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Benefits Plan Information and Costs

The REI Access Plan, administered by Aetna, provides comprehensive employee-only medical coverage. This plan allows you to pay lower payroll deductions to have medical coverage and requires you to meet a higher deductible at the time you use health services. Coverage includes:

  • Preventive care and preventive drugs at no-cost when provided by an in-network doctor or pharmacy
  • Coverage for doctor and specialist visits
  • Mental and behavioral health benefits
  • Coverage for hospitalization and surgery
  • Access to telehealth visits through Teladoc
  • Access to a Health Savings Account (HSA)

Here’s what you and REI pay each paycheck for coverage.

Learn about the 2023 benefits plan costs here.

 

You PayREI Pays
You Only$29.13$263.49

 

Medical Costs

 

In-NetworkOut-of-Network
Individual Deductible$1,800 (includes prescription drug costs)$5,400 (includes prescription drug costs)
Preventive care visits (routine physical exams, screening tests)1$0 (no coinsurance or deductible)Not covered
Physician office visits20% after deductible50% of R&C after deductible2
Labs and x-rays20% after deductible50% of R&C after deductible2
Emergency room emergency visits20% after deductible20% after deductible
Emergency room non-emergency visits50% after deductible50% of R&C after deductible2
Hospital inpatient services20% after deductible50% of R&C after deductible2
Inpatient behavioral health (chemical dependency and mental health)10% after deductible50% of R&C after deductible2
Outpatient behavioral health (chemical dependency and mental health)10% after deductible50% of R&C after deductible2
Alternative care (acupuncture, chiropractic, massage therapy; must be medically necessary; combined limit of 60 visits per plan year)20% after deductible50% of R&C after deductible2
Short-term rehabilitation (occupational, physical and speech therapy; must be medically necessary; combined limit of 60 visits per plan year)10% after deductible350% of R&C after deductible3
Vision exam (every 12 months)20% after deductible50% of R&C after deductible2
Individual out-of-pocket maximum$3,600 (includes prescription drug costs)No maximum

1 Preventive care includes a variety of routine services. See the plan document for limitations and details.
2 A reasonable and customary (R&C) charge is the average charge for a procedure in a particular geographic area. If you use out-of-network providers and they charge more than the R&C, you are responsible for your portion of the coinsurance plus any amount above the R&C.
3 Therapy Services – Habilitative physical, occupational and speech therapy for autism and developmental delay will be covered without any visit limits.

 

Prescription Drug Costs

 

In-Network
Individual Deductibleannual combined medical and prescription drug deductible1
Retail generic2$8 copay after deductible
Retail preferred brand25% ($15 minimum/$60 maximum) after deductible
Retail non-preferred brand40% ($15 minimum/$75 maximum) after deductible
Mail-order generic3$20 copay after deductible
Mail-order preferred brand25% ($30 minimum/$120 maximum) after deductible
Mail-order non-preferred brand40% ($30 minimum/$150 maximum) after deductible
Individual out-of-pocket maximumannual combined medical and prescription drug out-of-pocket maximum applies4

1 If you’re covering yourself and other family members, the plan does not start paying benefits until the $3,600 family deductible is met, even if one family member meets the $1,800 individual deductible.
2 Up to a 30-day supply
3 31- to 90-day supply

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