Q01
Message
All templatesEmployee & HR
Health Plan Enrollment Experience Survey
Evaluates the clarity, ease, and satisfaction of employer-sponsored health plan enrollment. Designed for HR and benefits teams seeking to identify communication gaps, decision-support needs, and friction points during open enrollment or new-hire onboarding.
Sample questions
A preview of what’s in the template. Every question is editable before you launch.
27 questions · ~12 min
Q02
Multiple Choice
In the last 12 months, did you select or review a health plan (during open enrollment or as a new hire)?
- Yes, during the most recent open enrollment
- Yes, as a new hire in the last 12 months
- No, I did not review or enroll
Q03
Multiple Choice
What was the main reason you did not review or enroll in a health plan this cycle?
- I was already satisfied with my current coverage
- Covered under a spouse/partner or parent
- Not eligible this cycle
- Missed the deadline
- Planning to enroll later due to a qualifying life event
- Other (please specify)
Q04
Multiple Choice
Which information sources did you consult before or during enrollment? Select all that apply.
- Benefits guide or PDF
- Company benefits site or intranet
- Online plan comparison tool
- Recorded webinars or videos
- Live info session or town hall
- HR or benefits help desk
- Insurance carrier websites
- Family, friends, or colleagues
- None of the above
- Other (please specify)
Q05
Opinion Scale
Overall, how easy or difficult was it to find the information you needed during enrollment?
Scale: 1 – 7
Min:Very difficultMax:Very easy
Q06
Multiple Choice
Which interactive support channels did you use during enrollment? Select all that apply.
- HR or benefits email or chat
- Phone support
- Live info session or office hours
- Recorded webinars or help videos
- Plan comparison or decision-support tool
- None of the above
- Other (please specify)
Q07
Opinion Scale
Overall, how satisfied or dissatisfied were you with your enrollment experience?
Scale: 1 – 7
Min:Very dissatisfiedMax:Very satisfied
Q08
Multiple Choice
What is your employment status with the company?
- Full-time
- Part-time
- Contingent/contract
- Intern
- Other
- Prefer not to say
Q09
Message
Thank you for your feedback! Your input will help us make future enrollments clearer and easier.
Q10
Long Text
What, if anything, would have made you more likely to review or enroll in a health plan?
Q11
Ranking
Please rank the following factors by how important they were in your plan decision. Drag the most important to the top.
- Monthly premium
- Deductible
- Out-of-pocket maximum
- Provider network
- Prescription coverage
- HSA/HRA eligibility
- Employer contributions
Drag to rank
Q12
Opinion Scale
How clear was the information provided about plan cost breakdowns (premiums, deductibles, copays)?
Scale: 1 – 7
Min:Not at all clearMax:Extremely clear
Q13
Opinion Scale
How helpful was the support you received during enrollment?
Scale: 1 – 7
Min:Not at all helpfulMax:Extremely helpful
Q14
Opinion Scale
How likely are you to recommend this company's enrollment process to a colleague?
Scale: 1 – 7
Min:Not at all likelyMax:Extremely likely
Q15
Multiple Choice
How long have you been with the company?
- Under 6 months
- 6–12 months
- 1–3 years
- 3–5 years
- Over 5 years
- Prefer not to say
Q16
Multiple Choice
What would help you feel more prepared for a future enrollment? Select all that apply.
- Short plan comparison checklist
- Plain-language explainer on key terms
- Cost calculator for typical scenarios
- Live Q&A with the benefits team
- One-page summaries for common situations (single, family, etc.)
- Earlier reminders and clear timelines
- Other (please specify)
Q17
Opinion Scale
How clear was the information provided about provider network coverage?
Scale: 1 – 7
Min:Not at all clearMax:Extremely clear
Q18
Multiple Choice
What, if anything, made choosing a plan difficult? Select all that apply.
- Too many plan choices
- Benefits jargon was confusing
- Costs were hard to estimate
- Conflicting or inconsistent information
- Not enough time to decide
- Uncertain about my future healthcare needs
- Website or tool issues
- Couldn't confirm my provider was in network
- Nothing — the process was straightforward
- Other (please specify)
Q19
Long Text
What could we improve to make the next enrollment clearer or easier?
Q20
Multiple Choice
Where are you primarily located?
- United States
- Canada
- United Kingdom
- European Union
- India
- Other
- Prefer not to say
Q21
Opinion Scale
How clear was the information provided about HSA or HRA eligibility and employer contributions?
Scale: 1 – 7
Min:Not at all clearMax:Extremely clear
Q22
AI Interview
Based on your responses, we'd like to explore a few of your experiences in more detail. An AI moderator will ask you 1–2 brief follow-up questions.
