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  1. Surveys
  2. 2011
  3. April
  4. E
  5. Employee Benefit Survey
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Hello:
You are invited to participate in our survey, Employee Benefits. In this survey, approximately 75 people will be asked to complete a survey that asks questions about the possibility of receiving Health Insurance. It will take approximately 5 minutes to complete the questionnaire.

Your participation in this study is completely voluntary. There are no foreseeable risks associated with this project. However, if you feel uncomfortable answering any questions, you can withdraw from the survey at any point. It is very important for us to learn your opinions.

Thank you very much for your time and support. Please start with the survey now by clicking on the Continue button below.
 
 
 
Do you currently have Health Insurance or a Medical Card?
 
Yes
 
No
 
 
 
If you do have Health Insurance or a Medical Card, who is paying the majority of the cost?
 
Employer
 
Spouse Employer
 
Private
 
Parent
 
Other
 
 
 
If you do not have Health Insurance, how long have you been without insurance?
 
Less than 1 month
 
1-6 months
 
6-12 months
 
Longer than 12 months
 
 
 
If Health Insurance was offered to you (employee only), what is the maximum amount you would be willing to pay weekly from your paycheck?
 
under $15
 
$16-$30
 
$31-$50
 
I am unwilling to pay for my Health Insurance
 
 
 
Would you need or want family coverage?
 
Yes
 
No
 
 
 
If Health Insurance was offered, would you choose a high deductible plan or would you choose a limited benefit plan.

-High Deductible: $5,000 per Person, per Year
After the deductible is meet services paid at 80%

-Limited Benefit Plan: Doctor's Office Visit- $360 per Person per Year
Emergency Room Visit-$100 per visit
Critical Illness- maximum payout $5,000 per occurence
 
High Deductible Plan
 
Limited Benefit Plan
 
Neither
 
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