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2010 Employer Wellness Survey
Required Required Question(s)
Progress: 
  

RESPONDENT DATA
 
41.
Which one of the following best describes the industry your organization is in? (If you are unsure of the correct category, mark the "other" response and provide a description of the industry your organization is in.)
Manufacturing/Process-
ing
Wholesale/Retail Sales
Services/Hospitality
Transportation
Communication
Agriculture/Mining
Construction
Education
Government
Healthcare
Repair/Maintenance
Other  
42.
Which one of the following job titles best describes your title or position at your organization? (If you are unsure of the correct category, mark the "other" response and provide a description of your title or position.)
CEO/President/Owner
Vice President or Senior Manager
Human Resources Director
Human Resources Representative
Other  
43.

Please indicate your organization size by number of full time employees.
2-50
51-99
100-500
501-2000
2001+
Unknown
44.
Medical Coverage Funding
Fully-Insured
Self-Insured
45.

Current Plan Administrator
Aetna
Anthem or other Blue Cross Blue Shield
Assurant Health/John Alden
Aultcare
Cigna
Humana
Kaiser
Medical Mutual
Summacare
UnitedHealthcare
Third Party Administrator
Other  
To receive a copy of the published report containing the information gathered from the survey, the contact information below must be completed.
 
Required 46.

Please enter the information indicated below. We will contact you after the survey is closed to distribute the results.
First Name:
Last Name:
Job Title:
Company Name:
Work Phone:
Email Address:
emailaddress@xyz.com