Benefits - Employee Survey Sample #7

Questionnaires Measuring Benefits:
Example 1 (5-point scale; numbers; NA)
Example 2 (7-point scale; radio buttons)
Example 3 (4-point scale; radio buttons)
Example 4 (5-point scale; radio buttons)
Example 5 (5-point scale; words)
Example 6 (Pulse Survey)
Example 7 (5-point scale; item comments)
Example 8 (3-point scale; words; N/A)
Example 9 (4-point scale; numbers)
Example 10 (Comment boxes only)
Example 11 (Single rating per dimension)
Example 12 (Slide-bar scale)

Dear Employee:

Welcome to the Employee Survey. We are on a journey to create a workplace that encourages success! A critical component of creating this culture is building a business you recognize as being a great place to work and one that provides you with challenge and recognition. We want to build a thriving and successful business that provides motivation and satisfaction. In order to do so we need to assess how we are doing and understand your thoughts, views and feelings.

We have developed this survey with questions tailored for our staff and business to provide you with an opportunity to anonymously rate many facets of the business. The survey will assess what you value most in your employment and allow you to make positive suggestions for improvement.

The survey is web-based, quick and simple to complete which allows fast reporting and analysis. To ensure your anonymity, the survey is being hosted by an external organization. You will not be required to identify yourself. We want to be very clear that we will not be able to attribute this data to any specific individual and it is not our intention to do so.

Dimensions Included:
Benefits, Employee Assistance Program, Work/Life, Staffing, Resources, Job Content and Design, Resourcefulness, Corporate Culture, Respect for Others

We encourage everyone to complete the survey. Please be honest, constructive and thoughtful in your input. The survey is designed to help us understand more about your thoughts and needs to make this a great company.

The results of this survey will be used to help drive our future success. We will report back to you about what you have said and what we plan to do about it. If you have any questions about the process please contact [Contact Person].

Please ensure that your submission is made between . The survey will only be available during these dates.

Thank you for your participation in the survey. We look forward to seeing the analysis of your responses and we are hoping for 100% participation.

Management Team

What changes would you like to see in your benefit plans? Please note that some of these may increase premium rates. Please check all that apply.

Add a higher deductible plan ($1,000 - $2,500)
Increase vision care
Increase dental care
Add wellness program (weight loss, nutrition, smoking cessation programs, etc.)
Add a Medical Spending Account (MSA) (allows employees to enroll in a high deductible health plan,

and then [Company] and the employee contribute on a pre-tax basis to an account used for eligible medical expenses)

What changes would you be willing to accept in order to help hold down premium increases? Please check all that apply.

Higher annual deductibles (the amount you pay out-of-pocket before benefits begin)
Higher office visit co pays (the dollar amount you pay for office visits)
Higher prescription drug co pays (the dollar amount you pay for prescription drugs)
More network restrictions (smaller group of doctors and specialists to choose from)
No dental coverage
Other, please specify

How often would you like to participate in after hours company event?

Every other month
Quarterly
Twice a year
Just the Christmas Party
How would you rate your satisfaction with the communication between you and [Company]?

Very Dissatisfied
Dissatisfied
No Opinion
Satisfied
Very Satisfied
What would you change about your current job or position?
Please identify factors that would improve your job performance in the coming year.
When your performance was discussed with you in the past,
how often did you receive practical suggestions for improving your work?

Very Often
Sometimes
Rarely
Never
How would you rate your overall satisfaction with the company in the past year?

Very Dissatisfied
Dissatisfied
No Opinion
Satisfied
Very Satisfied
Please give any comments or suggestions on how the company can be improved in the coming year:

Benefits	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
The Company offers better benefits than other companies (Click here to add a comment)
I recognize my benefits are part of an employee total compensation program (Click here to add a comment)
I understand the benefits that are available. (Click here to add a comment)
The premiums for benefits are reasonable (Click here to add a comment)
I think the benefits offered by the Company meet my needs (Click here to add a comment)
If [Participant Name] were to make improvements in Benefits, which item do you think should be emphasized most over the next two years in order to make us a more effective organization.
Type the number here:
What are your suggestions for how we can improve this?

