Survey Questions Insurance Continued
Life Insurance
Does your company offer or provide life insurance coverage for your employees?
[ ] Yes [ ] No
What length of service is required before employees are eligible for Life Insurance?
[ ] Hire Date
[ ] End Probation [ ] One Month
[ ] Six months [ ] Other
_________________________
Are all employees eligible for coverage?
[ ] Yes [ ] No
If no, which employees are not eligible? [ ] Part Time
[ ] Other Please explain __________________________
Is coverage paid for by the Company?
[ ] Yes [ ] No If yes, what percentage is company paid?
______%
Is dependent coverage paid for by the Company? [ ] Yes
[ ] No If yes, what percentage is company paid?______%
What is the monthly cost to the employee for:
Employee coverage? $_______ Dependent coverage?
$_______
What is benefit amount based on?
[ ] Salary [ ] Multiple of salary _______
[ ] Fixed amount_______________
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