Benefit Stories: Can You Relate?

Learn how people like you make their enrollment decisions.

What’s your story? Each of us has reasons we make the choices we do. That’s true in life and when it comes to the benefits we choose. Click a photo below to see what others may be thinking about when it’s time to enroll.* You may find some new ideas to consider.

This chart focuses primarily on in-network benefits under both Health Choice 1 and Health Choice 2. For 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

In-network: 100% covered; deductible does not apply

Out-of-network: After you meet the deductible, plan pays 60% and you pay 40%

Coinsurance

In-network: After you meet the deductible, plan pays 80% and you pay 20%

Out-of-network: After you meet this deductible, plan pays 60% and you pay 40%

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.

Access to comprehensive mental health resources, including an expanded network of diverse providers, through Spring Health.

No-cost in-network has been extended through Dec. 31, 2024.

Note: Limitations apply in some states.

Fertility Coverage Through Progyny

Progyny provides comprehensive fertility 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, 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%.
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

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 also may 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.

*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 qualified 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.

ANNUAL Wellness Rewards AVAILABLE FOR COMPLETING ELIGIBLE WELLNESS ACTIVITIES THROUGHOUT THE YEAR

For a covered employee* For a covered spouse/domestic partner*
Up to $800 Up to $400

*You must be enrolled in a PNC medical option and eligible to participate in the PNC BeneFit Plus HSA to receive HSA contributions from PNC. Learn more about Wellness Rewards

*These stories are fictional and are for illustrative purposes only.

*These stories are fictional and are for illustrative purposes only.

Meet Louis

  • I’ve been with PNC for 28 years.
  • My wife and I live in Dover, Delaware.
  • Our youngest daughter is in the Pharm D program at the University of Florida in Gainesville.
  • My daughter. She’s 25, and her birthday is coming up in a few months. I just got a letter from PNC that explained her coverage under PNC’s plans will end the last day of the month in which she turns 26, so we won’t be factoring in a lot of health care costs for her when choosing our medical option this year.
  • I like to use the “Project Your Retirement Income tool" in Pathfinder. It is good to see if I'm on track toward achieving my financial goals.
  • Health Choice 2 (You + Family coverage)
    • My wife and I are still pretty healthy and typically just have preventive care visits and screenings. Because we don’t have many medical needs during the year, we opted for the lower payroll contributions in Health Choice 2.
    • I cover our youngest daughter on my PNC medical coverage. She works part time as a pharmacy technician in Gainesville while studying for her doctorate degree in Pharmacy.
    • Because Ally is in another state and her primary care doctor is back home, telehealth has been a great solution when she is under the weather and needs a convenient way to get care.
  • Health Savings Account (HSA)
    • With retirement closing in, we want to take advantage of every tax-free savings opportunity. That’s why I’m making catch-up contributions to my HSA now that I’m 55, in addition to contributing $7,100 this year. By leaving room for $1,200 in Wellness Reward contributions, we know we won’t go over the allowed limits.
  • ISP 401(k)
    • I’ve been contributing to the 401(k) since I started working at PNC and have built a pretty good nest egg.
    • I converted some of my pretax 401(k) savings to Roth after-tax through the in-plan conversion, which means we’ll have at least one source of tax-free income in retirement.
    • I’m looking into signing up for professional investment advice through Alight Financial Advisors to help me manage my ISP 401(k) account into retirement.