Please enable JavaScript in your browser to complete this form. - Step 1 of 8MEDICAL QUESTIONSDo you participate in the Anthem Medical and Prescription Coverage Program?YesNoIf No, why not?If Yes, PPO or HSA Plan? PPOHSADo you feel that the Anthem Program currently meets your needs for medical and prescription coverage?If you participate in the PPO plan, would you consider moving to an HSA plan if the deductible was lowered? (You would have no co-pays, but use your HSA to pay out of pocket costs)YesNoWhat level deductible would be required for you to move to the HSA Plan?NextDENTAL QUESTIONSDo you participate in the Anthem Dental Program? YesNoIf yes, High or Low Plan? HighLowHave you used your Anthem Dental Benefits in 2020? YesNoIf yes, do you feel that the Anthem Program currently meets your needs for dental coverage?PreviousNextVISION QUESTIONSDo you participate in the Anthem Vision Program? YesNoHave you used your Anthem Vision Benefits in 2020? YesNoIf yes, do you feel that the Anthem Program currently meets your needs for vision coverage?PreviousNextLIFE, STD and LTD At no cost to you, VANTAGE Aging provides short-term disability and subsequent long-term disability to protect your income if you incur a significant accident or illness. Also, life insurance equal to your annual salary is paid by VANTAGE Aging. These are catastrophic benefits that you may never need, but help sustain you in the event you cannot work.Is Life Insurance important to you?Rate 1 out of 5Rate 2 out of 5Rate 3 out of 5Rate 4 out of 5Rate 5 out of 5(5 star is most important, 1 star is least important)Is Short-Term Disability important to you?Rate 1 out of 5Rate 2 out of 5Rate 3 out of 5Rate 4 out of 5Rate 5 out of 5(5 star is most important, 1 star is least important)Is Long-Term Disability important to you?Rate 1 out of 5Rate 2 out of 5Rate 3 out of 5Rate 4 out of 5Rate 5 out of 5(5 star is most important, 1 star is least important)Do you carry life insurance outside of your employer benefit? YesNoDo you feel that we should continue these benefits for your protection, or use the dollars to enhance/add new benefits?PreviousNext403(B) Retirement Plan VANTAGE Aging provides a 403(B) retirement plan to help you save for retirement with pre-tax (or post-tax) dollars, and matches 100% of your contribution up to 3% of your pay after one year of service.Do you participate in the 403(B) Plan?YesNoIf no, why not?Do you have any suggestions for improvement?PreviousNextDo you feel that you understand your benefits programs?YesNoWhat suggestions do you have to improve Benefits Communications?What would you do if you had a benefits question?Ask your supervisorCall HRCall the number listed on the back of your insurance cardCall Oswald (our broker)Other:If Other, explain:What communication method would you prefer at Open Enrollment?A video you can watch on your own time?Zoom meetings that you can attend according to your schedule so you can ask questions?In-person meetingsWritten CommunicationsPreviousNextIn addition to your insured benefits, you are also eligible for PTO and Paid Holidays. PTO Paid Time Off is designed to be used for whatever you choose, and you are able to accumulate up to two weeks in excess of your annual allotment. Sick, Vacation, and Bereavement are all covered by your PTO accrual, and VANTAGE Aging offers an annual opportunity to cash out one week of PTO. Do you have any suggestions for improvement?Are you satisfied with the number of paid holidays you receive per year? YesNoWhat feedback can you provide regarding the holiday schedule?PreviousNextAre there any benefits or policies not mentioned here that you would like to see added? Please explain:PreviousNameSubmit
