Page 4 - 2021-22 Velocity Employee Benefits Brochure

Velocity Mortgage Capital

2021–2022 Employee Benefits Brochure

Medical Plans

Aetna HMO (CA only)

In- Network only

Deductible (per calendar year)
Individual $0
Family $0

Out-of-pocket maximum (per calendar year)
Individual $3,000
Family $6,000

Hospital Services:
Inpatient $500 copay
Outpatient Surgery $200 copay
Emergency Room $150 copay (waived if admitted)

Physician Services:
Office Visit (PCP/Specialist*) $20 / $40
Pre-Natal Maternity Covered 100%
Diagnostic Lab & X-Ray Covered 100%
Imaging (CT/PET scans, MRIs) $100 copay
Urgent Care $35/visit
Acupuncture (limit 20 visits) $15 copay
Mental Health Office Visits $40 copay

Routine Care:
Preventative Checkups (screenings/immunizations) No charge
Routine Eye Exams (1 exam per 24 months) No charge

Prescription Drugs:
Premier Generic Drugs $10 retail/$20 Mail order
Preferred Brand-Name Drugs $35 retail/$70 Mail order
Non-Preferred Brand-Name Drugs $60 retail/$120 Mail order
Specialty Drugs 20% up to $200 per RX retail only
DME(Durable Medical Equipment) $20 copay

Retail Rx: Up to a 30-day supply from Aetna National Network
Mail Oder Rx: 31-90 day supply from CVS Caremark Mail Service Pharmacy

*You need a referral from PCP (primary care physician) to see a specialist.

Please refer to carrier benefit summaries for more detailed information. Should there be a discrepancy between this
booklet and the provisions of the insurance contracts or plan documents, the provisions of the insurance contracts or
plan documents will govern

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