2021 Medical Plan Rates - Standard

1 2021 Rates Medical plans available in most locations Cost per biweekly pay period Cost per biweekly pay period Premier Plan Tobacco- One Two Contribution Plan Tobacco- One Two tobacco tobacco tobacco tobacco free free user users user users Associate only $ $ Associate only $ $ . Associate + spouse/partner $ $ $ Associate + spouse/partner $ $ $ Associate + child(ren) $ $ Associate + child(ren) $ $ . Associate + family $ $ $ Associate + family $ $ $ Cost per biweekly pay period Saver Plan Tobacco- One Two tobacco tobacco free user users Associate only $ $ . Associate + spouse/partner $ $ $ Associate + child(ren) $ $ . Associate + family $ $ $ Local Plans available in select locations Cost per biweekly pay period Cost per biweekly pay period Banner, Arizona One Two Mercy Arkansas, NW Arkansas Mercy, SW Missouri Tobacco- Memorial Hermann, Texas tobacco tobacco One Two free UnityPoint, Illinois, Iowa Tobacco- user users tobacco tobacco Ochsner, Louisiana free user users Associate only $ $.

2 Associate + spouse/partner $ $ $ Associate only $ $ . Associate + spouse/partner $ $ $ Associate + child(ren) $ $ . Associate + child(ren) $ $ . Associate + family $ $ $ Associate + family $ $ $ 21AE-WM- Standard - Medical - Rates | 093020A. Confidential Internal Use Only | 2020 Walmart Inc. 1. HMO Plans available in select locations Geisinger Extra Health Cost per biweekly pay period Cost per biweekly pay period Plan, Pennsylvania Geisinger Extra Health Plan, eastern region Pennsylvania Health Net ExcelCare One Two One Two Geisinger Health Plan, Tobacco- High Option, California Tobacco- tobacco tobacco tobacco tobacco Pennsylvania free free user users user users Geisinger Health Plan, eastern region Pennsylvania Associate only $ $ Associate only $ $ . Associate + spouse/partner $ $ $ Associate + spouse/partner $ $ $ Associate + child(ren) $ $ Associate + child(ren) $ $ . Associate + family $ $ $ Associate + family $ $ $ Cost per biweekly pay period Cost per biweekly pay period Health Net ExcelCare Health Net Salud Y Mas, One Two One Two Low Option, California Tobacco- California Tobacco- tobacco tobacco tobacco tobacco free free user users user users Associate only $ $ Associate only $ $.

3 Associate + spouse/partner $ $ $ Associate + spouse/partner $ $ $ Associate + child(ren) $ $ Associate + child(ren) $ $ . Associate + family $ $ $ Associate + family $ $ $ Cost per biweekly pay period Cost per biweekly pay period Kaiser California High One Two Kaiser California Low One Two Option North and South Tobacco- Option North and South Tobacco- tobacco tobacco tobacco tobacco free free user users user users Associate only $ $ Associate only $ $ . Associate + spouse/partner $ $ $ Associate + spouse/partner $ $ $ Associate + child(ren) $ $ Associate + child(ren) $ $ . Associate + family $ $ $ Associate + family $ $ $ Cost per biweekly pay period Cost per biweekly pay period Kaiser of Colorado One Two Kaiser of Georgia One Two Low Option Tobacco- Low Option Tobacco- tobacco tobacco tobacco tobacco free free user users user users Associate only $ $ Associate only $ $ . Associate + spouse/partner $ $ $ Associate + spouse/partner $ $ $ Associate + child(ren) $ $ Associate + child(ren) $ $.

4 Associate + family $ $ $ Associate + family $ $ $ 21AE-WM- Standard - Medical - Rates | 093020A. Confidential Internal Use Only | 2020 Walmart Inc. 2. HMO Plans (cont.). Kaiser of the Mid-Atlantic Cost per biweekly pay period Cost per biweekly pay period Low Option, Maryland Kaiser of Oregon One Two High Option One Two Kaiser of the Mid-Atlantic Tobacco- Tobacco- tobacco tobacco tobacco tobacco Low Option, Virginia free free user users user users Associate only $ $ Associate only $ $ . Associate + spouse/partner $ $ $ Associate + spouse/partner $ $ $ Associate + child(ren) $ $ Associate + child(ren) $ $ . Associate + family $ $ $ Associate + family $ $ $ Cost per biweekly pay period Cost per biweekly pay period Kaiser of Oregon One Two One Two Tobacco- Kaiser of Washington Tobacco- Low Option tobacco tobacco tobacco tobacco free free user users user users Associate only $ $ Associate only $ $.

