2024 Health & Life Insurance

PNC offers two medical options for full-time [including Reduced Schedule Professionals (RSPs)] and part-time employees: Health Choice 1 and Health Choice 2.

What the two options have in common:

• Both are high-deductible health plans with a Health Savings Account (HSA) that offers tax advantages.
• Both plans include prescription drug coverage through CVS Caremark.
• Benefits cover eligible medically necessary care.
• You can see any doctor you’d like, but you’ll save money when you use in-network providers.
• When you get care, you must pay the full cost of services (this cost is discounted when you use in-network providers) up to a certain amount (the deductible) before the plan begins paying benefits. This doesn't apply to eligible in-network preventive care, which is 100% covered.
• Covered preventive care includes routine services like flu shots, mammograms and well-child care. Eligible in-network preventive services are not subject to the deductible or coinsurance.
• Certain preventive-care drugs are covered at 80% or 100% and not subject to the deductible.
• Once you meet the deductible, you pay a percentage of the cost for covered non-preventive services (20% for in-network). This is called coinsurance.
• Each plan has an out-of-pocket (OOP) maximum that protects you against very high health care costs in any given year. If you reach the OOP maximum, the plan pays 100% of eligible expenses for the rest of the plan year. (The OOP maximum amount is different for each option.)

How the options are different:

• Different deductible and out-of-pocket maximum amounts. Health Choice 1 has a lower deductible and lower out-of-pocket maximum; Health Choice 2 has a higher deductible and higher out-of-pocket maximum.
• Different payroll contribution amounts. You’ll pay more out of each pay for Health Choice 1 and less for Health Choice 2. (Contributions come out of your pay before taxes, regardless of which medical option you choose. If you cover a domestic partner and/or their child (if the child's enrollment impacts your coverage level), that portion of your cost will be deducted after taxes.) You can see the per-pay contribution rates on the Enrollment Hub (on PNC’s intranet) and on the UPoint enrollment site when you enroll.

2024 medical carriers

All employees will have a choice of either Highmark Blue Cross Blue Shield (Highmark) or UnitedHealthcare (UHC). Your carrier choice does not change your deductible, out-of-pocket maximum or any other features of the plan you choose. To see whether your preferred doctors and other providers are in a certain network, click the links below.

• Highmark Blue Cross Blue Shield* — BCBS PPO — highmarkbcbs.com
• UnitedHealthcare — UnitedHealthcare Choice Plus — uhc.com

To learn more about which family members you can cover on your PNC health and insurance benefits, please visit the Eligibility section of the PNC General Plan Information Summary Plan Description (SPD).

For details on when and how you can make changes to your coverage, see the Changing Your Elections section of the PNC General Plan Information SPD.

This chart highlights in-network* benefits under both Health Choice 1 and Health Choice 2.

For more information about out-of-network benefits, please refer to the Medical Benefits Summary Plan Description (SPD).

