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Thank you for taking time to evaluate our benefits program. We spends numerous hours every year evaluating options and comparing benefit plans to offer the best possible package to meet the needs of employees.

Your response is important and aids our team by helping us understand what benefits are working well and where we could make improvements. As always, we'll do the best we can to incorporate the feedback we receive into the next planning cycle. All responses are anonymous.
1. Please rate your satisfaction with our overall current benefits package.
  Very SatisfiedSomewhat SatisfiedNeutralSomewhat DissatisfiedVery Dissatisfied
 
2. Please explain your reason(s) for the overall benefits satisfaction rating:
3. Are you currently enrolled in the employee Health Care plan?
4. Please rate your satisfaction with our Health Care plan:
  Very SatisfiedSomewhat SatisfiedNeutralSomewhat DissatisfiedVery Dissatisfied
 
5. Are you able to find physicians that are within our Health Care plan's network?
6. Currently, our Health Care plan does not offer any coverage for certain type of specialists. Please indicate if you would visit each type of specialist:
  YesNo
Chiropractor
Massage Therapist
Herbalist
Acupuncturist
Reflexologist
7. Please add any other comments that you might have about our Health Care plan:
8. Are you currently enrolled in the employee Dental Care plan?
9. Please rate your satisfaction with our Dental Care plan:
  Very SatisfiedSomewhat SatisfiedNeutralSomewhat DissatisfiedVery Dissatisfied
 
10. Are you able to find a dentist that is within our Dental Care plan's network?
11. Please add any other comments that you might have about our Dental Care plan:
12. Are you currently enrolled in the employee Vision Care plan?
13. Please rate your satisfaction with our Vision Care plan:
  Very SatisfiedSomewhat SatisfiedNeutralSomewhat DissatisfiedVery Dissatisfied
 
14. Our Vision Care plan does not currently include advanced glaucoma screenings. If this type of screening was included in our Vision Care plan, would you take advantage of this option?
15. Please add any other comments that you might have about our Vision Care plan:
16. Please rate your satisfaction with our PTO (paid time off) benefit:
  Very SatisfiedSomewhat SatisfiedNeutralSomewhat DissatisfiedVery Dissatisfied
 
17. Please add any comments that you might have about our PTO benefit:
18. We're always looking to expand out benefits portfolio. Please select up to 3 items below that you would like to see added to our benefit offering:
19. Are there any other company benefits that you would like the Human Resources Team to consider? Please be as detailed as possible.
The last few questions are about you. The answers will only be used to group your responses with employees that responded similarly to you.
20. Are you...
21. Which category best describes your age?
22. How long have you worked at [Company Name]?
Thank you!

Thank you for taking our survey. Your feedback is very important to us.