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<p class=MsoNormal>According to our records, you have elected to decline health
insurance coverage through your agency and the State of Idaho. At the
request of the Idaho State Group Insurance Advisory Committee, I am conducting
a short survey to determine why you have elected to decline the insurance
provided by State of Idaho Group Insurance.<o:p></o:p></p>
<p class=MsoNormal><o:p> </o:p></p>
<p class=MsoNormal>We would appreciate you taking just a few moments to
complete this short survey. Please be assured that your name will not
utilized and your response will be merged with other respondents. You
will not be personally identified in any manner.<o:p></o:p></p>
<p class=MsoNormal><o:p> </o:p></p>
<p class=MsoNormal>Please select “Reply” from the menu bar above
and then place an “X” next to the response below that best
describes why you have declined the health insurance offered by the State of
Idaho Group Insurance:<o:p></o:p></p>
<p class=MsoNormal><o:p> </o:p></p>
<p class=MsoNormal>____ My spouse is also a State
employee and I have coverage under <o:p></o:p></p>
<p class=MsoNormal style='text-indent:.5in'>his/her policy. <o:p></o:p></p>
<p class=MsoNormal style='text-indent:.5in'><o:p> </o:p></p>
<p class=MsoNormal>____ My spouse is NOT a State
employee but I have coverage under <o:p></o:p></p>
<p class=MsoNormal style='text-indent:.5in'>his/her policy.<o:p></o:p></p>
<p class=MsoNormal style='text-indent:.5in'><o:p> </o:p></p>
<p class=MsoNormal>____ I can’t afford the
coverage.<o:p></o:p></p>
<p class=MsoNormal><o:p> </o:p></p>
<p class=MsoNormal>____ I don’t need the
coverage.<o:p></o:p></p>
<p class=MsoNormal><o:p> </o:p></p>
<p class=MsoNormal>____ I am coded as declined as I am
not eligible for health insurance <o:p></o:p></p>
<p class=MsoNormal style='text-indent:.5in'>but I am eligible for PERSI.<o:p></o:p></p>
<p class=MsoNormal style='text-indent:.5in'><o:p> </o:p></p>
<p class=MsoNormal>____ Other: (please explain) <o:p></o:p></p>
<p class=MsoNormal><o:p> </o:p></p>
<p class=MsoNormal><o:p> </o:p></p>
<p class=MsoNormal>Comments you wish to share? <o:p></o:p></p>
<p class=MsoNormal><o:p> </o:p></p>
<p class=MsoNormal><o:p> </o:p></p>
<p class=MsoNormal>Thank you so much for taking the time to complete and return
this short survey. Your input is very valuable to us. I would
appreciate receiving your response by May 12, 2010.<o:p></o:p></p>
<p class=MsoNormal><o:p> </o:p></p>
<p class=MsoNormal><span style='font-size:10.0pt;font-family:"Arial","sans-serif"'>Sincerely,<o:p></o:p></span></p>
<p class=MsoNormal><o:p> </o:p></p>
<p class=MsoNormal><o:p> </o:p></p>
<p class=MsoNormal><span style='font-size:10.0pt;font-family:"Arial","sans-serif"'>Rebecca
L. Fry, SPHR<br>
Human Resource Officer<br>
Department of Administration<br>
208-332-1831<br>
<a href="mailto:rebecca.fry@adm.idaho.gov"><span style='color:blue'>rebecca.fry@adm.idaho.gov</span></a></span><o:p></o:p></p>
<p class=MsoNormal> <o:p></o:p></p>
<p class=MsoNormal><o:p> </o:p></p>
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