ISPOR Employer Insurer Perspective Working Group Survey

	ISPOR Employer Insurer Perspective Working Group Survey

Section A: Organization information

1. Organization Name:

2. In which US region is your headquarters located?

3. In which US region do you work/represent?

4. Organizational Characteristics? (Please fill in the blanks.)

Number of Employees
Number of Retirees
Total Number of Lives Covered
Number of States where employee population located
Type of organization: SIC designation (Standard Industry Code)

5. Is your organization a ___?

	Self-insured employer
	Employer that purchases health benefits (fully insured)
	Third party insurer
	PBM
	Benefit consultant or broker
	Medicare / Medicaid Benefits Administrator
	Other (please state in the text field)

6. How would you classify the funding source for benefits offered by your organization?

	Federal Government
	Local/State Government
	Self-insured and directed health plan
	Fully-insured/Private insurer/managed care
	Other (please state in the text field)

7. Where is the benefit design and related decision-making work performed? (Check all that apply.)

	Entirely in-house staff
	Combined third party entity staff & in-house staff
	Entirely outsourced through third party
	Benefit consultant or broker (primarily, with limited in-house staff)
	Other (Please state in the text field)

8. I am involved in:
(Check all that apply)

	one-time exception	case-by-case	policy	N/A
Coverage (reimbursement) decisions
Formulary decisions
Clinical guidance
Other (please specify)

9. What are your top 3 unmet needs pertaining to healthcare benefit design and/or management?
(Please fill in the blanks.)

10. What is/are the therapeutic focus for your benefits review effort over the next 2-3 years?