#MyEmployees

HR Supplemental Insurance Questionnaire

Welcome

1. What types of benefits do you offer your employees? *This question is required.

• Health Insurance
• Accident Insurance
• Cancer Treatment Insurance
• Life Insurance
• Vision and Dental Insurance
• None

2. How familiar are you (or your employees) with using supplemental insurance as a strategy to reduce health insurance costs? *This question is required.

• Very Familiar
• Somewhat Familiar
• Not Familiar At All
• Never Thought About It

3. What products would you be most interested in learning about (click all that apply)? *This question is required.

• Adult Accident Insurance
• Youth Sports Injury Insurance
• Cancer Treatment Insurance
• Critical Illness Insurance
• Life Insurance

4. Did you know that there are some supplemental insurance plans that pay more than what someone would owe in medical bills? *This question is required.

• Yes
• No

5. How financially prepared do you think your employees are in the event of a cancer diagnosis, accident-related injury, or youth sports injury?  *This question is required.

• Very prepared
• Somewhat prepared
• Not at all
• Not really important to them

6. Contact Info *This question is required.

First Name

Last Name

Email Address

Phone Number