BENE F I T S SURVEY
1) WHICH OF THE FOLLOWING BENEFIT PLANS OFFERED BY COMPANY XYZ ARE YOU ENROLLED IN (CHECK ALL THAT APPLY)?
2) INSURANCE PREMIUMS FOR COMPANY XYZ MEDICAL PLAN ARE AFFORDABLE FOR ME AND MY FAMILY
Strongly Disagree Disagree Neutral Agree Strongly Agree Not applicable/Covered under other plan
3) WOULD YOU PREFER TO PAY MORE FROM YOUR PAYCHECK FOR MEDICAL INSURANCE OR MORE AT THE TIME YOU VISIT THE DOCTOR OR HOSPITAL (HIGHER DEDUCTIBLE AND/OR HIGHER CO-PAYS. )
More at the time I go to the doctor of hospital More from paycheck Undecided/Not sure
4) HOW WELL DO YOU CURRENTLY UNDERSTAND HOW YOUR BENEFITS WORK?
Extremely well Very Well Well Not very well Do not understand them at all
5) PLEASE RATE YOUR OVERALL SATISFACTION WITH COMPANY XYZ'S CURRENT BENEFITS PACKAGE
Very Satisfied Satisfied Neutral Dissatisfied Very Dissatisfied
6) PLEASE EXPLAIN YOUR REASON(S) FOR YOUR OVERALL BENEFITS SATISFACTION RATING
k.smith@bkcw.com I 405-306-4557
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