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Your opinion counts.

We want to provide you easy-to-use, relevant information. Please tell us how we're doing and how helpful UnitedHealth Premium^® is to you.

Your opinion will help us improve the efficiency and effectiveness of the program.

* First Name:		* Last Name:

* Company Name:

* 1: How likely are you to use the information provided by UnitedHealth Premium to select your physician or treatment facility?

* 2: How likely is it that you would switch to another primary care physician if you found that your current physician is not designated?

* 3: In the past 30 days, how many hours have you spent online searching for information on health and health-care-related topics?

4: Have you used myuhc.com to find the following information? (Select all that apply.)

Find a physician
Find a hospital
Find out what certain procedures will cost
Find information on my co-payments, deductible or coinsurance
Check the balance in my Health Savings Account (HSA) or Health Reimbursement Account (HRA)
Find discount programs through my health plan
Some other purpose
Never used health insurance company's Web site

5: Below are a number of statements about you, your feelings and your lifestyle. Please select one rating for each statement to indicate how well each statement describes you on a 1–7 point scale. A rating of 1 means the statement “does not fit you at all” and 7 means “it definitely fits you.”

* I like to have many choices when shopping for something important.

Does not fit you at all

1
2
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5
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7

Definitely fits you

* I don't like to have a regular physician. I usually see whichever physician is available.

Does not fit you at all

1
2
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5
6
7

Definitely fits you

* I actively manage my long-term savings.

Does not fit you at all

1
2
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4
5
6
7

Definitely fits you

* To me, being healthy is about having a positive attitude.

Does not fit you at all

1
2
3
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7

Definitely fits you

* I have so many responsibilities that I don't take care of myself the way I should.

Does not fit you at all

1
2
3
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5
6
7

Definitely fits you

* I lead a very healthy lifestyle.

Does not fit you at all

1
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5
6
7

Definitely fits you

* I save money for unexpected events.

Does not fit you at all

1
2
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5
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7

Definitely fits you

* I am willing to pay more of my own money to see a top physician.

Does not fit you at all

1
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5
6
7

Definitely fits you

* My health problems dominate my life.

Does not fit you at all

1
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5
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7

Definitely fits you

* I am concerned about not having enough money for the future.

Does not fit you at all

1
2
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5
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7

Definitely fits you

* The stress in my life affects my health and energy.

Does not fit you at all

1
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5
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7

Definitely fits you

* I feel I have too much credit card debt.

Does not fit you at all

1
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5
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7

Definitely fits you

* I keep on top of ways to reduce my taxes.

Does not fit you at all

1
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5
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7

Definitely fits you

* I worry about my health.

Does not fit you at all

1
2
3
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5
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7

Definitely fits you

* I gather as much information as possible before making a decision about my health.

Does not fit you at all

1
2
3
4
5
6
7

Definitely fits you

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