Employee Benefits Survey

Sample Templates
Business

This survey includes questions to evaluate the importance and satisfaction of employee health benefits, financial benefits, and other employee benefits. Thank you for participating in our employee benefits survey. Please share your opinions by filling in the information below.

1. Demographic Information

Gender
Length of Employment
Age

Health Benefits

2. How important are each of these health benefits to you?

	Very Important	Important	Average	Slightly Important	Not Important
Health plan	1	2	3	4	5
Dental plan	1	2	3	4	5
Vision plan	1	2	3	4	5
Prescription drug plan	1	2	3	4	5
Life insurance	1	2	3	4	5
Long term disability	1	2	3	4	5
Short term disability	1	2	3	4	5

3. How satisfied are you with each of these health benefits?

	Very Satisfied	Satisfied	Neutral	Dissatisfied	Very Dissatisfied
Health plan	1	2	3	4	5
Dental plan	1	2	3	4	5
Vision plan	1	2	3	4	5
Prescription drug plan	1	2	3	4	5
Life insurance	1	2	3	4	5
Long term disability	1	2	3	4	5
Short term disability	1	2	3	4	5

Financial Benefits

4. How important are each of these financial benefits to you?

	Very Important	Important	Average	Slightly Important	Not Important
Wages	1	2	3	4	5
Retirement plan	1	2	3	4	5
Promotion Opportunities	1	2	3	4	5
Employee Stock Purchase	1	2	3	4	5

5. How satisfied are you with each of these financial benefits?

	Very Satisfied	Satisfied	Neutral	Dissatisfied	Very Dissatisfied
Wages	1	2	3	4	5
Retirement plan	1	2	3	4	5
Promotion Opportunities	1	2	3	4	5
Employee Stock Purchase	1	2	3	4	5

Other Benefits

6. How important are each of these other benefits to you?

	Very Important	Important	Average	Slightly Important	Not Important
Vacation Days	1	2	3	4	5
Sick Days	1	2	3	4	5
Personal Days	1	2	3	4	5
Education Reimbursements	1	2	3	4	5
Child Care	1	2	3	4	5

7. How satisfied are you with each of these other benefits?

	Very Satisfied	Satisfied	Neutral	Dissatisfied	Very Dissatisfied
Vacation Days	1	2	3	4	5
Sick Days	1	2	3	4	5
Personal Days	1	2	3	4	5
Education Reimbursements	1	2	3	4	5
Child Care	1	2	3	4	5

8. If there is something you are dissatisfied with, please explain.

Summary

9. Please choose the best answer for each of the following

	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
Overall, I am satisfied with my current health benefits	1	2	3	4	5
Overall, I am satisfied with my current financial benefits	1	2	3	4	5
Overall, I am satisfied with my current other benefits	1	2	3	4	5
I know where to find information about my benefits.	1	2	3	4	5
I understand the benefit options that are available to me	1	2	3	4	5

10. Overall, how do you feel this company's benefits compare to those offered by other companies?

Much Better

Better

Same

Much Worse

Don't Know