,youwillreceivethepriorcoverageamount.
Ifyouleaclaimforyourspouse/partnerwithintherst
twoyearsofyourapprovaldate,Prudentialhastherightto
re-examineyourspouse’s/partner’sProofofGoodHealth
questionnaire.Ifmaterialfactsaboutyourspouse/partner
werestatedinaccurately,thetruefactswillbeusedto
determinewhatamountofcoverageshouldhavebeenin
eect,ifany,and:
• Theclaimmaybedenied;and
• Premiumspaidmayberefunded.
Ifyougoonaleaveofabsence
Youmaycontinueyourcoverageuptothelastdayofan
approvedleaveofabsence,providedthatyoupayyour
premiumseitherbeforetheleavebeginsorduringtheleave.
Forinformationaboutmakingpaymentswhileonaleaveof
absence,seetheEligibility and enrollmentchapter.
BREAK IN COVERAGE
Ifyourcoveragehasbeencanceled(byyourchoiceordue
tononpaymentofpremiumswhileyouareonleave)and
youreturntoactively-at-workstatuswithinoneyearfrom
cancellation,youwillautomaticallybeenrolledforthesame
coverage(or,ifthiscoverageisnotavailable,thecoverage
thatismostsimilartoyourpriorcoverage).Yourcoveragewill
beeectivetherstdayofthepayperiodthatyoumeetthe
actively-at-workrequirement.
Ifyourcoveragehasbeencanceled(byyourchoiceordue
tononpaymentofpremiumswhileyouareonleave)and
youreturntoactively-at-workstatusafteroneyearfrom
cancellation,youwillbeconsiderednewlyeligible;you
mayenrollforcoveragewithintheapplicabletimeperiod
andundertheconditionsdescribedintheEligibility and
enrollmentchapter.
Whencoverageends
Youroptionaldependentlifeinsurancecoverageends:
• Atterminationofyouremployment;
• Onthelastdayofthepayperiodwhenyourjobstatus
changestopart-time;
• Uponfailuretopayyourpremiums;
• Onthedateofyourdeath;
• Onthedatethatyouoradependentspouse/partneror
childloseseligibility(seetheEligibility and enrollment
chapter);
• Onthelastdayofanapprovedleaveofabsence(unlessyou
returntowork);
• Whenthebenetisnolongeroeredbythecompany;or
• Thedayafteryoudropyourcoverage.
Thispolicyhasnocashvalue.
136
Continuingyouroptionaldependent
lifeinsuranceafteryouleaveWalmart
Inmostcircumstances,youwillhavetwooptionstocontinue
youroptionaldependentlifeinsuranceifyourgrouplife
coverageends.Therstoption,calledportability,allows
youandyourdependentstocontinuealloraportionofyour
currentcoveragethroughagrouptermpolicywithPrudential.
Thesecondoption,calledconversion,allowsyoutoconvertall
oraportionofyourcoveragetoaPrudentialindividualpolicy.
Portabilityenablesyoutomaintainsimilartermlife
insurancewithPrudentialafteryouremploymentends
ifcertainconditionsaremet.Spouse/partnerandchild
coverageisonlyportableinconjunctionwiththeassociate’s
coverage(exceptionsaredeathoftheassociateordivorceor
terminationofdomesticpartnershiporlegalrelationship).
ProofofGoodHealthisnotrequiredtoportyourcoverage.
Youcan,however,receivepreferredratessimilartotherates
youpaidwhileanactiveassociateifyouandyourdependents
submitandpassProofofGoodHealth.Ifyoudonotpass
orsubmitProofofGoodHealth,yourrateswillbebasedon
Prudential’sstandardportrates.
Youwillbeabletoapplyfortermlifecoverageunderthe
portabilityfeatureifyoumeetalloftheseconditions:
1. Theoptionaldependentlifecoverageonthedependent
endsbecauseyouroptionalassociatelifecoverageendsfor
anyreasonotherthan:
a. yourfailuretopay,whendue,anycontributionrequired
forit;
b.theendofyouremploymentonaccountofyour
retirementduetodisability;or
c. theendoftheoptionalassociatelifecoverageforall
associateswhensuchcoverageisreplacedbygrouplife
insurancefromanycarrierforwhichyouareorbecome
eligiblewithinthenext31days.
2. Youapplyandbecomecoveredfortermlifecoverage
undertheportabilityplan.
3. Withrespecttoadependentspouse/partner,that
spouse/partnerislessthanage80.
4. Withrespecttoadependentchild,thatchildislessthan
age26.
5. Thedependentiscoveredforoptionaldependentlife
coverageonthedayyouroptionalassociatelife
coverageends.
6. Thedependentisnotconnedformedicalcareor
treatment,athomeorelsewhere,onthedayyouroptional
associatelifecoverageends.
ConversionisarequiredPlanprovisionthatallowsyouto
convertyourlifeinsurancecoveragetoanindividualpolicy.
Ratesarebasedonanindividual’sageandamountconverted.
ForresidentsofMinnesota,youmayelecttocontinue
coverageatyourexpenseifyouremploymentisterminated
eithervoluntarilyorinvoluntarily,orifyouarelaido,as
longasthegrouppolicyisstillinforcewiththeemployer.
Coveragemaybecontinueduntilyouobtaincoverage
underanothergrouppolicyoryoureturntoworkfrom
layo;however,themaximumperiodthatcoveragemaybe
continuedis18months.
Torequestinformationonportabilityorconversion,call
Prudentialat877-740 -2116.
Ifyouleavethecompanyand
are rehired
Ifyoureturntoworkwithin30days,youwillautomaticallybe
re-enrolledforthesamecoverageyouhadpriortoleaving
thecompany(orthemostsimilarcoverageoeredunder
thePlan).
Ifyoureturntoworkafter30days,youwillbeconsidered
newlyeligibleandwillberequiredtocompletetheapplicable
eligibilitywaitingperiod.ProofofGoodHealthisrequiredfor
spouse/partnercoverageplansabove$5,000.
SeetheEligibility and enrollmentchapterfordetails.
Ifyoudropordecreaseyourcoverage
andre-enroll
Ifyoudropordecreaseyourcoverageandrequesttore-enroll
within30days,youmayre-enrollforthesamecoverageplan
youhadpriortodroppingordecreasingcoverage.
Ifyoure-enrollmorethan30daysafterdroppingor
decreasingcoverage,youmayenrollforcoverageunderthe
timeperiodsandconditionsdescribedintheEligibility and
enrollmentchapter.ProofofGoodHealthwillberequiredfor
spouse/partnercoverageplans.
2014AssociateBenetsBook | Questions?LogontoWalmartOne.comortheWIRE,orcallBenetsCustomerServiceat800-421-1362
Optionaldependentlifeinsurance
137