2024 Health Plan Comparison Chart

Feature	Health Choice 1	Health Choice 2
Annual Deductible**	If you cover yourself only: $1,600 If you cover any family members: $3,200	If you cover yourself only: $2,500 If you cover any family members: $5,000
Eligible Preventive Care (generally based on federal guidelines)	100% covered; deductible does not apply
Coinsurance	After you meet the deductible, plan pays 80% and you pay 20%
Annual Out-of-Pocket Maximum (includes deductible)	If you cover yourself only: $3,000 must be met before you’re covered at 100% If you cover any family members: any individual who meets $3,200 is covered at 100% all other family members are not covered at 100% until family expenses total $6,000	If you cover yourself only: $5,000 must be met before you’re covered at 100% If you cover any family members: any individual who meets $6,850 is covered at 100% all other family members are not covered at 100% until family expenses total $10,000
Telehealth	You and your covered family members have access to convenient, affordable and in-network board-certified doctors by phone or video. Highmark and UHC partner with multiple telehealth providers for easy access to convenient care. Services and prices will vary based on the carrier, telehealth provider and type of service selected. You have access to comprehensive mental health resources, including an expanded network of diverse providers, through Spring Health. No-cost in-network telehealth has been extended through Dec. 31, 2024. Note: Limitations apply in some states.
Virta Health	PNC’s medical coverage includes access to Virta Health (Virta) — a virtual clinic that helps members manage type 2 diabetes, type 1 diabetes, prediabetes and obesity (defined as having a BMI of 25 or greater). Some participants may even reverse their type 2 diabetes and be able to reduce or stop their current diabetes-related medication. Learn more about Virta.
Virtual Second Opinion	Accessible through your medical carrier (Highmark or UHC), you and your covered family members have access to a no-cost virtual second opinion service with an expert physician who can provide education and information about complex medical conditions and treatment decisions.
Fertility Coverage Through Progyny	Progyny provides comprehensive fertility treatment coverage for all paths to parenthood, leveraging the latest technologies and treatments, access to high-quality care through a premier network of fertility specialists, and personalized support and guidance from dedicated Patient Care Advocates (PCAs). If you're enrolled in PNC's medical coverage, you automatically have access to Progyny fertility coverage. Call Progyny at 844-930-3285 if you have questions or to connect with a PCA for personalized support.
Well-being Center in Pittsburgh (Firstside)	If you live in or are visiting the Pittsburgh area and are enrolled in PNC’s medical coverage,* the Well-being Center at Firstside is available to you and your covered family members age 2 and up for primary care, preventive and urgent care, physical therapy, chronic condition support, immunizations and more. Services are billed the same way as any other health care provider. Limited mental health counseling services through the Employee Assistance Program (EAP) are offered as well; an onsite EAP counselor is available for appointments. *To align with other Living Well offerings, Biometric Screenings, flu shots and health education events are available at the Well-being Center for all employees, at no cost to you. This means you can take advantage of these services even if you’re not enrolled in a PNC medical option. Note: Family members must be covered under a PNC medical option to use any Well-being Center services.
Emergency Room (ER)	After you meet the deductible, plan pays 80% and you pay 20%.
Health Savings Account (HSA)	If eligible, the HSA lets you set aside pretax dollars to pay for current eligible health care expenses and/or save for future eligible expenses. You choose how much to contribute (up to IRS limits) and can change your contribution at any time, but no more than once a month (changes are effective as soon as possible in the month following). PNC may also contribute to your HSA, based on your salary and if you participate in the Wellness Incentive Program through Living Well. Learn more about the HSA.
Prescription Drug Coverage***	Covered Health Care Reform preventive care drugs: Deductible does not apply; you pay nothing (plan pays 100%) Covered preventive care drugs: Deductible does not apply; you pay 20% All other covered drugs: After you meet the deductible, you pay 20% If you use an out-of-network pharmacy, you must pay the full price and submit a claim to receive reimbursement. To see the lists of covered drugs, requirements for drugs in the CVS Caremark Maintenance Choice and/or Generic Step Therapy programs, or details about drugs that require pre-authorization, visit caremark.com.
Additional Mental Health Support Through Spring Health	Spring Health provides more in-network mental and behavioral health care options beyond what’s available through Highmark or UHC and makes it easier and faster for you and your family to connect with personalized, confidential mental health support and counseling. Services are available automatically to employees who are enrolled in PNC’s medical coverage and their covered family members ages 6 and up.

*In-network providers agree to accept negotiated rates.
**Deductible and coinsurance apply to eligible, medically necessary medical and prescription drug expenses. However, covered in-network preventive care and Health Care Reform preventive care prescription drugs are covered in full without having to meet the deductible or pay coinsurance. If you cover any family members, the full family deductible must be met before expenses are paid for any individual.
***Subject to the terms of the plan. Please see the Prescription Drug Program section in the Medical SPD for additional information.

Go to Pathfinder and then select Benefits, then Health Care, and then View Your Benefit Costs to see current rates for Health Choice 1 & 2 (and other available benefits). You can also find contribution rates* in the Enrollment Hub on PNC News Online. Payroll contribution rates are based on your pay and the coverage level you elect. To help keep coverage affordable, employees who earn less will have lower contribution rates, and those who earn more will have higher contribution rates.

*Your contributions for coverage will be deducted from your pay on a pretax basis in all cases except coverage for a domestic partner and/or their child (if the child's enrollment impacts your coverage level). Per IRS rules, contributions for medical and/or dental coverage of your domestic partner and/or their child(ren) (unless other eligible children are also on your coverage) are taken on an after-tax basis, and your taxable gross income will be increased by the value of PNC's contribution for their medical and/or dental coverage only, if applicable (this increase, called imputed income, is reported on your pay).

