RETIREE MEDICAL

Benefits and Rates

The Hartford will be the Medical Insurance carrier for retirees. They were chosen as the Medical Insurance carrier for the Retiree Group Medical Coverage because of their superior program and many years of experience in the retiree market. The NWRBT medical plans that are available to you are designed to pay in addition to Medicare and for those expenses which Medicare does not pay.

The coverage is guaranteed acceptance. In other words, you can obtain this coverage regardless of any previous medical condition you may have. The state in which you reside will determine which plan(s) are available to you.

Medical Plan Highlights

Effective January 1, 2022, The Hartford is offering a NEW Medical Plan, the Premium Plus Plan. Did you know the NEW Premium Plus Plan is similar to Medicare Supplement Plan F? On the Premium Plus Plan, you pay your premium and the Premium Plus Plan covers everything else with no deductible and no copays on most services*. The Florida Department of Insurance has not approved the issuance of this new offering, so Florida residents are not able to enroll in this new plan unless you have another residence you can list outside the state of Florida. Premium Plan and Value Plan Annual Out-Of-Pocket Maximum of $1,750 applies to Medicare Part B expenses only. Amounts you incur for covered expenses, such as your deductible and any Part B coinsurance, will count towards meeting the annual out-of-pocket maximum of this plan. The Value Plan is not available to Washington residents. *For additional benefit information, please see the 2025 Northwest Retiree Benefit Guide.

Quality Care Connect
Included with purchase of medical plan

Northwest Airlines Retiree Benefit provides you with exclusive access to QualityCare Connect®, a program that connects...

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Silver&Fit
Included with purchase of medical plan

The Silver&Fit healthy aging and exercise program supports every unique member...

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Medical Plan Premiums (Countrywide) - 2025

Plan OptionsCost Per Retiree or Spouse
 Retiree CoverageSpouse or Surviving Spouse Coverage
Premium Plus PlanAge: 65-69     $172.90
Age: 70-74      $210.35
Age: 75-79     $251.21
Age: 80-84     $293.88
Age: 85-89     $322.72
Age: 90+         $338.65		Age: 65-69     $172.90
Age: 70-74      $210.35
Age: 75-79     $251.21
Age: 80-84     $293.88
Age: 85-89     $322.72
Age: 90+         $338.65
Premium PlanAge: 65-69     $137.73
Age: 70-74      $166.55
Age: 75-79     $197.97
Age: 80-84     $230.80
Age: 85-89     $252.99
Age: 90+         $265.24		Age: 65-69     $137.73
Age: 70-74      $166.55
Age: 75-79     $197.97
Age: 80-84     $230.80
Age: 85-89     $252.99
Age: 90+         $265.24
Value PlanAge: 65-69     $120.19
Age: 70-74      $145.82
Age: 75-79      $174.36
Age: 80-84     $205.01
Age: 85-89     $226.91
Age: 90+         $240.39		Age: 65-69     $120.19
Age: 70-74      $145.82
Age: 75-79      $174.36
Age: 80-84     $205.01
Age: 85-89     $226.91
Age: 90+         $240.39
Age Group Cost Per Retiree or Spouse
Premium Plus Plan Premium Plan
65-69 $198.84 $146.69
Pre-65 & 70+ $278.69 $146.69
Plan Options Cost Per Retiree or Spouse
Retiree Coverage Spouse or Surviving Spouse Coverage
Premium Plus Plan Age: 65-69     $163.11
Age: 70-74      $198.45
Age: 75-79     $236.99
Age: 80-84     $277.25
Age: 85-89     $304.46
Age: 90+         $319.48		 Age: 65-69     $163.11
Age: 70-74      $198.45
Age: 75-79     $236.99
Age: 80-84     $277.25
Age: 85-89     $304.46
Age: 90+         $319.48
Premium Plan Age: 65-90+   $108.82 Age: 65-90+   $108.82

Medical Plan Premiums (Florida State Residents) - 2025

Age Group Cost Per Retiree or Spouse
Premium Plan Value Plan
65-69 $165.20 $122.41
Pre-65 & 70+ $229.95 $163.48
Plan OptionsCost Per Retiree or Spouse
 Retiree CoverageSpouse or Surviving Spouse Coverage
Premium PlanAge: 65-69     $137.73
Age: 70-74      $166.55
Age: 75-79     $197.97
Age: 80-84     $230.80
Age: 85-89     $252.99
Age: 90+         $265.24		Age: 65-69     $137.73
Age: 70-74      $166.55
Age: 75-79     $197.97
Age: 80-84     $230.80
Age: 85-89     $252.99
Age: 90+         $265.24
Value PlanAge: 65-69     $120.19
Age: 70-74      $145.82
Age: 75-79      $174.36
Age: 80-84     $205.01
Age: 85-89     $226.91
Age: 90+         $240.39		Age: 65-69     $120.19
Age: 70-74      $145.82
Age: 75-79      $174.36
Age: 80-84     $205.01
Age: 85-89     $226.91
Age: 90+         $240.39

Medical Plan Premiums (Washington State Residents) - 2025

Plan OptionsCost Per Retiree or Spouse
 Retiree CoverageSpouse or Surviving Spouse Coverage
Premium PlanAge: 65-90+     $115.35Age: 65-90+     $115.35

Note: There is an additional $1.00 VEBA Trust Fee, a $1.25 QualityCare Connect fee, and a $2.72 Silver&Fit® fee per person in addition to the rates quoted above.

Exclusions
This plan does not cover: any expense that is not a Medicare Eligible Expense or beyond the limits imposed by Medicare for such expenses or excluded by name or specific description by Medicare, except as specifically provided in the policy; any portion of a covered expense to the extent paid by Medicare; benefits payable under one benefit of the policy to the extent covered under another benefit of the policy; or expenses incurred after coverage terminates. The summary of program benefits described herein is for illustrative purposes only. In case of differences or errors, the Group Policy governs.

MEDICARE ADVANTAGE

Benefits and Rates

Humana is the Medicare Advantage carrier for retirees. They were chosen as the Medicare Advantage Insurance carrier for their experience, expertise and leader in the market. The plan was designed as an alternative for those that may not need a traditional Medicare supplemental plan and comes with a lower rate.

Medical Plan Highlights

The AirlineCare plan is a Medicare Advantage plan that can only be purchased here. And unlike most other Medicare Advantage plans, the Airline Care Plan is a PPO plan rather than the most common HMO plans that can be found on the open market. Effective June 15th 2025, we are pleased to bring this new Humana offering as NEW Medical Plan option to the additional unique plan offerings we make available to you. In addition to providing Medicare benefits, this new AirlineCare plan offers valuable non-Medicare benefits such as coverage for annual physicals, post discharge meals, post discharge rides, post discharge in-home assistance, access to telehealth and a fitness benefit.

Medical Advantage Plan Premiums (Countrywide) - 2025

Plan Options Cost Per Retiree or Spouse
Retiree Coverage Spouse or Surviving Spouse Coverage
AirlineCare Plan All Ages:         $19.86 All Ages:         $19.86
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