ABC COMPANY
Employee Benefit Survey
Dear EmployeeOur company is about to perform a full review of our various benefit programs.
Administration feels that this year, especially with range of personal and financial challenges
facing us all, is an appropriate time to start a dialogue with Staff to get a sense of what you think
about our benefit programs and further, to request your ideas and suggestions as to what
employee benefits you would like to see for yourself and your family’s health and well-being in
the future.
ABC is proud of our benefit program that we offer our loyal, valued employees, a program that
includes: medical, life, disability, retirement and other benefits, including vacation and sick time.
Ever since our beginning, we have been committed to providing meaningful benefits with the
aim to reward and retain our staff. We now ask for your input so that we can ensure continuing a
competitive, relevant and affordable menu of core and workplace benefits.
Following is a benefits survey that we ask you to complete with your ideas and constructive
comments. Please answer the following questions as best as you can and return to this office by
no later than________________. Confidentiality is assured.
Thank you for your time and input.
ABC COMPANY CEO
ABC COMPANY
Employee Benefit Survey
1. From 1 to 10, with 10 being the most important please assign a number value to each of the
following benefits that we currently have:
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Medical
_______

Life
_______

Short Term Disability
_______

Retirement
_______

Long Term Disability
________
2. Following is a wish list of popular benefits available in the market. From 1 to 10 please rate
benefits by desirability for you and your family:

















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Long Term Care
Supplemental Spouse and/or children Life Insurance
Dental
Pre-Paid Legal
College Tuition Rewards
Accident
Cancer
Critical Care Coverage
Deductible/Co pay Reimbursement
Pet Insurance
Adult Care
Child Care
Purchasing Power Discount
Employee Assistance
Wellness Program
Vacation Time
Personal/Family Time
Sick Time
_______
_______
_______
_______
________
________
________
________
________
________
_________
_________
_________
_________
_________
_________
_________
_________
3. In your wish list of the above benefits, what are the 5 most appealing benefits to your family?
___________ _____________ _______________ _______________ _______________
4. In your opinion, how would you (according to our same 1 to 10 scale) rate ABC Company’s
communications with you and your family about your employee benefits?
5. What would you suggest to improve communication between ABC Co. and yourself and
family?
______________________________________________________________________________
_______________________________________________________________________
6. Do you have any thoughts or suggestions about the brochures, benefits at a glance and other
written support materials provided
you?__________________________________________________________________________
____________________________________________________________________________
7. Would small group meetings be helpful to you to review and ask questions about your
benefits?
Y/N_______
8. Is on-line benefit access and information important to you?
Y/N_______
9. What do you feel about the amount of premium contribution you make towards your plan of
benefits?
______________________________________________________________________________
______________________________________________________________________
10. If you were able to access some of your desired benefits listed above in Questions 2 & 3 on a
voluntary basis, without ABC Co. contribution would you be interested in signing up?
Y/N__________
Other Comments:
______________________________________________________________________________
______________________________________________________________________________
___________________
Thank you for taking the time to complete this survey with your thoughts and suggestions.