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National Employee Benefits Survey

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* 1. Your Name

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* 2. Your Email Address

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* 3. Your Phone Number

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* 4. Your Company Name

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* 5. Do you have more than 50 employees on payroll?

Yes

No

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* 6. How many Full-Time/ Part-Time/ Seasonal employees are on payroll?

Full-Time

Part-Time

Seasonal

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* 7. Have your employees voiced concern over the cost of your health insurance program?

Yes

No

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* 8. How many Full-time employees average less than $40K per year?

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* 9. How many medical plans are currently offered to your employees?

One

Two

Three

More (please specify)

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* 10. Do you offer other benefits in addition to medical?

Yes

No

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* 11. Do you feel employees would like more control over their health insurance options?

Yes

No

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* 12. Does your current technology offer employee online decision support?

Yes

No

N/A

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* 13. What month do your medical plans renew?

	Month
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