The following additional contributions are the same for all employees, if applicable:

Tobacco User Contribution

When you elect PNC medical coverage, you need to affirm your tobacco user status. If you don’t indicate your status and/or if you use tobacco but don’t agree to complete an approved cessation program, you’ll pay an extra $30 per pay ($780 per year). This also applies separately to your covered spouse/domestic partner. Refer to these FAQs for more information.

Working Spouse Contribution

If your spouse/domestic partner has access to medical coverage through their own employer and you cover them under PNC’s medical benefits, you’ll pay an extra $125 per month. This amount is deducted from your pay in equal installments throughout the year. In most cases, this contribution will be deducted from your pay on a pretax basis.*

* The Working Spouse Contribution does not apply if both you and your spouse/domestic partner work for PNC, your spouse/domestic partner is self-employed, or if your spouse/domestic partner is enrolled in Medicare.

With telehealth, you and your covered family members can visit a doctor without ever leaving home — or your hotel room or anywhere else in the U.S. You can use telehealth for a variety of medical services, including general medical issues, dermatology and behavioral health. Telehealth physicians treat most non-emergency conditions including colds, flu, allergies, headaches, urinary tract infections, skin problems and pediatric illnesses. Dermatologists treat issues like psoriasis, eczema and acne. Behavioral health specialists can provide support for anxiety, depression, family issues and more. In many cases, physicians can call in prescriptions or refills.

Highmark and UHC partner with multiple telehealth providers for easy access to convenient care. Services and prices will vary based on the carrier, telehealth provider and type of service selected. No-cost in-network telehealth has been extended through Dec. 31, 2024.

Note: Limitations apply in some states.

PNC’s medical coverage includes access to Virta — a virtual clinic that helps members manage type 2 diabetes, type 1 diabetes, prediabetes and obesity¹ (defined as having a BMI of 25 or greater). Some participants may even reverse² their type 2 diabetes and be able to reduce or stop their current diabetes-related medication.

Virta’s virtual clinic offers programs for:

• Type 2 Diabetes Reversal: Lower your blood sugar, reduce medications and lose weight.
• Diabetes Management: Get tips to manage your A1c levels, plus access to a health coach and free testing supplies.
• Prediabetes: Prevent rising blood sugar and lose weight.
• Obesity: Lose weight without counting calories. Virta health coaches can help you gain control of cravings and keep you on track.

Virta is available at no cost³ to PNC employees and eligible family members between the ages of 18 and 79 who are enrolled in a PNC medical option. This benefit is currently being offered to those with type 2 diabetes, type 1 diabetes, prediabetes and obesity¹ (defined as having a BMI of 25 or greater).

What’s covered:

• A nutrition therapy plan backed by clinical research
• Tips to make meals tasty and healthier
• Personalized clinician care and coaching
• Daily support via mobile/desktop app
• Meter, scale and testing supplies

To learn more and check your eligibility, visit virtahealth.com/join/pnc or contact Virta directly at support@virtahealth.com.

¹There are some medical conditions that would exclude patients from the Virta treatment.

²Reversal on Virta is defined by reaching an A1c below 6.5% without the use of diabetes medications beyond metformin. Diabetes and related issues can return if lifestyle changes are not maintained.

³Virta’s diabetes reversal program is considered in-network telehealth; employees enrolled in PNC medical coverage (and their covered family members) can access all in-network telehealth at no cost through Dec. 31, 2024. Virta’s other free programs (for type 2 diabetes, prediabetes and obesity) are not subject to the Dec. 31, 2024, deadline for no-cost telehealth. Any required lab tests/screenings completed through Virta’s lab partnership are considered preventive and therefore covered 100%.

Progyny provides comprehensive fertility treatment coverage for all paths to parenthood, leveraging the latest technologies and treatments, access to high-quality care through a premier network of fertility specialists, and personalized support and guidance from dedicated Patient Care Advocates (PCAs).

Fertility treatment through Progyny is automatically included in both of PNC's Health Choice medical options for you and/or your enrolled spouse or domestic partner if applicable and is available through all carriers. Covered services will be subject to the same deductible and out-of-pocket maximum that apply to other eligible medical and prescription drug expenses.

