Washington State SHRM Employee Benefits Survey Questions...Washington State SHRM Employee Benefits...
Transcript of Washington State SHRM Employee Benefits Survey Questions...Washington State SHRM Employee Benefits...
Washington State SHRM Employee Benefits Survey Questions
Please Note: This document is for informational purposes only. It is intended to help
you gather the information you need to complete the online survey. Every survey
question is included in this document; however, when completing the online survey, you
will only view the questions applicable to you.
0 First of month following 30 days of employment
O First of month following 60 days of employment
0 90th day of employment
0 Other
Which of the following healthcare plans does your organization offer?
Select all that apply.
0PPO
0HMO
0HDHP
D Other
Healthcare Premiums
What are the total monthly premiums and percent of premiums paid for your
healthcare plan?
Enter the total monthly premium paid by both employer and employee and the percent of premium paid by your organization
for the following group(s).
If the employee pays 100% of premium and your organization makes no contribution, enter "0" for "% Paid by Employer".
Include medical costs only; do not include vision or dental costs.
Do not include $ or % symbols.
» Employee only
» Employee + Spouse
» Employee + Registered DomesticPartner
» Employee + Child(ren)
» Employee+ Family
$ Total Monthly Premium % Paid by Employer
What are the deductibles and out-of-pocket maximums for your healthcare plan?
In-Network Out-of-Network
$ Deductible $ Out-of-Pocket Max $ Deductible $ Out-of-Pocket Max
Individual
What are the deductibles and out-of-pocket maximums for your healthcare plan?
» Employee Only
» Employee + Spouse
» Employee +Registered DomesticPartner
» Employee +Child(ren)
» Employee + Family
Medical Flexible Spending
Account (FSA)
Dental & Vision Benefits
Health Savings Account (HSA)
Does your organization offer vision or dental coverage?
Yes; bundled in
Health Reimbursement
Arrangement (HRA)
[ l
healthcare coverage Yes; offered separately
Vision coverage
Dental coverage
0
0
0
0
Which of the following groups are offered vision coverage?
Select all that apply.
D Employee only
D Employee + Spouse
0 Employee + Registered Domestic Partner
D Employee+ Child(ren)
D Employee + Family
Defined Contribution Health Plan
No; not offered
0
0
What are the total monthly premiums and percent of premiums paid for your vision
plan?
Enter the total monthly premium paid by both employer and employee and the percent of premium paid by your organization
for the following group(s).
If the employee pays 100% of premium and your organization makes no contribution, enter "0" for "% Paid by Employer". Do
not include $ or % symbols.
0 Traditional defined benefit pension plan (frozen to current employees/not open to new hires)
D Supplemental executive retirement plan (SERP)
0 Profit-sharing plan
D No retirement benefits offered
Retirement Benefit Funding
How is your organization's retirement plan funded?
0 Employee contribution only
0 Company contribution only
0 Company contributes only if employee contributes
0 Company contributes and employee may contribute
0 Other
What type of contribution does your organization make to this plan?
0 Discretionary
0 Safe harbor contribution
0 Formula match
For discretionary contributions to this plan: What percentage of each employee's pay does
your organization contribute?
0 1.0-1.9%
0 2.0-2.9%
0 3.0-3.9%
0 4.0-4.9%
0 5.0-5.9%
0 6.0-6.9%
0 7.0-7.9%
0 8.0-8.9%
0 9.0-9.9%
0 10.0% or more