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).

2022 Health Plan Comparison Chart

Health Choice 1 Health Choice 2
Feature In-Network* In-Network*
Annual Deductible**

If you cover yourself only: $1,400
If you cover any family members: $2,800

If you cover yourself only: $2,500
If you cover any family members: $5,000

Preventive Care 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 the deductible, plan pays 60% and you pay 40%

Teladoc

Telemedicine service that gives you and your covered family members convenient, affordable access to a board-certified doctor by phone or online. Medical consultations are available 24/7 via phone or video, dermatology is available 24/7 and behavioral health consultations are available 7 a.m. to 9 p.m. every day via video or phone. Note: Limitations apply in some states. You save time and money: Regular medical visits are $40, dermatology visits are $75 and behavioral health support is $80 to $160, depending on the service. All fees can be paid from your HSA and are subject to your medical plan deductible, coinsurance and out-of-pocket maximum. That means you’ll pay the full cost of these services until you’ve met your deductible, then only 20% of the regular fee after that until you meet the out-of-pocket maximum.

If eligible, you can even earn Wellness Rewards when you register for Teladoc or complete a consultation. Register and/or log in to Castlight for details.

Well-being Centers (Pittsburgh and Miamisburg)

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 are also available at the Well-being Centers.

Onsite EAP counselors are also available on a monthly basis at each of PNC’s onsite Well-being Centers.

To align with other Living Well offerings, Biometric Screenings, flu shots and health education events are available at the Well-being Centers 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%

Non-emergency treatment is not covered in the ER.

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 $3,000 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 Rewards Program through Living Well.

Learn more

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 preventive-care 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

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

Meet Marilyn

  • I’ve been with PNC 33 years.
  • My husband and I recently became guardians for our two young grandchildren, ages 6 and 8.
  • My husband just retired but isn’t eligible for Medicare yet.
  • I’m looking forward to retirement, too, but it’s still a couple of years out.
  • Adding my husband to my coverage for the first time because he’s retired but isn’t yet eligible for Medicare. For us, PNC’s coverage offers better options than the healthcare exchange.
  • Adding my grandchildren to my coverage as dependents. I was happy to hear our legal guardianship makes this possible.
  • The Castlight app helps keep me motivated to stay active so I can keep up with my grandchildren. The kids like to join me for exercise when I compete in a challenge on Castlight!
  • I’m making an appointment with a financial advisor through GuidanceResources to get objective financial guidance, for free.
  • As a breast cancer survivor, I take advantage of all of the covered preventive care exams and screenings.
  • Health Choice 2 (You + Family coverage)
    • I used to have coverage for myself only, but now I need to switch to family coverage. I like knowing that Castlight will help me keep track of my family’s coverage and claims all in one place.
    • I’m switching from Health Choice 1 to Health Choice 2 because the contributions are lower, and I’d rather put that extra money in my HSA right now since I’m not expecting any big expenses this year.
  • Health Savings Account (HSA)
    • I already built up a decent balance in my HSA to cover the deductible and other medical costs if something unexpected happens.
    • I’m going to keep contributing the maximum to my HSA to try to keep it growing to use in retirement, and to invest a portion of my balance. I’m also going to take advantage of the extra $1,000 catch-up contribution since I’m over 55.
    • I also plan to earn the maximum rewards available through Living Well. Together with my husband, we expect to earn up to $1,200 deposited to my HSA by completing eligible wellness activities through Castlight.
  • ISP 401(k)
    • I’ve been putting 10% of my salary into the ISP 401(k), plus extra catch-up contributions, but this year I’m pulling back to 6%.
    • I’ll still get the full PNC company match, and this change won’t derail my savings goal very much. But it will give us a little breathing room with new, child-related expenses this year — though, the back-up childcare program offered through Bright Horizons has been a real savior to secure an affordable babysitter in a pinch!