Benefits Survey – 2021

Benefits Survey - 2021

Company Name

Contact Name

Email Address

Phone Number

Type of Business (Category)

Years in Business

Questions

Do you currently have benefits?

Yes

If no, would you be interested in benefits?

Yes

If yes, would you be willing to provide information on your existing plan?

Yes

Would you be interested in participating in an association group benefit plan if made available?

Yes

Number of part-time employees?

Number of full-time employees?

As we work to put together a benefit plan that you can offer your employees, please take the time to rate the benefits mentioned below using the scale of 1 to 4.

1 - Not Important
2 - Somewhat Important
3 - Important
4 - Very Important

Life Insurance

Accidental Death and Dismemberment

Dependent Life

Critical Illness

Short Term Disability

Long Term Disability

Health Benefits

Drug Coverage

Vision Care

Paramedical Services

Dental Benefits

Basic Services (fillings, cleanings, extractions...)

Major Services (crowns, bridges...)

Orthodontics (for children)

Virtual Doctor (the ability to talk to a medical practitioner online at your own time)

Employee Family Assistance Program

Questions or Comments?

Emery Village BIA
1885 Wilson Avenue, Suite 209 Toronto ON, M9M 1A2

E-mail: info@emeryvillagebia.ca
Tel: (416) 744 - 7242
Fax: (416) 744 - 7857

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