
Today we answer a few questions about estate planning and then explain what a Grantor Retained Annuity Trust is. We talk about contribution limits when you have multiple 401(k)s. We give some advice to a listener who is being gifted a property that is...
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This is the White Coat Investor podcast where we help those who wear the white coat get a fair shake on Wall Street. We've been helping doctors and other high income professionals stop doing dumb things with their money since 2011. This is White Coat Investor podcast number 400. As the new year begins, it's crucial to take a proactive approach to tax planning and leverage every money saving opportunity. Over the past decade, clients of Cerebral Tax Advisors have seen an average return of 453% on their investment in Cerebral's tax planning services. As a White Coat investor recommended firm trusted by physicians nationwide, Cerebral uses court tested IRS approved strategies to reduce personal and business taxes. Cerebral founder Alexis Galati comes from a family of physicians and brings over 20 years of expertise in tax strategy and multi state tax preparation. Schedule your free discovery session today@cerebral taxadvisors.com all right, welcome back to the podcast. This is podcast number 400. That's right, 400 of these episodes we've done and since we do what you know, about 50 of them a year. Given that there's 52 weeks a year, that means we've been doing this for eight years now. It's a long time to keep a podcast going. Most podcasts that get started don't even last a year, so pretty remarkable. We're excited about hitting that number this year. We're also excited this is the beginning of 2025, so hopefully you're going to have a great financial year in 2025 and we're here to help you do that as best we can. I need to take a minute to go back A couple of months ago and we were awarded the White Coat Investors Scholarship for 2024. We failed to thank our sponsors, particularly our platinum sponsors for that scholarship for their support and there were three of them that I want to mention in particular today. They are all insurance agents. Bob Baiani with DrDisabilityQuotes.com Matt Wiggins at Doc Insure LLC and Larry Keller at Physician Financial Services. Thank you for supporting the White Coat Investor scholarship. Of course, all of the money they donated to that went to the scholarship winners and we're excited to help reduce those docs indebtedness as well as to boost physician financial literacy by running that program through our medical, dental and other professional schools. I also want to make sure you guys know about our end of the year sale. There's only a few days left. This buy one get one sale ends January 6th. If you buy any WCI course you get our continuing financial education 2023 course for free. That's like 50 hours of content. Absolutely. For free for buying any of our other courses. So check that out. That link is wcicourses. Com. Okay. I wanted to talk about an article. This article came out in Vox last month. And of course Vox is known for a bit of a progressive viewpoint. That's okay, but keep that in mind as we talk about this article. The article was written by Eric Levitz and the title was A Big Insurer Backed Off Its Plan to Pay Less for Anesthesia that's Bad. The subtitle what the Fight Between Anthem and Anesthesiologists Was Really About. And this was as those of you in anesthesia know, they basically wanted to pay anesthesiologists less. They felt like they were making too much money, basically. But their plan to do that was actually to put a limit on how long they would pay for anesthesia. Even if the procedure went longer than it was supposed to, they wanted to not have to pay the anesthesiologist for their time beyond that amount, which obviously sounds kind of crazy at first. What are we supposed to do? Wake them up before the procedure's done? Right. Why is the anesthesiologist being punished? Because the surgeon's slow. And all these other questions come into mind. And so of course, patients worried that they would have that cost passed on to them, which probably wasn't going to happen in the first place. It just means the doctors make less money. It works out. And they're treating doctors unfairly by paying them for less than the work they actually do. And this article pointed out that, yeah, this would have cost anesthesiologists, not their enrollees. But the author took the perspective that, hey, you know, these guys are getting paid too much. And so one of the subtitles in the article was that providers, not insurance companies, are the primary drivers of high healthcare costs. And he goes on to say private insurance companies have earned the public's