Retiree_Benefits_MWAA | Page 10

MONTHLY BENEFITS CONTRIBUTION

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)

$ 369 $ 405 $ 359 $ 48 $ 8

$ 552 $ 610 $ 539 $ 75 $ 11

$ 532 $ 573 $ 438 $ 75 $ 11

Surviving child( ren) $ 166 $ 183 $ 162 $ 19 $ 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 $ 165 n / a n / a $ 61 n / a $ 19 $ 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)

$ 344 n / a n / a $ 122 n / a $ 37 $ 7

n / a $ 367 $ 388 n / a $ 259 $ 37 $ 7

n / a $ 363 $ 384 n / a $ 241 $ 37 $ 7

n / a $ 331 $ 348 n / a $ 223 $ 48 $ 8

NVA Vision

n / a $ 510 $ 527 n / a $ 284 $ 75 $ 11

n / a $ 534 $ 570 n / a $ 420 $ 75 $ 11

n / a $ 530 $ 568 n / a $ 402 $ 75 $ 11

Surviving spouse( over 65) $ 178 n / a n / a $ 61 n / a $ 19 $ 3

Surviving spouse( over 65) + child( ren)

Retiree + spouse( both 65 or older) + child( ren)( Medicare) n / a $ 344 $ 361 n / a $ 223 $ 48 $ 8

$ 489 n / a n / a $ 182 n / a $ 75 $ 11

Surviving child( ren)( Medicare) $ 145 n / a n / a $ 61 n / a $ 19 $ 3

10 | METROPOLITAN WASHINGTON AIRPORTS AUTHORITY