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Note: The content below applies to employees enrolled in the Access and San Francisco Medical Plans prior to January 1, 2026. Learn about the 2025 benefits plan costs here.

Access and San Francisco Plan

Benefits Eligibility

REI Access Plan

2026 Eligibility

The REI Access and San Francisco medical plans are only available to employees who enrolled in the Access or San Francisco medical plan prior to January 1, 2026.

2025 Eligibility

You’re eligible if:

  • You’re a part-time employee who has worked at REI for at least three months,
  • You aren’t eligible for the REI full benefits plan, and
  • You aren’t eligible for medical coveragte through another employer that you work for (attestation will be required at time of enrollment).

You will be eligible to enroll in employee-only medical coverage on the first of the month following three months of employment.

What’s New for 2026

Medical

To help connect employees to high-quality providers, we are moving to Aetna’s Premier Care Multi Tier (APCN+) high-performance network. This is a specialized network selected by Aetna based on quality and cost efficiency. This network assigns doctors and healthcare providers into Maximum Savings, Standard Savings, and out-of-network providers. Use the APCN+ Docfind to review if your provider is a Maxium Savings Provider.

Out-of-Network Reimbursement Level

The reimbursement level for out-of-network claims is changing for the Saver and Choice plans. If you see an out-of-network provider, the amount the plan reimburses may be lower, and you could see an increase in balance billing from your out-of-network provider. To pay less for your care, find an in-network provider.

Lantern

The Lantern Surgery Network will be added to provide support for planned surgeries. Latern is optional and connects employees to board certified surgeons with little to no out-of-pocket costs for eligible planned procedures. Lantern’s dedicated Care Advocates provide personalized support through your surgery journey; handle scheduling and paperwork; and act as your go-to resource before, during and after your procedure. To learn more about costs and what’s covered—contact Lantern at 1-855-317-6383 or visit lanterncare.com/for-members and create an account to get started.

Hinge Health

Hinge Health will no longer be offered to employees enrolled in the Saver or Choice Medical Plans. If you need to continue care for musculoskeletal issues, you can use Aetna Docfind through your medical plan to find a provider.

Pharmacy

REI is changing pharmacy benefit providers from Express Scripts to Optum Rx. With this change, you’ll receive a new ID card. If you use mail order, you’ll need to set up an account with Optum Rx. Most active prescriptions will transfer automatically to Optum Rx, but some may require a new prescription. OptumRx has a broad network of retail pharmacies. Click here to find a pharmacy near you. Contact an Optum Rx Customer Service Advocate at 1-855-261-2736 beginning on November 1.

Eligibility

Part-time employees will need to average 23 hours per week over an evaluation period to become eligible for the Full Benefits Plan. This change begins with the ongoing evaluation period that runs from October 4, 2025, to October 3, 2026, and determines eligibility for the 2027 plan year. We’re sharing this information now so you can make informed decisions in advance of next year’s open enrollment period.

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 for coverage.

Learn about the 2025 benefits plan costs here.

You Pay Bi-WeeklyREI Pays Bi-Weekly
You only$40.80$276.07

 

Medical Costs

In-NetworkOut-of-Network
Individual deductibleTier 1: $1,800 (includes prescription drug costs)
Tier 2: $2,800 (includes prescription drug costs)
$5,400 (includes prescription drug costs)
Preventive care visits (routine physical exams, screening tests)1Tier 1 and 2: $0 (no coinsurance or deductible)Not covered, except no charge for Pap smears
Physician office visitsTier 1: 20% after deductible
Tier 2: 35% after deductible
50% of R&C after deductible2
Labs and X-raysTier 1: 20% after deductible
Tier 2: 35% after deductible
50% of R&C after deductible2
Emergency room (emergency visits)Tier 1: 20% after deductible
Tier 2: 20% after deductible
20% after deductible
Emergency room (non-emergency visits)Tier 1: 50% after deductible
Tier 2: 50% after deductible
50% of R&C after deductible2
Hospital inpatient servicesTier 1: 20% after deductible
Tier 2: 35% after deductible
50% of R&C after deductible2
Inpatient behavioral health (chemical dependency and mental health)Tier 1: 10% after deductible
Tier 2: 25% after deductible
50% of R&C after deductible2
Outpatient behavioral health (chemical dependency and mental health)Tier 1: 10% after deductible
Tier 2: 25% 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)Tier 1: 20% after deductible
Tier 2: 35% after deductible
Combined limit of 60 visits per plan year
50% of R&C after deductible2
Combined limit of 60 visits per plan year
Short-term rehabilitation (occupational, physical and speech therapy; must be medically necessary; combined limit of 60 visits per plan year)Tier 1: 10% after deductible
Tier 2: 25% after deductible
Combined limit of 60 visits per plan year3
50% of R&C after deductible
Combined limit of 60 visits per plan year3
Vision exam (every 12 months)Tier 1: 20% after deductible
Tier 2: 35% after deductible
50% of R&C after deductible2
Individual out-of-pocket maximumTier 1: $3,600 (includes prescription drug costs)
Tier 2: $5,000 (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
4 The plan does not start paying 100% of in-network services until the $7,200 family out-of-pocket maximum is met, even if one family member meets the $3,600 individual out-of-pocket maximum.

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