Q23
Multiple Choice
What is your age range?
- 18–24
- 25–34
- 35–44
- 45–54
- 55–64
- 65 or older
- Prefer not to say
Q24
Opinion Scale
How clear were the enrollment deadlines and steps you needed to complete?
Scale: 1 – 7
Min:Not at all clearMax:Extremely clear
Q25
Multiple Choice
Which coverage tier best describes your current enrollment?
- Not enrolled in a company plan
- Self only
- Self + spouse/partner
- Self + child(ren)
- Family (self + spouse/partner + child[ren])
- Prefer not to say
Q26
Opinion Scale
How confident were you in your ability to compare plan options and choose the best fit?
Scale: 1 – 7
Min:Not at all confidentMax:Extremely confident
Q27
Opinion Scale
How well did you understand the key trade-offs between plan options (e.g., lower premiums vs. higher deductibles)?
Scale: 1 – 7
Min:Did not understand at allMax:Completely understood
What’s included
AI follow-ups
Adaptive probes on open-ended answers that pull out detail a static form would miss.
Attention checks
Built-in safeguards against rushed answers and low-quality respondents.
AI-drafted copy
Wording, ordering, and branching written by the AI — tuned to your research goal.
Auto report
Themes, quotes, and a plain-English summary write themselves once responses come in.
How it compares
We reviewed the closest templates from other survey tools. Here’s what they do well — and where this template goes further.
Why this template
- Combines closed-ended opinion-scale ratings on cost clarity, network coverage, HSA/HRA eligibility, and deadlines with an open-text question asking what would improve the next enrollment cycle.
- Uses a ranking question to surface which decision factors (e.g., premiums vs. coverage trade-offs) actually mattered most to employees, not just satisfaction scores.
- Includes an AI follow-up interview that adapts based on each respondent's prior answers, letting HR teams probe specific friction points instead of relying only on static multiple-choice options.
- Segments results by employment status, tenure, location, age range, and coverage tier so HR/benefits teams can identify communication gaps for specific employee groups.
Jotform
Benefits Open Enrollment Form TemplateThis is a form for administering open enrollment elections (plan selection, dependent info, signatures) rather than a survey measuring the enrollment experience itself. It's fielding-ready as an intake form but doesn't ask employees to evaluate clarity, satisfaction, or decision difficulty. Useful for the transactional side of enrollment, not for feedback collection.
What it does well
- Purpose-built for capturing plan elections and dependent/beneficiary data during enrollment
- Drag-and-drop form builder with e-signature and conditional fields typical of Jotform templates
- Likely integrates with Jotform's broader HR form ecosystem
Where it falls short
- No mechanism to measure satisfaction, clarity, or friction points in the enrollment process
- Static form fields only — no adaptive follow-up questioning based on responses
- No built-in scoring or reporting on communication gaps or decision-support needs
SurveyMonkey
CAHPS® Health Plan Survey 5.0This is a standardized CAHPS instrument measuring member experience with a health plan (getting care, customer service, plan information) rather than the enrollment/decision process specifically. It's a recognized, fielding-ready template for regulatory or benchmarking purposes, but it isn't designed around open enrollment clarity or plan-selection friction. Best suited to health plans and payers, not employer HR/benefits teams running enrollment.
What it does well
- Based on a standardized, widely recognized CAHPS methodology used in healthcare quality reporting
- Fielding-ready survey template hosted on an established survey platform
- Useful for benchmarking against other CAHPS-based results
Where it falls short
- Not focused on open enrollment or plan-selection experience — it targets ongoing care/member service experience
- Static question set with no adaptive AI follow-up to probe individual pain points
- No transparent prompt or methodology disclosure for any AI-driven analysis
QuestionPro
Health insurance coverage survey questions + sample questionnaire templateThis page presents sample questionnaire content and question ideas for health insurance coverage satisfaction rather than a single ready-to-field enrollment-specific survey. It's a useful reference for question wording but reads more like a guide/question bank than a packaged enrollment-experience instrument. Employer HR teams would need to assemble and customize it themselves.
What it does well
- Broad bank of sample questions covering coverage satisfaction topics
- Backed by QuestionPro's established survey platform and distribution tools
- Flexible starting point for teams wanting to build a custom insurance satisfaction survey
Where it falls short
- Reads as a question-bank/guide rather than a single deployable enrollment-experience survey
- No adaptive AI interviewing or voice interview option to follow up on low ratings
- No automated per-response quality scoring or auto-generated report shown
Ready to launch?
Open this template in the editor. Every part is yours to change before the first respondent sees it.
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