Healthcare Insurance Survey

Question Title

* 1. Do you and/or your family have healthcare insurance?

Yes

Question Title

* 2. Is your healthcare insurance for?

Just myself

My spouse and myself only

For my family, including children

Question Title

* 3. What type of healthcare insurance do you have? Mark all that are appropriate.

Health Maintenance organization

Preferred Provider Organization

Health Reimbursement Accounts

Flexible Spending Account

Health Savings Accounts

Purchased by me or my spouse

Obtained through employer

Purchased through an association

Purchased by me through a company I own

Question Title

* 4. How long have you had your current insurance?

One year or less

Two years

Three years

Four years

More than four years

Question Title

* 5. How long have you had your current insurance provider?

One year or less

Two years

Three years

Four years

More than four years

Question Title

* 6. Rate the factors that influenced your choice of healthcare insurance fom very important, somewhat important, important, not important.

	Not important	Somewhat important	Important	Very important	N/A
Price/cost	Price/cost Not important	Price/cost Somewhat important	Price/cost Important	Price/cost Very important	Price/cost N/A
Type of insurance	Type of insurance Not important	Type of insurance Somewhat important	Type of insurance Important	Type of insurance Very important	Type of insurance N/A
Deductible	Deductible Not important	Deductible Somewhat important	Deductible Important	Deductible Very important	Deductible N/A
Co-pay options	Co-pay options Not important	Co-pay options Somewhat important	Co-pay options Important	Co-pay options Very important	Co-pay options N/A
Company reputation	Company reputation Not important	Company reputation Somewhat important	Company reputation Important	Company reputation Very important	Company reputation N/A
Company officials	Company officials Not important	Company officials Somewhat important	Company officials Important	Company officials Very important	Company officials N/A
Recommendation of agent	Recommendation of agent Not important	Recommendation of agent Somewhat important	Recommendation of agent Important	Recommendation of agent Very important	Recommendation of agent N/A
Recommendation of others	Recommendation of others Not important	Recommendation of others Somewhat important	Recommendation of others Important	Recommendation of others Very important	Recommendation of others N/A
Internet search	Internet search Not important	Internet search Somewhat important	Internet search Important	Internet search Very important	Internet search N/A
Television, radio ad	Television, radio ad Not important	Television, radio ad Somewhat important	Television, radio ad Important	Television, radio ad Very important	Television, radio ad N/A

Other (please specify)

Question Title

* 7. Would you recommend your current healthcare insurance to a family member of friend

Yes

	Somewhat agree	Agree	Somewhat disagree	Strongly disagree	Have no opinion
This legislation will reduce my overall healthcare costs.	This legislation will reduce my overall healthcare costs. Somewhat agree	This legislation will reduce my overall healthcare costs. Agree	This legislation will reduce my overall healthcare costs. Somewhat disagree	This legislation will reduce my overall healthcare costs. Strongly disagree	This legislation will reduce my overall healthcare costs. Have no opinion
This legislation will NOT reduce my overall healthcare costs.	This legislation will NOT reduce my overall healthcare costs. Somewhat agree	This legislation will NOT reduce my overall healthcare costs. Agree	This legislation will NOT reduce my overall healthcare costs. Somewhat disagree	This legislation will NOT reduce my overall healthcare costs. Strongly disagree	This legislation will NOT reduce my overall healthcare costs. Have no opinion
This legislation will add to overall healthcare costs.	This legislation will add to overall healthcare costs. Somewhat agree	This legislation will add to overall healthcare costs. Agree	This legislation will add to overall healthcare costs. Somewhat disagree	This legislation will add to overall healthcare costs. Strongly disagree	This legislation will add to overall healthcare costs. Have no opinion
This legislation will NOT add to overall healthcare costs.	This legislation will NOT add to overall healthcare costs. Somewhat agree	This legislation will NOT add to overall healthcare costs. Agree	This legislation will NOT add to overall healthcare costs. Somewhat disagree	This legislation will NOT add to overall healthcare costs. Strongly disagree	This legislation will NOT add to overall healthcare costs. Have no opinion
Any legislation is better than no legislation.	Any legislation is better than no legislation. Somewhat agree	Any legislation is better than no legislation. Agree	Any legislation is better than no legislation. Somewhat disagree	Any legislation is better than no legislation. Strongly disagree	Any legislation is better than no legislation. Have no opinion
Congress should start over and do it right.	Congress should start over and do it right. Somewhat agree	Congress should start over and do it right. Agree	Congress should start over and do it right. Somewhat disagree	Congress should start over and do it right. Strongly disagree	Congress should start over and do it right. Have no opinion

Somewhat agree

Agree

Somewhat disagree

Strongly disagree

Have no opinion

This legislation will reduce my overall healthcare costs.

This legislation will reduce my overall healthcare costs. Somewhat agree

This legislation will reduce my overall healthcare costs. Agree

This legislation will reduce my overall healthcare costs. Somewhat disagree

This legislation will reduce my overall healthcare costs. Strongly disagree

This legislation will reduce my overall healthcare costs. Have no opinion

This legislation will NOT reduce my overall healthcare costs.

This legislation will NOT reduce my overall healthcare costs. Somewhat agree

This legislation will NOT reduce my overall healthcare costs. Agree

This legislation will NOT reduce my overall healthcare costs. Somewhat disagree

This legislation will NOT reduce my overall healthcare costs. Strongly disagree

This legislation will NOT reduce my overall healthcare costs. Have no opinion

This legislation will add to overall healthcare costs.

This legislation will add to overall healthcare costs. Somewhat agree

This legislation will add to overall healthcare costs. Agree

This legislation will add to overall healthcare costs. Somewhat disagree

This legislation will add to overall healthcare costs. Strongly disagree

This legislation will add to overall healthcare costs. Have no opinion

This legislation will NOT add to overall healthcare costs.

This legislation will NOT add to overall healthcare costs. Somewhat agree

This legislation will NOT add to overall healthcare costs. Agree

This legislation will NOT add to overall healthcare costs. Somewhat disagree

This legislation will NOT add to overall healthcare costs. Strongly disagree

This legislation will NOT add to overall healthcare costs. Have no opinion

Any legislation is better than no legislation.

Any legislation is better than no legislation. Somewhat agree

Any legislation is better than no legislation. Agree

Any legislation is better than no legislation. Somewhat disagree

Any legislation is better than no legislation. Strongly disagree

Any legislation is better than no legislation. Have no opinion

Congress should start over and do it right.

Congress should start over and do it right. Somewhat agree

Congress should start over and do it right. Agree

Congress should start over and do it right. Somewhat disagree

Congress should start over and do it right. Strongly disagree

Congress should start over and do it right. Have no opinion

Healthcare Insurance

1. Default Section

Question Title

* 1. Do you and/or your family have healthcare insurance?

Question Title

* 2. Is your healthcare insurance for?

Question Title

* 3. What type of healthcare insurance do you have? Mark all that are appropriate.

Question Title

* 4. How long have you had your current insurance?

Question Title

* 5. How long have you had your current insurance provider?

Question Title

* 6. Rate the factors that influenced your choice of healthcare insurance fom very important, somewhat important, important, not important.

Question Title

* 7. Would you recommend your current healthcare insurance to a family member of friend

Question Title

* 8. The proposed healthcare bill is about to pass Congress? Please register your thoughts on this bill. (Responding to this question is strictly voluntary.)