The REI Options Plan consists of three employee-only plan options administered by Administrative Concepts (ACI), which utilizes the Aetna First Health Network. Find a First Health Network provider at firsthealthlbp.com/fhlbpfi or by calling 800-226-5116.
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Benefits Plan Information and Costs
Medical
The REI Options Plan is Group Limited Indemnity (GLI) insurance, which pays a fixed benefit amount for a limited number of days when an enrolled employee incurs certain medical expenses.
Note: Group Limited Indemnity is NOT major medical insurance.
When you go to a provider or hospital, present your ID card and assign the benefits to them, the provider will file the claim directly with Globe Life on your behalf. When it has been processed, Globe Life will pay the provider first and send you any benefit that is remaining, if appropriate. If Globe Life has paid the provider and there is still a balance due, it is the patient’s responsibility to pay any remaining balance.
Here’s what you pay each paycheck for coverage:
| Core | Preventive | Plus | |
|---|---|---|---|
| Bi-Weekly | $35.87 | $54.04 | $86.94 |
| Weekly | $17.94 | $27.02 | $43.47 |
Medical costs:
Below are the medical costs paid by the Options Plan. This is Group Limited Indemnity (GLI) insurance, which pays a fixed benefit amount for a limited number of days when an enrolled employee incurs certain medical expenses, unless otherwise noted.
Note: Group Limited Indemnity is NOT major medical insurance.
| Description | Core Plan |
Preventive Plan |
Plus Plan |
|---|---|---|---|
| Primary Care or Specialist Office Visit | |||
| Primary Care or Specialist Office Visit | N/A | N/A |
$30 copay1 3 visits per year |
| Outpatient Diagnostic Lab, X-ray benefit (during Primary or Specialist visit) | N/A | N/A | Covered under the Office visit copay1 |
| Physician Office Visits | |||
| Outpatient Physician Office Visits |
$75 6 days per year |
$75 6 days per year |
N/A |
| Urgent Care Office Visit | |||
| Urgent Care Office Visit | N/A | N/A | $50 copay1
1 visit per year |
| Outpatient Diagnostic Lab, X-ray benefit (during Urgent care visit) | N/A | N/A | Covered under the Office visit copay1 |
| Hospital Benefits | |||
| Hospital Confinement | $1,500
10 days per year |
$1,500
10 days per year |
$2,500
10 days per year |
| Hospital ICU Confinement | $2,000
10 days per year |
$2,000
10 days per year |
$3,500
10 days per year |
| Hospital Admission | $1,000
1 day per year |
$1,000
1 day per year |
$2,500
1 day per year |
| Surgery Benefits | |||
| Inpatient Surgery | $1,000
1 day per year |
$1,000
1 day per year |
$3,500
1 day per year |
| Outpatient Surgery | $500
1 day per year |
$500
1 day per year |
$1,000
2 days per year |
| Anesthesia | $250
2 days per year |
$250
2 days per year |
$1,000
2 days per year |
| Emergency Room & Physician Benefits | |||
| Emergency Room Sickness | $250
1 day per year |
$250
1 day per year |
$1,000
1 day per year |
| Ambulance Benefits | |||
| Ground or water ambulance | $100
1 day per year |
$100
1 day per year |
$500
1 day per year |
| Air ambulance | $100
1 day per year |
$100
1 day per year |
$500
1 day per year |
| Diagnostic Labs, X-Ray and Testing Benefits | |||
| Outpatient Diagnostic Lab | $50
3 days per year |
$50
3 days per year |
$75
3 days per year |
| Outpatient Diagnostic X-Ray | $100
2 days per year |
$100
2 days per year |
$300
2 days per year |
| Outpatient Major Diagnostic Testing | $250
1 day per year |
$250
1 day per year |
$1,000
1 day per year |
| Other Benefits | |||
| Outpatient Therapy Services | N/A | N/A | $100
3 days per year |
| Durable Medical Equipment | N/A | N/A | $50
4 days per year |
| Skilled Nursing Care Facility | N/A | N/A | $250
30 days per year |
1These benefits are considered minimal essential coverage. See the Options Plan Enrollment Guide for a list of covered preventive services
Virtual Primary Care
Recuro Health provides telehealth services to address your routine medical issues on demand, 24/7 by phone or video from the convenience of your home or office. Visit recurohealth.com or call 855-673-2876.
| Core Plan | Preventive Plan | Plus Plan | |
|---|---|---|---|
| Virtual Primary Care | $0 per visit Unlimited visits | $0 per visit Unlimited visits | $0 per visit Unlimited visits |
| Telephonic/Video Doctor Visits | $0 per visit Unlimited visits | $0 per visit Unlimited visits | $0 per visit Unlimited visits |
| Therapy and Counseling Virtual Visits | $0 copay 3 visits per year | $0 copay 3 visits per year | $0 copay 3 visits per year |
Prescription Drug Benefit
Drexi is the prescription benefits manager for non-preventive medications. To get more information on pharmacy specific pricing of your medication you can either call Drexi’s customer service line or log in to their website to use their medication lookup tool.
| Drexi Prescription Benefit | Core Plan | Preventive Plan | Plus Plan |
|---|---|---|---|
| Tiered RX Prescription Drug Benefit | $0.00 Tier 1 $10.00 Tier 2 $25.00 Tier 3 $50.00 Tier 4 Non-Formulary Drugs average 67% Discount | $0.00 Tier 1 $10.00 Tier 2 $25.00 Tier 3 $50.00 Tier 4 Non-Formulary Drugs average 67% Discount | N/A |
| RX Prescription Drug Copay Card Benefit | N/A | N/A | $10 copay – Generic $30 copay – Preferred Brand $300/$600 limit per month |
RxAssist by Medalist
RxAssist by Medalist provides ACA preventive drugs, including birth control, at no cost to you.
To view the ACA Preventive Prescription Drug List, visit RX Assist by Medalist > HCR Medication List or call 855-633-2579.
| RX Assist by Medalist | Core Plan | Preventive Plan | Plus Plan |
|---|---|---|---|
| ACA Preventive Prescriptions, including birth control | None | $0 copay for Preventive Prescriptions | $0 copay for Preventive Prescriptions |
Benefits Plan Information and Costs
Here’s what you and REI pay each paycheck for coverage.
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Medical Costs
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Prescription Drug Costs
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