2027_Retiree_Benefits_MWAA | Page 13

MONTHLY BENEFITS CONTRIBUTION

Failure to pay required benefits contributions on time may result in the termination of coverage. UNDER AGE 65( NOT MEDICARE-ELIGIBLE)

Surviving spouse( under 65) + child( ren)

Retiree + spouse( both under 65) + child( ren)

Retiree + spouse( both under 65) + child( ren)( Medicare)

$ 404 $ 447 $ 353 $ 53 $ 8

$ 607 $ 671 $ 530 $ 82 $ 11

$ 585 $ 630 $ 435 $ 82 $ 11

Surviving child( ren) $ 182 $ 201 $ 159 $ 20 $ 3

RETIREES AND / OR SPOUSE AGE 65 AND OLDER( MEDICARE-ELIGIBLE)

UHC Medicare Advantage Only

UHC Medicare Advantage + Choice

UHC Medicare Advantage + Choice Plus

Kaiser Medicare Advantage Only

Kaiser Medicare + pre-65 Kaiser

United Concordia Dental

Retiree only $ 181 n / a n / a $ 64 n / a $ 20 $ 3

Retiree + spouse( both 65 and older)

Retiree( 65 and older) + spouse( under 65)

Retiree( under 65) + spouse( 65 and older)

Retiree( 65 and older) + child( ren)

Retiree + spouse( both 65 and older) + child( ren)

Retiree( 65 and older) + spouse( under 65) + child( ren)

Retiree( under 65) + spouse( 65 and older) + child( ren)

$ 378 n / a n / a $ 129 n / a $ 41 $ 7

n / a $ 403 $ 427 n / a $ 258 $ 41 $ 7

n / a $ 402 $ 423 n / a $ 241 $ 41 $ 7

n / a $ 363 $ 382 n / a $ 223 $ 53 $ 8

NVA Vision

n / a $ 560 $ 579 n / a $ 288 $ 82 $ 11

n / a $ 585 $ 628 n / a $ 417 $ 82 $ 11

n / a $ 584 $ 625 n / a $ 399 $ 82 $ 11

Surviving spouse( over 65) $ 197 n / a n / a $ 64 n / a $ 20 $ 3

Surviving spouse( over 65) + child( ren)

Retiree + spouse( both 65 or older) + child( ren)( Medicare) n / a $ 379 $ 398 n / a $ 223 $ 53 $ 8

$ 538 n / a n / a $ 193 n / a $ 82 $ 11

Surviving child( ren)( Medicare) $ 160 n / a n / a $ 64 n / a $ 20 $ 3

13 | METROPOLITAN WASHINGTON AIRPORTS AUTHORITY