Start Your Benefits Snapshot
Whether you currently offer benefits or are exploring where to begin, this assessment provides a clear view of what’s in place, what may be missing,and where opportunities may exist.
CONTACT INFO
Name
*
First Name
Last Name
Email
*
Company Name
*
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COMPANY SIZE
How many employees do you have?
*
1–10
11–25
26–50
51–100
100+
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BENEFITS STATUS
Do you currently offer employee benefits?
*
Yes
No
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CURRENT PLAN TYPE
What type of plan do you currently have?
Fully Insured
Level-Funded
Self-Funded
Not Sure
MONTHLY COST
What is your estimated monthly benefits cost?
<$10,000
$10,000–$25,000
$25,000–$50,000
$50,000+
RENEWAL INCREASE
What was your most recent renewal increase?
<5%
5–10%
10–15%
15%+
Not sure
PRIMARY CHALLENGE
What is your biggest challenge right now?
Rising costs
Limited transparency
Limited plan options
Employee dissatisfaction
Compliance complexity
Not sure
CURRENT BENEFIT OFFERINGS
Which benefits do you currently offer?
Medical
Dental
Vision
Life
Disability
HSA / FSA
Retirement plans including 401k
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TIMELINE
When are you planning to offer benefits?
Within 3 months
3–6 months
6–12 months
Not sure
BUDGET RANGE
What monthly budget are you considering?
<$5,000
$5,000–$15,000
$15,000+
Not sure
PRIMARY GOAL
What is your primary goal?
Attract talent
Stay competitive
Control costs
Just getting started
HIRING PLANS
Do you plan to grow your team in the next 12 months?
Yes
No
Not sure
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NEXT STEP INTEREST
Would you like a personalized strategy review based on your results?
Yes, schedule a call
Maybe later
Just exploring
COMPLIANCE
*
I agree to be contacted regarding my benefits assessment.
Get My Benefits Snapshot
Takes less than 2 minutes
No obligation
For informational purposes only
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