The Virginia Bar Association Health Plan Survey
RequiredRequired Question(s)
Required 1.

Employer name and full address 

 

350 characters left.
Required 2.

Approximate number of full-time (30 hours a week) employees. 

 

50 characters left.
Required 3.

Name of current health insurance carrier. 

 

50 characters left.
Required 4.

Are you:  

Fully-insured
Level-funded
Self-insured (please list your Third-Party Administrator or Stop Loss Carrier in Question 5)
Don't know
5.

If you answered Self-Insured to question 4, list your Third-Party Administrator or Stop Loss Carrier. If you answered one of the other choices in question 4, leave this question blank.  

 

50 characters left.
6.

Plan design: 

PPO
POS
HMO
7.

Number of plans offered: 

1 plan
2 plans
3 plans
More than 3 plans
8.

Deductible and out-of-pocket maximum of each plan: 

 

350 characters left.
9.

Renewal date: 

 

50 characters left.
10.

What are your major concerns relating to your current employee benefits portfolio? 

 

1000 characters left.