Getting it Right-Know Your Feduciary Responsibilities and Health Benefits Education Campaign Surveys

OMB#1225-0088
Experation Date: 06/30/2014

d. Common Mistakes in 401(k) Plans & IRS Correction Programs
Very
Helpful

Not at all
Helpful

5 4 3 2
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1
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Don’t
Know

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Too
Long

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Just
Enough

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Too
Short

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Don’t
Know

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Does Not
Apply

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Comments/Suggestions

Not at all
Helpful

5 4 3 2
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1
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Don’t
Know

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Too
Long

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Just
Enough

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IT

RIGHT

KNOW YOUR
FIDUCIARY
RESPONSIBILITIES

e. DOL Voluntary Correction Program
Very
Helpful

GETTING

Too
Short

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Don’t
Know

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Does Not
Apply

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Comments/Suggestions

7. What additional information would you want to receive?

COMMENTS
8. What ONE thing could the Department of Labor do to improve the
seminar for someone like you?

PLEASE RETURN THE COMPLETED FORM TO THE SESSION ORGANIZERS.
Paperwork Reduction Act Notice
This survey has been approved under Office of Management and Budget (OMB) control number 1225-0088 (exp. 6/30/14). The
Paperwork Reduction Act of 1995 provides that no person is required to respond to a Federal collection of information unless it
displays a valid OMB control number. Your response is voluntary, and we will use this information to evaluate and improve the
quality of our services. The Department estimates that it will take approximately 2.5 minutes (on average) for respondents to
complete the survey. Please send comments regarding the burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to the U.S. Department of Labor, Office of the Chief Information Officer, Attention:
Information Management Program, 200 Constitution Avenue, N.W., Room N-1301, Washington, DC 20210 or email dol_pra_
[email protected] and reference the OMB Control Number 1225-0088.

SURVEY

6. Please rate the helpfulness of each of the seminar sessions/discussions and whether
you felt the session was too long, too short, or just long enough. You may wish to
write comments or suggestions in the space provided.

WHAT IS YOUR ROLE?
1. Please indicate your role below:

Mark ONE response for each helpfulness and length of the session Mark “Does Not
Apply” if you did not attend the session or the session was not offered.

Employer/Plan Sponsor/Human Resources Manager/In House Benefits
Manager
Service Provider (Examples: Third Party Administrator, Insurance Broker,
Agent)
State or Federal Representative

a. DOL Fiduciary Responsibility: General Overview
Very
Helpful

Not at all
Helpful

5 4 3 2
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Other (please specify)

1
∇

Don’t
Know

∇

Too
Long

∇

Just
Enough

∇

Too
Short

∇

Don’t
Know

∇

Does Not
Apply

∇

Comments/Suggestions

PLEASE RATE THE SEMINAR OVERALL:
Very
Helpful

2. Please rate your overall satisfaction with the
seminar:

5
∇

4
∇

3
∇

2
∇

Not at all
Helpful

1
∇

Don’t
Know

∇

b. DOL Fiduciary Responsibility: Prohibited Transactions & Exemptions

3. Please rate the overall usefulness of the
information you received at the seminar:

Very
Helpful

5 4 3 2
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4. Please rate the overall performance of the
presenters:
5. Please rate how much you agree or disagree with the following statements as they
pertain to the Getting it Right - Know Your Fiduciary Responsibilities seminar.
(Mark ONE response for EACH statement)
Strongly
Agree

a. The information I received was clear and
easy to understand
b. The information I received increased my
understanding of the retirement benefits
regulations and issues
c. The presenters were well informed and
knowledgeable
d. The presenters gave the right level of
detail
e. The presentations answered all of my
questions

Not at all
Helpful

5
∇

4
∇

3
∇

2
∇

Not at all
Satisfied

1
∇

1
∇

Don’t
Know

∇

Too
Long

∇

Just
Enough

Too
Short

Don’t
Know

Does Not
Apply

Just
Enough

Too
Short

Don’t
Know

Does Not
Apply

∇

∇

∇

∇

Comments/Suggestions

Don’t
Know

∇

c. DOL Reporting and Disclosure
Very
Helpful

Not at all
Helpful

5 4 3 2
∇∇∇∇

1
∇

Don’t
Know

Comments/Suggestions

∇

Too
Long

∇

∇

∇

∇

∇