[Company Name] wants to ensure that our retirement savings plan and its investment choices are competitive and of value to our employees. Please complete and return this survey to the human resources department. Feel free to sign the form or return it anonymously.
Are you participating in the 401(k) plan? ☐ Yes ☐ No
If yes, what deferral percentage or amount are you contributing? ____% or $_______
If no, please state the reason: ____________________________________________
If you are participating in the plan, please complete the following:
Using a scale of 1-5, with 5 being strongly agree and 1 being strongly disagree, please select one response for each statement.
| | | | | | | |
|---|---|---|---|---|---|---|
| | 5 | 4 | 3 | 2 | 1 | N/A |
| I understand the 401(k) plan and its benefits. | ° | ° | ° | ° | ° | ° |
| The plan does not provide sufficient investment options. | ° | ° | ° | ° | ° | ° |
| The savings and investment education provided is helpful. | ° | ° | ° | ° | ° | ° |
| I don't feel confident in my investment choices. | ° | ° | ° | ° | ° | ° |
| The administrative fees for plan funds are competitive. | ° | ° | ° | ° | ° | ° |
| Change requests are handled promptly. | ° | ° | ° | ° | ° | ° |
| Comments or suggestions for improvement: | | |||||
| | | | | | | |
|---|---|---|---|---|---|---|
| Transaction type | 5 | 4 | 3 | 2 | 1 | N/A |
| Change of information | ° | ° | ° | ° | ° | ° |
| Fund transfer | ° | ° | ° | ° | ° | ° |
| Withdrawal | ° | ° | ° | ° | ° | ° |
| Loan | ° | ° | ° | ° | ° | ° |
| Other: | ° | ° | ° | ° | ° | ° |
Are there other investment options would you like to see added to the plan? ____________________________________________________________________
____________________________________________________________________
Additional comments or suggestions:
____________________________________________________________________
____________________________________________________________________
Optional:
Date: _____________ Employee name: __________________________
Department: _______________________________________________
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