Changes
Benefit Plan Structure
Wellbeing Copay Plan
Vendors and Programs
100
a new Blue Cross Blue Shield brand name for select self-funded national account business
What is Skai Blue?
100
plan has no HRA or HSA. Copay plan.
What is Premier PPO Plan?
100
New ITS prefix for this plan- the Tennessee select network
What is WON?
100
Replaced Contigo Health as the COE administrator for spine, joint, and bariatric services
Who is Carrum Health?
200
reissue for 2026 to incorporate the new Skai logo and contact information
What is ID Cards and SPD?
200
Only HRA plan. will be phased out completely in 2027.
What is the Contribution HRA Plan?
200
RxGroup number for this plan
What is WELLBEING?
200
Replaced HealthSCOPE Benefits as the COE administrator for Cancer/Cardiac/Doula/Travel Benefits/Tansplant services
Who is Consociate Health?
300
two TPA's utilized by WM in 2026
Who is Skai Blue Cross Blue Shield and United Healthcare?
300
High deductible plan with HSA
What is Saver HSA Plan?
300
8 states the Wellbeing Copay Plan will be piloted in
What is LA, MS, TN, KY, WV, CA, WA, NJ? Louisiana/Mississippi/Tennessee/Kentucky/West Virginia/California/Washington/New Jersey
300
accident and critical illness insurance (Formerly Allstate)
What is The Standard?
400
handles CM and UM for stores locations with UHC as TPA
Who is Included Health?
400
$0 copay Doctor On Demand/ Omada virtual physical therapy/Quest at-home lab
What is virtual health visits?
400
New ITS prefix for this plan- for all other pilot states (except TN)
What is WOC?
400
Walmart associates/families receive 20 free counseling sessions per person per year. Eff 1/1/26 Walmart expanding services and claims for those services will be submitted through the medical plan.
What is Lyra Health?
500
removing the limitation to cover for children only, and will cover the service for all members under certain provisions.
Benefits are limited to three visits per condition per year for chronic diseases. This visit limit does not apply to mental health conditions.
What is Nutritional Counseling?
500
not a group plan. separate and distinct from the active employee Walmart Medical Plan and can be identified by the prefix. warm transferred to the ABCBS Regular Business product line, using the existing transfer process in Five9.
What is Retiree Medical Plan?
500
Will oversee utilization management (UM) for the pilot states starting in 2026. They will continue to oversee utilization management services for the existing Included Health states as well.
Who American Health Holdings (AHH) and HealthHelp?
500
Pharmacy Formulary management for Inflammatory Conditions, that will move from Optum
Who is TruDataRx?