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ARTICLE 2014 Shining Light Award Nomination Form

Please complete your nomination of your social responsibility program by filling out all of the fields below. Please note the number of characters allowed for your response after each question.

 

Unfortunately, there is not an option to save the form as a draft while you work. Please prepare your responses in advance and complete the form once you have compiled all of the necessary data.

 

Nominations must be submitted online and received by midnight on
February 28, 2014.

 

Questions? Please contact your UnitedHealthcare primary contact.

 

Thank you for submitting a nomination for the Shining Light Award!


* Required field

Company Information

Company nominated*
Number of employees*
Where is the company headquartered?*
What is the company's core business?*

Company Primary Contact Information

Name*
Title*
Telephone number*
Email*

Person Submitting Nomination (if different from Primary Contact)

Name
Title
Telephone number
Email address
Person submitting nomination is:
An employee of the nominated company
A UnitedHealth Group employee submitting the nomination on behalf of the nominated company
Who is the company's primary contact at UnitedHealthcare?

Approval to Nominate

The senior-most benefits executive at the nominated company is aware of and has approved this nomination:*
Yes    No
*Note: Approval from this individual must be secured before the nomination can be submitted.
If selected as a finalist or winner, this nomination and any resulting photos or videos from the awards ceremony become the property of UnitedHealth Group and can be used in future internal and external publications.*
Agree    

Nominated Program Overview

Program name* (500 characters)
What is the health or social issue the program is designed to address?* (1000 characters)
Please identify specific goals and objectives of the program.* (1000 characters)
Who is the primary beneficiary of the program?* (1000 characters)
When did the program begin and how long has it been operating?* (1000 characters)
Please provide an overview of the program.* (2000 characters)
What results/impact has the program achieved?* (2000 characters)
How did the program create shared value and provide benefit to your company and society?* (2000 characters)
How did the program demonstrate innovation and leadership?* (2000 characters)
How did you communicate the program to employees and other stakeholders?* (1000 characters)


Thank you for your nomination!