Fertility Clinical Policy Change

Aetna’s clinical policy related to fertility services will expand access to artificial insemination (AI) and intrauterine insemination (IUI), and beginning January 1, AI and IUI will no longer have cycle limits.

For more detailed information, visit myaetnawebsite.com or contact the Health Guide at 1-800-451-2967.

Travel & Lodging Benefits

REI currently provides Travel & Lodging benefits for employees who have pre-certified medical and prescription services and need to travel more than 100 miles to see an in-network provider for certain services.

Beginning January 1, there are a few enhancements to the Travel & Lodging benefits offered:

1. Expansion of Travel & Lodging benefits will apply to all covered services through our Aetna Saver and Choice plans and will no longer be limited to fertility, gender affirming or reproductive services.
   • Employees and enrolled dependents still need to have pre-certified medical services and need to travel more than 100 miles to see an in-network provider.
2. Administration of benefits will move from HealthEquity to Aetna beginning January 1. Employees or enrolled dependents will need to submit a reimbursement request through Aetna.
3. The total allowable reimbursement amount per incident is increasing to $10,000 and eligible expenses—for example, lodging, transportation, meals (only at a hospital or similar institution)—will be aligned to the IRS reimbursable amounts.

For 2025: For eligible services that are incurred in 2025, employees can begin submitting eligible expenses for reimbursement through Aetna.

Submit expenses online through myaetnawebsite.com or through the Aetna Health App. Once logged in, select Claims from the menu and then Submit a Claim. Follow the prompts to provide details regarding the dates of service and expenses. Upload any forms or receipts and submit once completed.

Advanced Utilization Management

REI is expanding utilization management for certain prescription medications. Utilization management is a set of measures that ensures patients receive appropriate, effective and cost-efficient medications. These measures include:

• Prior authorization: Approval from the insurance company will be required before certain prescriptions can be filled. This ensures that the medication is necessary and appropriate for treating the condition.
• Step therapy: Step therapy requires you to try a less expensive medication before “stepping up” to a more costly medication. This helps find the most effective and economical treatment.

If these new measures impact a medication(s) you take, you’ll receive a mailed communication from Express Scripts in December 2024 about the change and will need to work with your treating provider to find a new medication. If you have questions prior to the communication, contact Express Scripts Member Services at 1-800-417-1764.

Preventive Drug List

REI will be adopting Express Scripts standard preventive drug list, which will change the plan’s cost share for certain drugs. The purpose of a preventive drug list is to add new medications that are effective in preventing and managing chronic conditions and to remove medications when more effective alternatives are available.

As a result of the update to the preventive drug list, there are medications that are being removed and will now be subject to your plan deductible. Please reference the updated preventive drug list effective January 1.

If your prescription is no longer on the preventive drug list, you will receive communication from Express Scripts mailed to your home address. That outlines the following next steps:

• Keep taking your medications as prescribed by your doctor(s).
• Call Express Scripts Member Services at the toll-free number on your prescription ID card to understand how your prescription drug cost will change for 2025.
• Review your medical plan details to determine if you want to change your election for 2025.
• In 2025, you can also check the new cost of your medication by logging on at express-scripts.com. When you log on, select Price a Medication from the Prescriptions menu. Enter your medication’s name and view cost information on the result page.

If you would like to know more about this plan change, call Member Services at 1-800-417-1764.

Prescription Drugs Deductible

Effective January 1, Kaiser Colorado prescription drugs will be subject to the plan deductible.

Delta Dental Core Plan and Core + Orthodontia Plan

The dental plan will now include coverage for Silver Diamine Fluoride (SDF) at no cost. SDF is a liquid used in dentistry to help prevent and treat cavities. It combines the benefits of fluoride, which helps re-mineralize and strengthen teeth, with the antibacterial properties of silver to help kill the bacteria that causes tooth decay.

To find a Delta Dental network provider, visit the Delta Dental provider website.

VSP Vision Plan

• UV coating and high-index lens coverage will be added as covered services at 100% to the VSP vision plan.
• Beginning January 1, Walmart will be included as an in-network provider.

Find a participating VSP Provider at vsp.com or call VSP member services at 1-800-877-7195.

Employee Assistance Program (EAP)

All employees and their household members have access to the EAP. The EAP provides eight free individual counseling sessions per issue, per year, either face to face, over video or through text messaging.

• Talkspace (available through the EAP): Talkspace services are expanding to include video chat. Talkspace is an online therapy platform that makes it easy and convenient to connect with a licensed behavioral therapist from just about anywhere, at any time.

Retirement

Coming soon! Voya Financial will be the new record-keeper for the REI Retirement and Profit-Sharing Plan beginning November 18, 2024. For more information about the transition, including the blackout period, fund mapping and FAQs, visit go.voya.com/rei or talk to a Voya representative at 1-833-734-0304.

Delaware Paid Leave

Delaware Paid Leave will provide paid leave to employees who have been employed for at least one year and have worked at least 1,250 hours with a single employer. In order to fund the program, which begins in January 2026, deductions for Delaware Paid Leave will begin in January 2025. The rate which is guaranteed through 2026 is 0.8% of wages and will be funded through a combination of employee and employer contributions.

Beginning in 2026, Delaware Paid Leave offers paid leave to eligible employees. If their leave is approved, up to 80% of their wages (up to $900 per week) to cover the following, and are limited to a maximum of 12 weeks of total, combined leave per year:

• Care for a new child (up to 12 weeks per year),
• Care for a family member with a serious health condition (up to 6 weeks, every 24 months),
• Address a personal serious health condition or injury (up to 6 weeks, every 24 months), or
• Assist while loved ones are on overseas military deployment (up to 6 weeks, every 24 months).

For additional information please see the Delaware Paid Family Leave website.

Maine Paid Family and Medical Leave

Beginning in May 2026, Maine Paid Family & Medical Leave (PFML) will provide up to 12 weeks of paid leave to employees. Deductions for Maine PFML will begin January 1, 2025. The deduction rate is set at 1%, which will be funded through a combination of employee and employer contributions. Additional information on Maine PFML can be found on the Maine Paid Family and Medical Leave website.

Beginning in 2026, Maine PFML will provide employees with up to 12 weeks of medical and/or family care leave per year for the following:

• The employees own serious health condition: A serious health condition includes illness, injury, impairment, pregnancy, recovery from childbirth, or any physical, mental or psychological condition involving inpatient care or continuing treatment by a healthcare provider
• Bond with a new child
• Family care
• Qualifying exigency: To handle matters related to a covered family member’s active-duty military service or notice of an impending call or order to active duty
• Care for a covered service member
• Organ donation
• Military bereavement