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Employer Benchmark Survey

Benchmark Your Plan Against Peers in Your Market

* Indicates required questions
Complete the fields below to request a custom benchmarking report tailored specifically for your company.
Name *
First
Last
Email *
Company Name *
Job Title *
Work Phone # *
State *
Zip Code *
Industry *
# of Employees *
Do you offer more than one health plan? *
Plan 1 - Type of Plan (Check all that apply) *
Does Your Plan Offer any of the following:
# of Participants on Health Plan *
In-Network Deductible - Individual (if none, enter $0) *
In-Network Deductible - Family (if none, enter $0)
In Network Coinsurance  *
In Network Out of pocket max - Individual  *
In Network Out of pocket max - family  *
Copays are subject to medical plan deductible and % coinsurance *
Type of Premium Split *
Funding Method *
Maximum Lifetime Benefit *
Is Regular (post-65) Retiree Coverage Offered? *
Retiree Plan Type *
Is a Prescription/Rx Plan Being Offered? *
Rx Plan Design *
Rx Copay/Coinsurance Tiers *
Rx Mail Order - Number of Retail Copays/90-Day Supply *
Contribution Strategy *
Comments
Best Contact Method *
Submission Consent *
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