모든 템플릿

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.

샘플 질문

템플릿에 포함된 내용을 미리 확인해 보세요. 모든 질문은 설문 공개 전에 자유롭게 수정할 수 있습니다.

질문 13개 · 약 7분
Q01
메시지

Thanks for taking a few minutes to share your honest experience with your health insurance. This helps improve coverage and service for people like you. Your responses are completely confidential and anonymized. About 5-6 minutes.

Q02
객관식필수

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
Q03
의견 척도필수

Overall, how satisfied are you with your current health insurance plan?

척도: 010
최소:Not at all satisfied최대:Extremely satisfied
Q04
매트릭스필수

How satisfied are you with each of the following aspects of your plan?

7개 행 × 5개 열
  • Monthly premium cost
  • Deductible and out-of-pocket costs
  • Size of the provider network
  • Ease of finding in-network doctors
  • Prescription drug coverage
  • 외 2개
: Very dissatisfied · Dissatisfied · Neutral · Satisfied · Very satisfied
Q05
객관식

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
Q06
객관식

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
Q07
평점 척도필수

How easy is it to understand what your plan covers and what you'll owe out of pocket before receiving care?

범위: 15
최소:Very difficult최대:Very easy
Q08
최선·최악 선택형(MaxDiff)

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
세트별 최선·최악 선택최선:Matters most최악:Matters least
Q09
점수 배분

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
100점 배분
Q10
AI 인터뷰

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.

Q11
객관식

Which age range do you fall into?

  • 18-24
  • 25-34
  • 35-44
  • 45-54
  • 55-64
  • 65+
  • Prefer not to say
Q12
객관식

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
Q13
메시지

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.

포함된 기능

  • AI 후속 질문

    정형화된 설문이 놓치는 세부 내용을, 주관식 답변에 맞춰 AI가 심층 질문으로 끌어냅니다.

  • 주의력 확인 장치

    성의 없는 답변과 저품질 응답자를 걸러내는 내장 안전장치입니다.

  • AI가 작성한 문안

    문구, 질문 순서, 분기 로직까지 AI가 연구 목표에 맞춰 작성합니다.

  • 자동 리포트

    응답이 모이면 주요 주제, 인용문, 이해하기 쉬운 요약이 자동으로 작성됩니다.

다른 서비스와 비교

다른 설문 도구의 가장 유사한 템플릿을 검토했습니다. 그 도구들이 잘하는 점과, 이 템플릿이 한발 더 나아가는 지점을 정리했습니다.

이 템플릿을 선택하는 이유

  • 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 Template

A 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.

잘하는 점

  • 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

아쉬운 점

  • 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 Template

SurveyMonkey'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.

잘하는 점

  • Established survey analytics dashboard and reporting tools
  • Large-scale distribution and panel options
  • Recognizable, trusted respondent experience

아쉬운 점

  • 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

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