5 Associate + spouse/partner $ $ $ Associate + spouse/partner $ $ $ Associate + child(ren) $ $ Associate + child(ren) $ $ . Associate + family $ $ $ Associate + family $ $ $ eComm Plans eComm PPO. Cost per biweekly pay period Aetna eComm PPO Plan One Two Tobacco- tobacco tobacco free user users Associate only $ $ . Associate + spouse/partner $ $ $ Associate + child(ren) $ $ . Associate + family $ $ $ eComm HMO Plans Cost per biweekly pay period Cost per biweekly pay period Kaiser of Oregon One Two Kaiser California North, One Two eComm Tobacco- South, eComm (Jet only) Tobacco- tobacco tobacco tobacco tobacco free free user users user users Associate only $ $ Associate only $ $ . Associate + spouse/partner $ $ $ Associate + spouse/partner $ $ $ Associate + child(ren) $ $ Associate + child(ren) $ $ . Associate + family $ $ $ Associate + family $ $ $ 21AE-WM- Standard - Medical - Rates | 093020A.

6 Confidential Internal Use Only | 2020 Walmart Inc. 3. Hawaii plans Cost per biweekly pay period Cost per biweekly pay period HMSA Hawaii One Two Kaiser Hawaii One Two Tobacco- Tobacco- tobacco tobacco tobacco tobacco free free user users user users Associate only $ $ Associate only $ $ . Associate + spouse/partner $ $ $ Associate + spouse/partner $ $ $ Associate + child(ren) $ $ Associate + child(ren) $ $ . Associate + family $ $ $ Associate + family $ $ $ Vision and dental plans Vision Cost per biweekly pay period coverage Rate Associate only $ Associate + spouse/partner $ Associate + child(ren) $ Associate + family $ Note: 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. Dental Cost per biweekly pay period coverage Rate Associate only $ Associate + spouse/partner $ Associate + child(ren) $ Associate + family $ 21AE-WM- Standard - Medical - Rates | 093020A.

7 Confidential Internal Use Only | 2020 Walmart Inc. 4. Income protections and extra insurance Optional associate life insurance Cost per biweekly pay period Associate's All eligible associates Management/truck drivers only age $25,000 $50,000 $75,000 $100,000 $150,000 $200,000 $300,000 $500,000 $750,000 $1,000,000. $ $ $ $ $ $ $ $ $ $ under 25. $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 25 29. $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 30 34. $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 35 39. $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 40 44. $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 45 49. $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 50 54. $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 55 59. $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 60 64. $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 65 69. $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 70+. $ $ $ $ $ $ $ $ $ $ Tobacco-free user Tobacco user Tobacco-free user Tobacco user 21AE-WM- Standard - Medical - Rates | 093020A.

8 Confidential Internal Use Only | 2020 Walmart Inc. 5. Optional spouse/partner life insurance*. Cost per biweekly pay period Associate's age $5,000 $15,000 $25,000 $50,000 $75,000 $100,000 $150,000 $200,000. $ $ $ $ $ $ $ $ under 25. $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 25 29. $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 30 34. $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 35 39. $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 40 44. $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 45 49. $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 50 54. $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 55 59. $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 60 64. $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 65 69. $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 70+. $ $ $ $ $ $ $ $ Tobacco-free user Tobacco user *Spouse/partner life insurance is based on associate's age. Optional dependent life insurance child(ren). Cost per biweekly pay period coverage Rate $5,000 per dependent $ $10,000 per dependent $ $20,000 per dependent $ 21AE-WM- Standard - Medical - Rates | 093020A.

9 Confidential Internal Use Only | 2020 Walmart Inc. 6. Critical illness Cost per biweekly pay period*. Associate only Associate's age $5,000 $10,000 $15,000 $20,000. $ $ $ $ under 25. $ $ $ $ $ $ $ $ 25 29. $ $ $ $ $ $ $ $ 30 34. $ $ $ $ $ $ $ $ 35 39. $ $ $ $ $ $ $ $ 40 44. $ $ $ $ $ $ $ $ 45 49. $ $ $ $ $ $ $ $ 50 54. $ $ $ $ $ $ $ $ 55 59. $ $ $ $ $ $ $ $ 60 64. $ $ $ $ $ $ $ $ 65 69. $ $ $ $ $ $ $ $ 70+. $ $ $ $ Tobacco-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. 21AE-WM- Standard - Medical - Rates | 093020A. Confidential Internal Use Only | 2020 Walmart Inc. 7. Critical illness Cost per biweekly pay period*. Associate + spouse/partner Associate's age $5,000 $10,000 $15,000 $20,000. $ $ $ $ $ $ $ $ under 25. $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 25 29. $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 30 34.

10 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 35 39. $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 40 44. $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 45 49. $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 50 54. $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 55 59. $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 60 64. $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 65 69. $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 70+. $ $ $ $ $ $ $ $ Tobacco-free users One tobacco user (associate) One tobacco user (spouse/partner) 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. 21AE-WM- Standard - Medical - Rates | 093020A. Confidential Internal Use Only | 2020 Walmart Inc. 8. Critical illness Cost per biweekly pay period*. Associate + dependent child(ren). Associate's age $5,000 $10,000 $15,000 $20,000. $ $ $ $ under 25. $ $ $ $ $ $ $ $ 25 29. $ $ $ $ $ $ $ $ 30 34. $ $ $ $ $ $ $ $ 35 39. $ $ $ $ $ $ $ $ 40 44.