Health Care Survey for Roosevelt Adjuncts

OPTIONAL:  Please let us know who you are and where you teach:

First Name
Last Name

College	Choose from the list below Arts and Sciences College of Education Chicago College of Performing Arts Walter E. Heller College of Business Administration Evelyn T. Stone University College
School (if in Arts and Sciences)	Choose from the list below Communication Computer Science and Telecommunications Liberal Studies Policy Studies Psychology Science and Mathematics

THE SURVEY

For the first six of these questions, enter yes or no (y or n) in the box. For the last two, enter text (there's more room than it seems).

1. Do you currently have health insurance coverage, personally or through your spouse?
   

2. Would you sign up for a group health care plan offered by Roosevelt, if Roosevelt made contributions to the premiums?
   

3. Would you sign up for a group health care plan offered by Roosevelt, even if Roosevelt made no contributions to the premiums?
   

4. Would you sign up for a Health Savings Account? For some questions and answers about these, try this: http://www.kiplinger.com/features/archives/2004/02/hsa.html
   

5. Should RAFO set up a task force with Roosevelt and other nearby higher ed institutions to explore wider access to group plans?
   

6. If so, would you be willing to serve on that task force?
   

7. What would you most like to see in a group health care plan, e.g. reasonable deductibles, reasonable co-pays, choice of facilities and doctors.
   

8. What would be the absolute minimum you'd want in a health care plan offered by Roosevelt University to adjunct faculty?
   

Please confirm your entries by clicking the confirm button below. This will display your information below.  To send your information to RAFO, click on the send button below that display. You may make specific changes on this form before clicking on "confirm," or you may start from scratch by clicking the "clear" button below.

Name
Adequate Health Care Now?
Group Plan with RU contribution?
Group Plan without RU contribution?
Health Savings Account?
Task Force with other Schools?
Volunteer for Task Force?
Aspects of Ideal Health Plan:
Aspects of Minimum Health Plan:

Please ignore this box (or, if curious, at least do not modify it).