Service Provider Performance Evaluation - Life Broker
    Please rate the effectiveness of service provided by the contractor listed below. If you have no opinion, or do not recall using or receiving the service, indicate not applicable (N/A).
 
1.
Contractor Company:
2.
Contact Person:
3.
Contract Anniversary:
4.
Service Provided to SELF:
       
    Activity Rating
      Poor -- 1 -- 2 -- 3 -- 4 -- 5 -- N/A -- Excellent
    CONTRACT TASKS  
5.
Coordinate marketing efforts.
 1   2   3   4   5   N/A  
6.
Monitor insurance services provided and fees charged by the insurer. Reconcile the insurance premiums and fees to SELF.
 1   2   3   4   5   N/A
7.
Design wording for program contracts to meet the needs of SELF.
 1   2   3   4   5   N/A
8.
Review insurance policies, binders, certificates and other documents related to the program for accuracy and obtain revisions in such documents when needed.
 1   2   3   4   5   N/A
9.
 Prepare written reports to SELF on the program activity and present reports to the Board. 1   2   3   4   5   N/A
10.
 Evaluate the program success by comparison to the business plan approved by the Board. 1   2   3   4   5   N/A
       
    COMMUNICATION  
11.
Ability to communicate thoughts and ideas orally and in written form, and have them understood by others; ability to carefully listen, observe, understand and respond to what is communicated by others; skill in preparing written documents in a thorough and professional manner; skill in preparing, articulating and presenting material in a public meeting.
 1   2   3   4   5   N/A
       
    INTERPERSONAL SKILLS  
12.
Ability to deal with people; skill in maintaining cooperative, friendly relations with the Board and members; skill in handling conflict and confrontation; skill in inspiring confidence in others.
 1   2   3   4   5   N/A
       
    FOLLOW THROUGH  
13.
Ability to not just accomplish goals and objectives as stated, but to provide additional value for members.
 1   2   3   4   5   N/A
       
14.
Specific examples or comments: