2022 Benefits Information for Walmart Associates
This document provides essential information for Walmart associates who are leaving the company regarding their benefits. It outlines coverage details, options for continuation of coverage, and important steps to take. Understanding these benefits is crucial during the transition period.
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How do I fill this out?
To fill out this document, start by gathering your personal information and employment details. Next, review the sections related to your specific benefits plans to understand your options. Lastly, ensure you fill out any required forms accurately before submission.

How to fill out the 2022 Benefits Information for Walmart Associates?
1
Gather your personal and employment information.
2
Review the continuation options for your benefits.
3
Complete the required forms as instructed.
4
Submit your forms within the outlined deadlines.
5
Keep a copy of all submitted documents for your records.
Who needs the 2022 Benefits Information for Walmart Associates?
1
Walmart associates who are leaving the company for any reason.
2
Dependents of associates who are eligible for continued coverage.
3
HR personnel needing to guide employees through the benefits process.
4
Financial advisors assisting former employees with benefits decisions.
5
Insurance agents helping clients understand their options.
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Finalize your edits by ensuring all changes are saved.

What are the instructions for submitting this form?
To submit this form, complete all fields accurately and ensure all required information is included. Once completed, you can either fax the documents to the associated number provided or email them. Physical mailing is also an option, but ensure allowances for processing times.
What are the important dates for this form in 2024 and 2025?
Key dates include the last employment day, COBRA election deadline within 60 days, and premium payments due each month. Associates need to be aware of these dates to ensure they don’t lose their coverage opportunities.

What is the purpose of this form?
The purpose of this form is to provide a clear understanding of the benefits available to associates leaving Walmart. It outlines continuation options like COBRA, critical illness, and life insurance among others. Ensuring that all associates are informed will facilitate a smoother transition as they leave Walmart.

Tell me about this form and its components and fields line-by-line.

- 1. Personal Information: Details including name, address, and contact information.
- 2. Employment Information: Your Walmart employment dates and company details.
- 3. Coverage Choices: Options regarding COBRA, life insurance, and other benefits.
- 4. Acknowledgment: Confirmation of understanding the terms and conditions.
What happens if I fail to submit this form?
Failure to submit this form may result in the loss of eligibility for continued benefits. It is crucial to adhere to deadlines to maintain the necessary coverage. Late submissions could lead to complications in receiving the benefits.
- Coverage Loss: Losing your benefits when coverage deadlines are not met.
- Ineligibility for COBRA: Missing the COBRA election period means you cannot extend your health benefits.
- Financial Implications: Not securing necessary benefits could lead to unexpected medical expenses.
How do I know when to use this form?

- 1. Departing Associates: For associates completing their final employment preparations.
- 2. Dependent Beneficiaries: Useful for dependents reviewing their ongoing coverage options.
- 3. HR Departments: For HR personnel guiding employees through the termination process.
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