First, Let's start with some basic information
Please select an option from the dropdown
- Agriculture, Forestry, Mining
- Industrials (Manufacturing, Construction, etc.)
- Energy, Utilities
- Transport, Logistics
- Media, Creative Industries
- Data Infrastructure, Telecom
- Healthcare
- Education
- Life Sciences
- Retail / ecommerce
- Hospitality, Food, Leisure Travel
- Public Service, Social Service
- Financial Services
- Professional Services
- Other
Total Participating Employees*
Please make sure only to include the number of employees who are currently participating/electing for major medical health insurance through your company.
Please select a state from the dropdown
- Alabama
- Alaska
- Arizona
- Arkansas
- California
- Colorado
- Connecticut
- Delaware
- Florida
- Georgia
- Hawaii
- Idaho
- Illinois
- Indiana
- Iowa
- Kansas
- Kentucky
- Louisiana
- Maine
- Maryland
- Maryland
- Massachusetts
- Michigan
- Minnesota
- Mississippi
- Missouri
- Montana
- Nebraska
- Nevada
- New Hampshire
- New Jersey
- New Mexico
- New York
- North Carolina
- North Dakota
- Ohio
- Oklahoma
- Oregon
- Pennsylvania
- Rhode Island
- South Carolina
- South Dakota
- Tennessee
- Texas
- Utah
- Vermont
- Virginia
- Washington
- West Virginia
- Wisconsin
- Wyoming
What is your average monthly premium per employee?*
(For employee-only coverage, including both employer and employee contributions)
Please make sure to only include the average total premium for an employee. If you offer plans to spouses and dependents, wait to include their information. This number should also reflect the average gross premium (do not subtract any employer or employee contribution)
(Does this look right? If not, please provide a more accurate figure)