|
Member's
Family
Status
|
Married With Dependent Children
Married Without Dependent Children
Single With Dependent Children
Single Without Dependent Children |
|
Member's Age
|
|
|
Approximately
how many times in the past 12 months have you or your spouse contacted the benefit office?
|
| |
1-2 times
3-5 times
over 5 times
|
|
Quality of Medical
Services
|
|
Rating:
5 = Excellent, 1 = Poor
|
|
| Hours of operation |
|
| Prompt service
on the phone |
|
| Friendly and courteous
staff |
|
| Ability to answer
questions |
|
| Length or time
on hold |
|
| Handling
of paperwork by staff |
|
| Speed of processing
your claims |
|
| Accuracy of processing
your claims |
|
| Request for additional
information from benefit office is clear |
|
| Explanation of
benefits for claims are understandable |
|
|
Quality of Retirement
Services
(skip, if no comment)
|
|
Rating:
5 = Excellent, 1 = Poor
|
|
| Hours of operation |
|
| Prompt service
on the phone |
|
| Friendly and courteous
staff |
|
| Ability to answer
questions |
|
| Length or time
on hold |
|
| Handling
of paperwork by staff |
|
|
|
Quality of
SUB Fund
Services
(skip, if no comment)
|
|
Rating:
5 = Excellent, 1 = Poor
|
|
| Hours of operation |
|
| Prompt service
on the phone |
|
| Friendly and courteous
staff |
|
| Ability to answer
questions |
|
| Length or time
on hold |
|
| Handling
of paperwork by staff |
|
|
Quality of
Eligibility
Services
(skip, if no comment)
|
|
Rating:
5 = Excellent, 1 = Poor
|
|
| Hours of operation |
|
| Prompt service
on the phone |
|
| Friendly and courteous
staff |
|
| Ability to answer
questions |
|
| Length or time
on hold |
|
| Handling
of paperwork by staff |
|
|
|
Quality of
Disability
Services
(skip, if no comment)
|
|
Rating:
5 = Excellent, 1 = Poor
|
|
| Hours of operation |
|
| Prompt service
on the phone |
|
| Friendly and courteous
staff |
|
| Ability to answer
questions |
|
| Length or time
on hold |
|
| Handling
of paperwork by staff |
|
|
|
Quality of
Receiving
Agency
Services
(skip, if no comment)
|
|
Rating:
5 = Excellent, 1 = Poor
|
|
| Hours of operation |
|
| Prompt service
on the phone |
|
| Friendly and courteous
staff |
|
| Ability to answer
questions |
|
| Length or time
on hold |
|
| Handling
of paperwork by staff |
|
|
|
Quality of
COBRA
Services
(skip, if no comment)
|
|
Rating:
5 = Excellent, 1 = Poor
|
|
| Hours of operation |
|
| Prompt service
on the phone |
|
| Friendly and courteous
staff |
|
| Ability to answer
questions |
|
| Length or time
on hold |
|
| Handling
of paperwork by staff |
|
|
|
|
|
In your opinion,
what is the greatest service that the IBEW 292 Benefit Fund office provides?
|
|
In your opinion,
what is the greatest problem you have encountered with the IBEW 292 Benefit Fund office?
|
|
Optional:
If you would like someone in the fund office to contact you regarding a problem, please
fill out any or all of the contact information below.
|
|
Your Name:
|
|
| Your
Phone No. |
|
|
Member Id #:
|
|
| E-mail:
|
|