distrusts. They routinely put profitability above their policyholders wellbeing. The system of private health insurance provision also has higher administrative costs than a single payer system in which the government is the sole insurer. But the avarice and inefficiencies of private insurance are not the sole or even primary reasons why vital medical services are often unaffordable and inaccessible in the United States. The bigger issue is that America's healthcare providers, hospitals, physicians and drug companies, charge much higher rates than their peers in other wealthy nations. And that's a bit of a tired comparison because let's be honest. Everything costs more in America. Everybody makes more in America. No matter what your profession is, no matter what your job is, go travel the world. Guess what, stuff's cheaper in other places. And so you shouldn't be surprised when healthcare is cheaper there as well. I just returned recently from a trip to Africa and guess what? Healthcare is real cheap in Africa, but it's not the same healthcare you're getting here for sure. But the other thing is that this idea that doctors are a major driver of healthcare expenses just isn't true. If you look at the percentage of the healthcare dollar that goes toward physician payments, it's about 20%. It's about 20%. But you know what? That is not going to physician salaries. Only 8% of the health care dollar goes to physician salaries. So let's say you want to pay doctors a quarter less than what they're being paid. They cut all of their salaries by 25%. How much does that save on your health care dollar? It saves 2%. Right. It's kind of the same old tired thing when people talk about, well, let's keep people from going to the er Cause that's what's driving up the whole expense of our healthcare system. Well, emergency medicine payments, both to hospitals, doctors, everything is only about 3% of the healthcare dollar. Right? It's a tiny percentage. Even if you cut it in half, you're only saving one and a half percent of what is spent on healthcare in this country. There are much bigger drivers of healthcare expenses out there. And the insurance companies and the inefficiencies created by them are not a small chunk of this. They are a large chunk of this. Yes, hospitals are a big chunk as well. Pharmaceuticals are a big chunk as well. There's plenty of inefficiency in the system. But even if we run all of that inefficiency out, you're probably not saving that much money. Maybe you can cut it by 20% by getting all that inefficiency out of there. The fact is, healthcare is expensive because we can do some pretty awesome stuff. Now that stuff takes people that have been trained for a long time and are taking on a lot of risk. And it takes equipment that takes a long time to develop and is really expensive, made out of very high grade materials, and it's expensive stuff we're doing. It's pretty amazing stuff we're doing, but it's not cheap. And America has decided, hey, a lot of this stuff we're willing to spend money on. And that is why healthcare is so expensive. And I sometimes wonder if my third job is going to be working on helping to fix our crazy healthcare system, because it truly is crazy. But this idea of heaping all the blame on doctors just making too much money probably is not the answer to fixing our healthcare issues in this country. All right, I had somebody ask for a guest to come on the podcast and I had no idea who I could call. But they asked for somebody who has left the medical field to work in the insurance industry. So if you fit that bill and would be interested in doing a short interview on this podcast, there's some demand for to hear your story. So email us@podcastor.com if you fit that bill. Let's get into your questions now. Here's a question by email. I wanted a bit of clarification since my hospital retirement staff don't know the answer to this. If I max out the employer and employee max of $69,000 in my 403, does that mean that I cannot put in 20% of my 1099 income in a Solo 401? My establishment has a 401A where all the employer contributions go and is coupled with the 403 at the end of the year. We don't need to contribute anything to the 401 plan. But that means I can contribute $46,000 after the max for a backdoor Roth on my 403. This will be all great if I can also contribute 20% of my 1099 income to a Solo 401. Please let me know your thoughts. Yeah, this is a bummer. Okay, one of the rules and if you have access to multiple retirement accounts, you really need to read my blog post called multiple 401 rules. But it goes through all the rules and one of the rules, the last one I have listed on that page is really a bummer. For those of you with 403bs who also do some self