Here’s what you and REI pay each paycheck for coverage.
Learn about the 2023 benefits plan costs here.
| You Pay | REI Pays |
| You Only | $29.13 | $263.49 |
Medical Costs
| In-Network | Out-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 visits | 20% after deductible | 50% of R&C after deductible2 |
| Labs and x-rays | 20% after deductible | 50% of R&C after deductible2 |
| Emergency room emergency visits | 20% after deductible | 20% after deductible |
| Emergency room non-emergency visits | 50% after deductible | 50% of R&C after deductible2 |
| Hospital inpatient services | 20% after deductible | 50% of R&C after deductible2 |
| Inpatient behavioral health (chemical dependency and mental health) | 10% after deductible | 50% of R&C after deductible2 |
| Outpatient behavioral health (chemical dependency and mental health) | 10% after deductible | 50% 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 deductible | 50% 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 deductible3 | 50% of R&C after deductible3 |
| Vision exam (every 12 months) | 20% after deductible | 50% 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 Deductible | annual combined medical and prescription drug deductible1 |
| Retail generic2 | $8 copay after deductible |
| Retail preferred brand | 25% ($15 minimum/$60 maximum) after deductible |
| Retail non-preferred brand | 40% ($15 minimum/$75 maximum) after deductible |
| Mail-order generic3 | $20 copay after deductible |
| Mail-order preferred brand | 25% ($30 minimum/$120 maximum) after deductible |
| Mail-order non-preferred brand | 40% ($30 minimum/$150 maximum) after deductible |
| Individual out-of-pocket maximum | annual 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
