Page 27 - Benefits-Guide-2020
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MEDICAL & PRESCRIPTION DRUG PLANS
Plan Option
Monthly premiums are for one person. For married couples, multiply the costs above by two. Premiums apply to Delta Air Lines retirees, spouses of current or former Delta Air Lines employees, surviving spouses of former Delta Air Lines employees, and those with a Delta Air Lines pension.
Premiums do not reflect subsidies that may be available for certain Delta Air Lines retirees. Check your Summary of Current Elections that came in your enrollment packet
for subsidy eligibility details.
You do not have to purchase medical and prescription drug coverage through the Insurance Trust in order to purchase Dental or Vision coverage. However, members who only purchase Dental and/or Vision coverage pay a $2 per month administration fee.
Supplement-Type Standard Plan
Medicare Advantage Standard Plan
Medicare Advantage Enhanced Plan
DENTAL PLANS
VISION PLANS
$232.46
$321.34
$136.54
$174.86
MetLife Dental PPO (Ground & Flight Attendant)
MetLife Dental PPO (Pilots)
Cigna Dental HMO
$54.00/$109.25 w/spouse
$63.95/$129.52 w/spouse
$27.55/$55.05 w/spouse
EyeMed Vision Plan
$6.61/$12.30 w/spouse
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Insurance Trust For Delta Retirees | 2020 Benefits & Resources Guide | 27
Medical & Prescription Drug Coverage
Supplement-Type Enhanced Plan
SUMMARY OF BENEFITS & PLAN PREMIUMS