employment work, most of the time if you have two separate unrelated employers, right, and you have a 401 at one, then you have your side gig, your 1099 work and you open a solo 401 there. Both of those accounts get a separate 415 limit. You know that 415C limit is the total contribution amount last year was $69,000. I don't have it on top of my head what it is for this year, $72,000 probably something like that. You get that total limit with both of those 401s. Now your employee contribution, you know, $23,000 or $24,000 or whatever that is. This year you only get one of those shared among all of the 401s you have, but you get the total limit for each of them. Well, that's not the case for a 403. Your 403 and your solo 401k share, one 415 limit. So if you're maxing out your 403 in this case with this email, it was last year, it was $69,000. You can't put anything as solo 401. You can't make an employer or an employee contribution. I'm sorry about that. You can always save more in taxable, of course, but that's the way it works. Okay. Another one came in, said my CPA is suggesting I do a SEP IRA next year with my 1099 side hustle. Considering that I have the opportunity to do a mega backdoor Roth through my regular W2 job, and the SEP IRA has a different 415C limit from the 403 plan, I'm thinking that combining that with a cash balance plan for my 1099 and doing a mega backdoor Roth through my work 403B, I will come out ahead on tax savings despite the fact that my wife and I will miss the $14,000 Roth. She is also a 1099 nurse practitioner can set up a customized Solo 401 with Roth option or do a SEP IRA and later roll it over into a Roth. Let me know what you think. Well, let's talk about this, right? We're talking about retirement account contribution limits, and you're in a pretty complicated situation here. Again, I refer you to that multiple 401 rules post. But the real question is, we boil this down here. There's a lot of moving parts here. First of all, your spouse ought to do a Solo 401. A Solo 401 is almost always better than a SEP IRA for multiple reasons. And occasionally you find a reason where that's not the case. For the most part, you want a Solo 401. But the real question as we boil this down is does your SEP IRA get treated any differently than a solo 401k would in this situation? And I think that's probably not the case. I think it does not. But I wasn't 100% sure. So I checked with Mike Piper. You guys know Mike Piper. He blogs at the Oblivious Investor. We've had him on this podcast multiple times. And he actually got back to me very quickly and he agreed with me. He said this. I haven't been asked this before, but after looking, I'm pretty confident this is not a workaround. You can't just use a SEP IRA and get around this limit that you have with 403s. Right. The issue with 403 plans, he says with respect to the 415 limitation comes from section 415 which says 403 plans count as under your control. So when we do the aggregation of plans under 415, the 403 is going to be problematic when combined with any type of plan. It actually is under your control, whether that's a solo 401 or, or a SEP IRA. Okay. So you cannot because you can't combine a 403 with a solo 401K. You also can't combine a 403 with a SEP IRA and get a totally new 415C limit. They're going to share the same limit. All right, and that's just a bummer if what your employer offers is a 403. And I'm real sorry about that, but that's the way the rules work. Okay, new subject. Let's talk a little bit about gifting.
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Hi Jim, this is Nick from the Midwest. My grandparents have been working with an estate lawyer and they're planning as if the estate tax threshold will be cut in half in 2026, the expiration of the Tax Cuts and Jobs Act. My grandparents wealth is majority in commercial and rental real estate. They donate a large amount and contribute to all of their great grandkids 529s to maximize gifting yearly. They are planning on giving each of their kids and grandkids a property to. At the end of this year I will be receiving a debt free duplex. Most of the properties they own have been purchased long ago and have increased significantly in value. So unfortunately we will not be getting a step up in basis since the properties are being given before their death. My question is, I do not necessarily desire to be a landlord, but I also don't want to pay a huge tax bill on selling the property. The consideration I may inherit more properties in the future. Should I just assume this new side hustle of being a landlord and hire a property manager? Is there anything the estate lawyer should think about when a person's wealth is mostly real estate? Thanks for all you do.
