Health Insurance Plan Evaluation Survey
Evaluates how members experience their current health insurance — cost, coverage, network access, claims handling, and customer service — for health plans, employer benefits teams, or brokers assessing plan performance. An AI follow-up interview reconstructs a real recent claim or service interaction to surface exactly where the experience broke down or exceeded expectations.
設問の例
テンプレートの内容をプレビューできます。すべての設問は公開前に自由に編集できます。
Which best describes your current health insurance?
- Employer-sponsored plan
- Government marketplace/exchange plan
- Medicare
- Medicaid
- Individual plan purchased directly
- I don't currently have health insurance
Overall, how satisfied are you with your current health insurance plan?
How satisfied are you with each of the following aspects of your plan?
- Monthly premium cost
- Deductible and out-of-pocket costs
- Size of the provider network
- Ease of finding in-network doctors
- Prescription drug coverage
- ほか2件
In the last 12 months, how often did you file or use a claim through your insurance?
- Never
- Once
- 2-3 times
- 4-6 times
- More than 6 times
In the last 12 months, has a claim of yours been denied, delayed, or paid for less than you expected?
- Yes
- No
- Not sure / don't recall
How easy is it to understand what your plan covers and what you'll owe out of pocket before receiving care?
When you think about what matters most in a health insurance plan, which of these matters most and which matters least to you?
- Low monthly premium
- Low deductible
- Large provider network
- Prescription drug coverage
- Mental health/behavioral health coverage
- Telehealth or virtual care access
- Customer service quality
- Digital tools for claims and coverage
Think about the last $100 you spent out of pocket on healthcare. Roughly how was it split across these categories? (It's fine to estimate.)
- Doctor visit copays
- Prescription drugs
- Deductible payments toward a procedure or hospital visit
- Dental or vision care not covered by the plan
- Other out-of-pocket costs
Reconstruct the respondent's most recent significant interaction with their health insurance — a claim, doctor visit, prescription fill, or customer service call. Ask what happened step by step, whether the cost or coverage matched what they expected going in, and what specifically went well or caused friction. If their overall satisfaction was low, probe whether the root cause was cost, network access, claims processing, or communication; if satisfaction was high, ask what specifically earns that loyalty and whether it would survive a premium increase.
Which age range do you fall into?
- 18-24
- 25-34
- 35-44
- 45-54
- 55-64
- 65+
- Prefer not to say
How many people, including yourself, are covered under your current health insurance plan?
- Just me
- 2
- 3
- 4
- 5 or more
- Prefer not to say
That's everything — thank you for the honest feedback! Your responses will be combined with others to identify where health plans should improve coverage clarity, cost transparency, and claims service.
含まれる機能
AIによる深掘り
自由回答に合わせてAIが追加で質問し、固定のフォームでは拾えない具体的な内容を引き出します。
注意確認設問
急いだ回答や質の低い回答者を除外する仕組みを標準で備えています。
AIが作成する設問文
文言、設問の順序、条件分岐をAIが調査の目的に合わせて作成します。
自動レポート
回答が集まると、テーマ、引用、わかりやすい要約が自動で作成されます。
他ツールとの比較
ほかのアンケートツールで最も近いテンプレートを調べました。それぞれの優れている点と、このテンプレートがさらに踏み込んでいる点をまとめています。
このテンプレートを選ぶ理由
- Includes a dedicated AI follow-up interview that reconstructs the respondent's most recent claim or service interaction to pinpoint exactly where the experience broke down or exceeded expectations, not just a satisfaction score.
- Pairs a satisfaction matrix (cost, coverage, network, claims, customer service) with targeted follow-ups on claim frequency and denial/delay/underpayment history, so quantitative ratings are backed by specifics.
- Uses a MaxDiff exercise to force real prioritization of what matters most in a plan, plus a constant-sum question to quantify how out-of-pocket spend actually breaks down — richer than single Likert items.
- Automated per-response quality scoring and auto-generated reports mean plan teams and brokers get analysis-ready output without manually reading open-ends.
Jotform
Health Insurance Evaluation Survey Form TemplateA fielding-ready static form template covering health insurance evaluation, built on Jotform's drag-and-drop form builder. It's easy to customize and embed but relies on fixed question sets with no adaptive questioning. Good for quick deployment, less suited to probing individual claim experiences in depth.
優れている点
- Simple drag-and-drop customization and fast deployment
- Broad integration ecosystem typical of Jotform (payments, storage, notifications)
- Familiar, easy-to-fill form format for respondents
物足りない点
- Static question set with no adaptive AI follow-up to dig into a specific recent claim or service interaction
- No automated per-response quality scoring or AI-generated analysis of open-ended feedback
- No voice AI interview option or guided screen-share tasks
SurveyMonkey
Health Insurance Evaluation Survey TemplateSurveyMonkey's template offers a standard, fielding-ready health insurance evaluation survey with the platform's established analytics and benchmarking features. It's built around fixed multiple-choice and rating questions rather than conversational probing. Strong for broad quantitative tracking, weaker for capturing the 'why' behind a specific bad or good claim experience.
優れている点
- Established survey analytics dashboard and reporting tools
- Large-scale distribution and panel options
- Recognizable, trusted respondent experience
物足りない点
- No adaptive AI interview to reconstruct a respondent's actual recent claim or service interaction
- Fixed-question format only — no voice AI interview or guided task with screen share
- No transparent, published prompt methodology or automated per-response quality scoring
よくあるご質問
「Health Insurance Plan Evaluation Survey」テンプレートにはどのような設問が含まれていますか?
すぐに使える設問が13問含まれており、最初の設問は次のとおりです:「Thanks for taking a few minutes to share your honest experience with your health insurance. This helps improve coverage…」・「Which best describes your current health insurance?」・「Overall, how satisfied are you with your current health insurance plan?」。すべての設問は上でプレビューでき、自由に編集できます。
このアンケートの回答にはどのくらい時間がかかりますか?
回答者は通常、13問を約7分で回答し終えます。
テンプレートは編集できますか?
はい。公開前であれば、すべての設問、選択肢、順序を編集できます。設問の追加や削除のほか、調査の目的に合わせた作り直しをAIエディターに依頼することもできます。
このテンプレートは無料で使えますか?
はい。エディターで開けば、すぐに編集を始められます。お試しにアカウントは不要で、無料プランでアンケートを公開できます。
公開の準備はできましたか?
このテンプレートをエディターで開いてみてください。最初の回答者が目にする前に、すべてを自由に変更できます。
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