Health Insurance Evaluation Survey
Please take a moment to complete this survey and evaluate your health insurance coverage.
On a scale of 1-5, how satisfied are you with your health insurance coverage?
1
2
3
4
5
What is the name of your health insurance provider?
Please rate the affordability of your health insurance premium.
Very Affordable
Affordable
Neutral
Expensive
Very Expensive
Are you satisfied with the coverage provided for your prescription medications?
Very Satisfied
Satisfied
Neutral
Dissatisfied
Very Dissatisfied
Do you feel that the network of healthcare providers offered by your health insurance is sufficient?
Yes
No
How satisfied are you with the customer service provided by your health insurance company?
Very Satisfied
Satisfied
Neutral
Dissatisfied
Very Dissatisfied
Do you have any suggestions or feedback to improve your health insurance coverage?
Would you recommend your health insurance provider to others?
Yes
No
Not Sure
Name
First Name
Last Name
Email
example@example.com
Please verify that you are human
*
Submit
Should be Empty: