Annual Enrollment Nov. 2-17, 2017 Learn more. 

Health & Life Insurance

Dental

You can choose from two options through Aetna. Both options cover the same services but work differently.

Preferred Dental Organization (PDO) Dental Maintenance Organization (DMO)
Network You may see any dentist but will save money if you use an in-network PDO provider. If you use an out-of-network dentist, you’re reimbursed based on a percentage of the reasonable and customary (R&C) charge for services. If an out-of-network provider’s fees are greater than R&C, you must pay the excess directly to the provider. You must select and use a primary-care dentist from the Aetna DMO network before you receive services.
Primary-Care Dentist There is no requirement to choose a primary-care dentist. You must choose a primary-care dentist, selected from Aetna’s DMO network when you enroll and before you receive any dental services. Each covered family member may choose a different primary-care dentist. Only services received from or referred by your primary-care dentist are covered.
Annual Deductible $50 employee/$150 family None
Preventive Care (includes two checkups and cleanings per person in a calendar year) 100% covered and not subject to the deductible 100% covered
Primary Services (includes fillings and root canals) 80% covered after deductible 100% covered
Restorative Services (includes bridges and crowns) 50% covered after deductible 50% covered
Annual Maximum Benefit $1,500 per person Unlimited
Orthodontia Deductible (Note: Orthodontia covered only for eligible dependent children age 19 or younger) $50 lifetime per person (this is in addition to the annual deductible) None
Orthodontia Benefit (Note: Orthodontia covered only for eligible dependent children age 19 or younger) 50% of provider’s charge after deductible, up to $1,500 lifetime limit per eligible child Up to 50% of provider’s charge from a DMO in-network provider; limit of one lifetime treatment per eligible child

To find in-network providers: Visit aetna.com or call 877-238-6200 and specify PDO or DMO network. Note: The Aetna website lists the PDO as “Dental PPO/PDN with PPO II Network.”

At the dentist: Show your Aetna dental ID card — it specifies whether you are in the PDO or the DMO and lists your covered family members. After each visit, you’ll get an Explanation of Benefits (EOB) that shows the cost of services and what the plan paid. If you’re in the PDO, it will also show your remaining deductible and annual benefit maximum. If you have questions about the EOB, contact Aetna at 877-238-6200.

For additional details: Please see the PNC Dental Benefits Summary Document.

Aetna Voluntary Dental Coverage
Annual Deductible $50 per person
Preventive Services Includes checkups and cleanings 80% of negotiated cost (in-network) or recognized charge (out-of-network) covered after deductible; no waiting period
Basic Services Includes fillings; oral surgery; denture, bridge and crown repair 60% of negotiated cost (in-network) or recognized charge (out-of-network) charge covered after deductible once enrolled in this coverage with no interruptions for three months
Major Services Includes periodontics and endodontics, crowns, bridges and dentures 50% of negotiated (in-network) or recognized (out-of-network) charge covered after deductible once enrolled in this coverage with no interruptions for 12 months
Annual Maximum Benefit $500 per person
Orthodontia Not covered

To find in-network providers: Visit aetna.com or call 888-772-9682.

At the dentist: Show your Aetna enrollment confirmation letter which specifies whether you are in the PDO or the DMO (and your primary care dentist, if selected) and lists your covered family members. After each visit, you’ll get an Explanation of Benefits (EOB) that shows the cost of services and what the plan paid. If you’re in the PDO, it will also show your remaining deductible and annual benefit maximum. If you have questions about the EOB, contact Aetna at 877-238-6200.

For additional details: Please see the PNC Part-Time Benefits Summary Document