Employee Benefits Survey

Name


  1. Do you have more than one Medical Plan? e.g. High Deductible and Low Deductible, Silver and Gold, etc.
    Yes
    No


  1. What is the employee deduction for your Medical Plan(s)?


  1. What is the employee deduction for your Dental Plan?


  1. Is your Vision Insurance 100% paid by the employee?
    Yes
    No


  1. What is the employee deduction for your Vision Plan?


  1. What is the employee deduction for Life Insurance, or is it 100% paid by the employer?


  1. What is the employee deduction for Short-Term Disability, or is it 100% paid by the employer?


  1. What is the employee deduction for Long-Term Disability, or is it 100% paid by the employer?


  1. Do you offer any insurance to retired employees?
    Yes
    No


  1. If you answered "Yes" to question 10, what benefits do you offer to retirees?


  1. What is the employer match for your 401K?


  1. Does your company offer a defined benefit plan (pension)?
    Yes
    No


  1. Which of the following do you offer for time off?
    PTO
    Vacation Time
    Sick Time
    Personal Time
    Mental Health Days
    Other


  1. Does your company offer any of the following educational assistance programs?
    Tuition Reimbursement
    Student Loan Repayment
    Other


  1. Do you offer company paid maternity leave?
    Yes
    No


  1. Do you offer company paid paternity leave?
    Yes
    No


  1. Do you offer flex time or a flex schedule to your employees?
    Yes
    No


  1. Do you allow your employees to work from home?
    Yes
    No


  1. If you answered yes to the above question, what positions do you allow to work from home?


  1. Do you offer any of the following "fun" benefits to your employees?
    Blue Jean Day/T Shirt Day
    Bring Your Child To Work Day
    Bring Your Pet To Work Day
    Catered Lunches
    Appreciation Weeks
    Other




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