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Surveys
2014
August
B
Benefit Satisfaction
Benefit Satisfaction
0%
Exit Survey
Are you currently enrolled in the employee health care plan?
Yes
No
If you answered no to question 1, are you:
Covered under spouse’s plan?
Covered under another plan?
Uninsured?
If you do not have health insurance, are you uninsured because of:
Cost
Other - please explain: ________________________________
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Weekly
Monthly
Quarterly
Annually
Which benefits are most important to you? Rank the following benefit plans in order of
importance, with number 1 being most important, and number 6 being least important.
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____ Dental plan
____ Prescription plan
____ Employee Assistance Program
____ Short-term disability plan
____ Long-term disability plan
Which benefits are most important to you? Rank the following benefit plans in order of
importance, with number 1 being most important, and number 6 being least important.
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____ Dental plan
____ Prescription plan
____ Employee Assistance Program
____ Short-term disability plan
____ Long-term disability plan
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