EMPLOYEE Frequently Asked Questions
Please use the links below to aid you in your search for answers to your small business insurance and wellness questions.
If you are not a client of John J Boyd, you can contact your human resources department or you can contact your insurance carrier directly.
A formulary drug is a drug that is listed on a preferred drug list from your insurance carrier. They are drugs that insurance carriers believe to be well suited to treat specific conditions, while keeping costs more manageable for both the carrier and the insured individual.
A specialty drug is a high-cost medication used to treat a chronic or complex health condition. These drugs require special handling, administration or monitoring and generally need prior authorization to order them.
Note: SmartBenefits Online accounts are only available if your employer has elected this service from John J Boyd.
Your Doctor’s Office: If you can wait to be seen during normal office hours, your doctor offers a trusted on-going relationship to manager your care. Many doctors now offer extended hours and can be reached by phone or email for after-hours questions.
Telemedicine: No appointments or waiting room, available when your doctor isn’t, care is delivered via smartphone, tablet or computer. Great for sore throat, cough, low-grade fever, earache, cold and flu, mild allergies, skin rash, eye irritation, sprains and strains and minor asthma.
Urgent Care Center: Evening and weekend walk-in hours with convenient locations. Urgent Care Centers generally have a higher co-pay but offer a convenient solution when your doctor’s office is not open.
Great for sore throat, cough, low-grade fever, earache, cold and flu, mild allergies, skin rash, eye irritation, sprains and strains and minor asthma.
Emergency Room: If you are experiencing a life-threatening situation, you should call 911 or go to the nearest emergency room. The emergency room is open 24/7 and is suitable for all emergency situations. Emergency room co-pays are higher than Urgent Care and Office Visit co-pays.
Make sure to check if your provider is in-network.
A co-pay is a fixed amount that you pay for a healthcare service. The amount of the co-pay can vary by the type of service and for some services you may have both a co-pay and coinsurance. An example of a co-pay is a $30 office visit charge or $40 prescription co-pay.
Coinsurance is your share of the costs of a healthcare service. You begin to pay your coinsurance after you have met your plan’s deductible. It is generally a percentage of the allowed amount that your plan covers for a service.
A PPO is a Preferred Provider Organization that has a network of providers but also allows use of medical providers outside of the plan’s network, typically with greater employee cost sharing. A PPO is generally more flexible than an HMO, as a Primary Care Physician (PCP) and referrals for specialty providers are not generally required.