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

Due to temporary legislation, virtual visits through Teladoc, PNC's Well-being Centers and other in-network providers (including specialists) are available at no cost April 1 through Dec. 31, 2022, for those enrolled in PNC’s medical coverage. Refer to News Online for important details.

Teladoc is a 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.

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.

Fertility Treatment 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 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, COVID-19 testing, 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.