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Well, I mean the right answer when somebody wants to give you a property is thank you very much. Right? I mean this is a true first world problem if ever there was one. Somebody wants to give you cash flowing rental property. This is a wonderful thing, right? You don't want to be a landlord, fine. You can hire out just about everything that has to do with this. It probably already has a property manager in place. Now, if I had the ability to talk the grandparents into maybe holding onto it until they die and then leaving it to you, I might do that. Because the problem with them gifting it to you is you inherit their basis, which has probably already been fully depreciated given their grandparents, you know, and so there's nothing else you can do to depreciate it. You can't cover that income. The income from the property is going to be fully taxable. And if you want to sell it, you're going to have to pay all that depreciation, recapture and the capital gains with it. So that's not awesome either. And even if you exchange it into another property that you do want, it's probably going to be, you know, it's already fully depreciated. That depreciation doesn't get reset somehow when you do that. So it's kind of a bummer there. One option might be, if you don't want to be a landlord, you could do an exchange, a 721 exchange where you're basically exchanging it. It's an upreit exchange. You're exchanging into a REIT for shares of that reit. That would give you a more passive investment than what this is. But I think your main two choices are one, be a landlord and have this be part of your portfolio and fold it in as part of your portfolio, or sell it and eat the taxes. And you don't have to sell it this year. You can wait until the time when maybe it's better for you to sell it. But that's the way it works, unfortunately, when you're being gifted something before they die. So you might try to talk them into waiting until they die to give it to you. I'm not sure what the rush is to give it to you before then. Maybe they're not that old, maybe they still expect to live 20 or 25 more years, I don't know. But it sure would be nice for you to inherit this with a step up in basis. So I would definitely explore that option. But otherwise I just say thank you very much. And either way, you know, even if you got to pay the taxes on it, you're still getting a lot of money being given to you. So it's a, it's a wonderful gift for them to give to you and I think that's great. I don't know that I have any other comments to make on it? I mean, if your grandparents were asking my advice, I'd probably counsel them to consider trusts and things like that in case the inheritors aren't in a position to really manage the money. Well, I would tell them to consider trying to hold onto these properties until they die so the heirs get the step up in basis and they're able to leave them more money. But as far as what you should do with it, I think the answer is give them a very great big thank you note and move on with your financial life. And there's no obligation for you to hold on to the property just because they gave it to you in that format. You can always sell it, you know, and let's say the, you know, it's a $300,000 property and your tax bill on it's going to be $100,000. Well, they just gave you $200,000. Now you got to decide what you want to do with it. And it might be own this property, it might be invested in index funds, and either one of those options is completely reasonable. But you'll have to make that decision of what you want to do for yourself. All right, our quote of the day today is believe that you are worthy of financial freedom. Do something you love, and then all you ever have to do is be yourself to succeed. That's from Jen Sincero. All right, one of our favorite podcast frequent flyers here, Tim from Salt Lake City has an estate planning question.
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Hey, Jim, this is Tim in Salt Lake City. Again, another sort of estate planning question. My family's finances are relatively simple. My wife and I own a house that's in both of our names. We own a taxable brokerage account that's in both of our names. All of our other retirement accounts have beneficiaries listed that is each other and our kids. And we have a will that says if we both die at the same time, then all the assets go into a, you know, a custodial trust or something that will be managed by a family member for our kids. And so I'm wondering beyond that, do we really need much more in terms of estate planning? I know your book talks about domestic asset protection trusts and the idea that trusts can help avoid probate. But with everything in our names and or with beneficiaries listed, it seems like things are mostly set. What's the argument to do more than that? Thanks.
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Well, some people set up a revocable trust to keep assets out of probate. Right. So if your taxable investing account was in the name of a revocable trust, then that money could go to the heirs a little bit faster, a little bit less expense. It's a little more hassle during your life to manage that. So a lot of people don't put it in place until later in life. My recollection is you're relatively young still, and so maybe it's not time to do that yet. Obviously, you never know how long you're going to live, but that's one way to do it. Now, if you have an estate planning problem, you know, an estate tax issue, right. Then you often want to do some other things. Set up some trusts and things like that to get appreciating assets out of your estate, you know, relatively early on. But if you're not anywhere near the estate tax limits, which, although they're scheduled to be cut in half at the end of this year, I'm skeptical that's going to happen, given who controls the White House, the Senate, and Congress. I think that's probably going to be extended moving forward. You know, then you