Association Health Plan Survey

MSV Association Health Plan

MSV is in the process of evaluating alternative health insurance solutions for our members and healthcare community as a whole. We have been meeting with recognized industry leaders in hopes of leveraging recent changes in association health plan regulations to seek out cost containment measures and better long-term health insurance options. The goal of this survey is to get a better understanding of which groups would be interested.

Please understand that according to the law of large numbers, the greater the participation in this survey, the more leverage we have in the marketplace. Also, it is important to note, that by completing this survey you in no way are obligated to participate in this program. If you are interested in helping us establish rates and product information, please do so by completing the following survey (LESS THAN 10 QUESTIONS).

Question Title

* 1. Employer name and full address?

Name *

Company *

Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

Question Title

* 2. Approximate number of full time (30 hours a week) employees?

Question Title

* 3. Name of current health insurance carrier?

Question Title

* 4. Are you:

Fully-Insured

Level-Funded

Self-Insured (please list your Third-Party Administrator or Stop loss Carrier)

Don't Know