Employee Assistance Program	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
The EAP providers follow up with employees who are absent from work. (Click here to add a comment)
Representatives from the EAP provide followup/referral services. (Click here to add a comment)
The EAP is convenient for me (Click here to add a comment)
I am able to reach someone quickly when I have questions or need to use the service. (Click here to add a comment)
There is one-on-one counseling services provided by professionals. (Click here to add a comment)
If [Participant Name] were to make improvements in Employee Assistance Program, which item do you think should be emphasized most over the next two years in order to make us a more effective organization.
Type the number here:
What are your suggestions for how we can improve this?

Work/Life	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
I feel the company is committed to my well-being (Click here to add a comment)
The Company should establish a program to assist employees who have to care for an elderly relative (Click here to add a comment)
I am able to attend to both my personal life and my work schedule (Click here to add a comment)
I can decline work assignments if I do not have the time for it (Click here to add a comment)
I do not feel that I am too busy to take a break once in a while (Click here to add a comment)
If [Participant Name] were to make improvements in Work/Life, which item do you think should be emphasized most over the next two years in order to make us a more effective organization.
Type the number here:
What are your suggestions for how we can improve this?

Staffing	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
My Department has the right people in the right places (Click here to add a comment)
My Supervisor is good at determining staffing needs (Click here to add a comment)
The Company has a good supply of emerging leaders (Click here to add a comment)
The Company has adequate help during peak work loads (Click here to add a comment)
My Supervisor is good at building a staff of creative and innovative individuals (Click here to add a comment)
If [Participant Name] were to make improvements in Staffing, which item do you think should be emphasized most over the next two years in order to make us a more effective organization.
Type the number here:
What are your suggestions for how we can improve this?

Resources	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
My workplace is a physically comfortable place to work (Click here to add a comment)
The Company has the right people in the right places. (Click here to add a comment)
I have all the tools and equipment I need to do my job well (Click here to add a comment)
I understand the process of allocating fiscal resources (Click here to add a comment)
I understand the budget process (Click here to add a comment)
If [Participant Name] were to make improvements in Resources, which item do you think should be emphasized most over the next two years in order to make us a more effective organization.
Type the number here:
What are your suggestions for how we can improve this?

Job Content and Design	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
My job makes good use of my skills and abilities (Click here to add a comment)
The job re-classification process is simple and efficient (Click here to add a comment)
Overall, my workload is reasonable. (Click here to add a comment)
I can adjust my job description as needed (Click here to add a comment)
I am clear about the expectations of my role. (Click here to add a comment)
If [Participant Name] were to make improvements in Job Content and Design, which item do you think should be emphasized most over the next two years in order to make us a more effective organization.
Type the number here:
What are your suggestions for how we can improve this?

Resourcefulness	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
Efficiency is encouraged (Click here to add a comment)
Resourceful employees get ahead in this organization (Click here to add a comment)
Employees who are resourceful are more likely to be promoted in this organization (Click here to add a comment)
The Company makes sure employees have information and data as needed (Click here to add a comment)
Employees in my department are committed to fixing issues and solving problems (Click here to add a comment)
If [Participant Name] were to make improvements in Resourcefulness, which item do you think should be emphasized most over the next two years in order to make us a more effective organization.
Type the number here:
What are your suggestions for how we can improve this?

Corporate Culture	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
The Company culture promotes employees to stay within the organization. (Click here to add a comment)
CompanyName has an image of a high quality company. (Click here to add a comment)
Employees are generally friendly and willing to help you if needed (Click here to add a comment)
The Company is a good community neighbor (Click here to add a comment)
The culture helps employees work together (Click here to add a comment)
If [Participant Name] were to make improvements in Corporate Culture, which item do you think should be emphasized most over the next two years in order to make us a more effective organization.
Type the number here:
What are your suggestions for how we can improve this?

Respect for Others	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	Not Applicable
I am treated with respect by others with whom I work. (Click here to add a comment)
Co-workers respect each others' opinions (Click here to add a comment)
I feel respected by management in this organization. (Click here to add a comment)
I feel I am valued at work. (Click here to add a comment)
Disrespectful behavior is not tolerated. (Click here to add a comment)
If [Participant Name] were to make improvements in Respect for Others, which item do you think should be emphasized most over the next two years in order to make us a more effective organization.
Type the number here:
What are your suggestions for how we can improve this?