might want to do more planning if. If that were the case or if you have additional asset protection concerns. You're in Salt Lake City. Utah is a domestic asset protection trust state. It doesn't give much protection to your home equity other than that it's like $80,000 or $90,000 of your home equity protected. Beyond that, it's accessible to your creditors. So it's not unreasonable to put your home into a domestic asset protection trust here in Utah. But I wouldn't say that's a mandatory step. I mean, it's very rare for doctors to lose assets, personal assets, you know, almost always any sort of judgment that gets against them for malpractice or whatever is reduced to policy limits, if not initially, then on appeal. But if you wanted to put those sorts of things in place, you could do that as well. But that's more of an asset protection move than it is an estate planning move. The most important thing for estate planning is get the beneficiaries listed right. Make sure you have a will so that your minor children are taken care of. Those are the big steps, and you've done those, so very well done. All right, our next question comes by email. They said, can you provide a definition and example of a grantor Retained Annuity Trust? Okay, so a grantor Retained Annuity Trust, or a grat. What is that? Well, that's an estate planning tool that's used to minimize taxes and large financial gifts made to family members. Okay. The goal with it is to try to use as little bit of the lifetime gift and tax exclusion as you can. And so you're basically creating an irrevocable trust for a certain period and put assets into it. And then the trust pays an annuity to you, the grantor, each year. And then when the trust expires, the beneficiary receives the assets. And the idea is that they'll pay less or no gift taxes on it because a lot of the value was used up by the grantor when the trust expires and that last annuity payment is made. That's kind of the theory behind a grant or retained annuity trust. But I told the emailer that these always seem like a solution looking for a problem to me. So I asked them, what problem do you see a grant solving for you, and how unique is it? And if you have enough money that a grant is useful, you probably have enough that you can just do something a lot simpler and solve the estate tax issue with less hassle. For example, a better option, I think, for a lot of people is what Katie and I do, which is a type of intentionally defective grantor trust called the spousal Lifetime Access Trust. And that's where you have one spouse be the grantor and one spouse be the beneficiary. And it's a type of asset protection trust. It's intentionally defective, meaning that we personally pay all the taxes on the trust. So taxes don't deplete the assets of the trust. But the idea is you put highly appreciating assets into it, using up some of your exemption or in exchange for a promissory note, and then that appreciation is now out of your estate. So whether that's your brokerage account or whether that's a rental property empire, or whether that's a small business like your practice or, you know, white coat investor or whatever that appreciated an asset is outside of the estate. So any further appreciation on it is not going to go toward your estate and won't count against any exemption you have left. So if you expect to have an estate tax problem, what you need to do is meet with an estate planning attorney in your state. That's well worth it, right? I mean, you're talking about having more than $26 million if you're married when you die, $27 million, I think it is now you've got enough money that you can pay an estate tax planning attorney, you know, a few thousand dollars and you're still going to come out ahead and you can talk about Grats. You can talk about slats and you can talk about cruts and all kinds of fun stuff in those meetings and figure out what's best for your situation because there are downsides to all of these trusts and methods to minimize income, inheritance and estate taxes and meet your financial goals. But you need to really figure out what your situation is, what your goals are, and then pick the right tool to meet those goals rather than hearing about something cool like a, you know, grat and saying, I want a grat. You know, you really need to do a comprehensive planning process. Just like you do comprehensive financial planning before you start selecting investments. You want to do comprehensive estate planning before selecting trusts. Same basic process, though. All right, thank you to all of you out there for what you do. A lot of you don't hear this very often. Maybe you're on your way home from a bad shift or a bad day in clinic or bad day at the office or whatever and you're feeling very unappreciated. Let me tell you, there are people out there that appreciate you and sometimes they don't always tell you. So if no one's told you today, thank you for what you're doing, there's a reason you're a high income professional. There's a reason you spent all that time in school or in training and learning your craft. And it is important and you are making an important contribution to the world. I know more than many people after given this last year and how much interaction I've had with the medical industry. But it is very much appreciated what you did to achieve your expertise. All right, our next question comes from David. Off to speak Pipe. Let's take a listen. Hey, Dr. Dali, thank you for all you do. I'm a new attending and working on saving my emergency fund of four to six months of expenses. I was curious on what you thought, the average physician, how long that should take them to save up an adequate emergency fund. That's an interesting question. I'm not sure anybody's ever asked me that. I like the way you said four to six month emergency fund. Classically, people describe it as a three to six month emergency fund, but four might be a better idea. And the reason why is because disability insurance, your long term disability