Progyny uses a “smart cycle" approach, which is designed to simplify the often complicated and highly personalized care to successfully support each individual and their unique needs. You also have access to knowledgeable PCAs who are prepared to discuss your goals and to help you navigate medical and pharmacy questions throughout your journey. Through PNC’s medical coverage, you and your covered spouse/domestic partner have access to two smart cycles per lifetime, plus access to a third smart cycle if the first two do not result in a live birth. Call Progyny at 844-930-3285 if you have questions or to connect with a PCA for personalized support.

PNC medical plan participants who live in or are visiting the Pittsburgh area, and their family members age 2 and up, are welcome to use our onsite Well-being Center. Conveniently located at Firstside, our Well-being Center offers high-quality primary care, preventive and urgent care, physical therapy, chronic condition support, immunizations and more. Services are billed the same way as any other health care provider.

Walk in or call for an appointment: 412-807-7878 (7 a.m. to 5 p.m. ET Monday through Friday)

Limited mental health counseling services through the Employee Assistance Program (EAP) are available as well.

To align with other Living Well offerings, Biometric Screenings, flu shots and health education events are available at the Well-being Center for all employees, at no cost to you. This means you can take advantage of these services even if you’re not enrolled in a PNC medical option.

Note: Family members must be covered under a PNC medical option to use any Well-being Center services.

What does being a “good health care consumer” mean? It means taking advantage of tools and resources, making informed decisions about your care and comparing the cost and quality of what’s available. Check out the tips below and watch this short video for easy tips to help you save and make the most of your health and health care dollars.

1. Take advantage of eligible in-network preventive care at no cost to you. Free preventive care can often help you detect potential issues before they become bigger concerns.

2. Use in-network providers — they typically cost you less. Use Castlight to find in-network providers and provider quality ratings. Or use the “Find a provider” or similar tool on your medical carrier’s website to find participating doctors or call the customer service number on your medical coverage ID card.

3. Compare costs when you can. Castlight provides cost estimates when you search for your care through their app or website. Or, use the cost comparison tools (if available) on your medical carrier’s website or call the customer service number on your medical coverage ID card.

4. Maximize your Wellness Rewards from Living Well. If you’re enrolled in a PNC medical option with a PNC BeneFit Plus Health Savings Account (HSA), you can earn rewards in the form of points that you can redeem for money in your HSA. Simply complete eligible wellness activities throughout the year and record them in Castlight to earn up to $800, plus up to an additional $400 if your covered spouse/domestic partner (if applicable) participates. If you’re not enrolled in a PNC medical option or don’t have an associated HSA, you can still earn up to $100 in gift cards. (After you earn your points, be sure to redeem them in Castlight’s rewards center to receive your HSA dollars or gift cards, as applicable.)

5. Try telehealth. You and your eligible family members can speak with a board-certified doctor by phone or video for non-emergency issues. Note: Limitations apply in some states. More information.

6. Use the Well-being Center in Pittsburgh. Employees enrolled in PNC medical coverage (and their covered family members age 2 and older) who live in or are visiting the Pittsburgh area can visit the center at Firstside for primary, preventive and urgent care, physical therapy, chronic condition support, immunizations and more. All employees, regardless of coverage, have access to free Biometric Screenings, flu shots and health education events.

   More information

7. Get help managing diabetes. PNC’s medical coverage includes access to Virta Health (Virta) — a virtual clinic that helps members manage type 2 diabetes, type 1 diabetes, prediabetes and obesity (defined as having a BMI of 25 or greater). Some participants may even reverse their type 2 diabetes and be able to reduce or stop their current diabetes-related medication. Learn more about Virta.

   At the PNC Well-being Center, covered employees in the Pittsburgh area and their covered family members age 2 and up can also meet with a nurse practitioner for an evaluation and diabetes or pre-diabetes coaching and referral to a specialist, as appropriate.

8. Take advantage of your HSA. Not only will you save on taxes when you make pretax contributions to your HSA, but you can then use the funds in your account to help pay for eligible health care expenses with tax-free money now and/or save and invest for the future. Watch this short video or check out the HSA User Guide for more information.