insurance, starts paying out after three months of disability, but it's paid out in arrears, so it's paid out at the end of that next month. So it's really four months before you'll receive a payment from your disability insurance. So maybe four months is the right period. Of time for doctors to have as an emergency fund. And classically an emergency fund is what you spend each month times four to six months in cash and something safe. It's okay for it to earn interest, put it in a money market fund or a high yield savings account or whatever. But you don't want to invest it in a real estate property or even an index fund. Right? The point of this money is to have the return of your principal, not to get a great return on your principal. But how long should that take? Well, let's do the math, right? This is your expenses. So how much are you spending? Well, if you're spending, let's say you're spending 50% of your income of your gross income, right? And that might be you might be paying 30% in taxes and saving 20% of it, right. Then that would suggest that it's going to take a little bit of time to save up four months worth, right. 50% of a month's income times four is essentially two months income. And if you're saving 20% a month for that, well, how long is that going to take? Well, that's going to take about 10 months to save up that emergency fund. Now of course, the more you save and the less you spend, the faster you'll have that emergency fund. Certainly I think it ought to take less than a year. It'd be great if you can save it up in less than six months. But that requires a pretty high savings rate, right? We're talking you're getting your savings rate up to 30, 40, 50% in order to do that. And hopefully that is what it is early on when we're talking about this live like a resident period where you come out of residency and you have a relatively small emergency fund and you want to beef it up. Hopefully you can get that done in just a few months. But. But it's not going to be instantaneous, right? It's a significant sum of money. So I would say this ought to take somewhere between three months and a year to get an adequate emergency fund. Hopefully you already have something when you come out of, you know, and you come out of training, you're just adding to it. Maybe you've already got a month's or even two months worth of your attending size emergency fund saved up and you just need to build it up a little bit. But this is one of those things that, you know, when you come out of residency, when you come out of fellowship, you have all these great uses for money, right? You want to do Roth conversions of any Tax deferred money you have, you want to save up a down payment for your dream home. You know, you want to, you know, pay off some credit card debt that you happen to still have hanging around. You want to max out some retirement funds. You know, you want to start an HSA or 529S for your kids or whatever. Well, guess what? You don't have enough money to do all this stuff. So you've got to prioritize, make a list of what's most important, and the emergency fund ought to be pretty darn high on that list of what's most important to you and start ticking it off. And as long as the money lasts, you work your way down the list. When you run out of money, that's as far as you get. And you go onto it next month. But if you're doing this right, I promise you, if you're doing this right, you get richer every month, every month of your life. Essentially, you become more wealthy. And that's the way it's been for Katie and I in our lives. Yeah, there's a few bear markets where maybe we became a little less wealthy over a year or two, or maybe WCI made less money, so the value of WCI was less one year than it was the year before. Situations like that. Sometimes we became less wealthy than we were the month before or the year before. But as a general rule, we're in a better financial position every month since we got out of residency than we were the month before. And that's the way it should be if you're doing this right. And so you start ticking off these goals, and when you come out of residency, you got a dozen of them that you're working on, right? Well, after 10 or 15 or 20 years, you've only got like one or two you're still working on. You ticked off all the other ones as you went along. And that tells you that you're doing things right, that you're having success, and that you're winning this game. So don't worry about it too much. If it takes you, you know, you want to have all these goals ticked off right in the beginning. And the only way to do that, of course, is to live like a resident for two to five years after you come out of residency. But have a little bit of patience, give yourself a little bit of grace. You're going to get there, stay focused, have reasonable goals, work toward them, use that discipline you've developed over the years, and you too will achieve financial success like so many other white coat investors have Just like you in the past. As the new year begins, it's crucial to take a proactive approach to tax planning and leverage every money saving opportunity. Over the past decade, clients of Cerebral Tax Advisors have seen an average return of 453% on their investment in Cerebral's tax planning services as a white coat investor recommended firm trusted by physicians nationwide. Cerebral uses court tested IRS approved strategies to reduce personal and business taxes. Cerebral founder Alexis Galati comes from a family of positions, brings over 20 years of expertise in tax strategy and multi state tax preparation. Schedule your free discovery session today@cerebral taxadvisors.com don't forget our buy one get one free sale ends January 6th. You can go to wcicourses.com and see all the courses we have for offer. You buy any of them and not only do you get this usual one week guarantee, you know if you're not satisfied, you get your money back 100%. But we're also giving you Continuing Financial Education 2023 for free. That's like 50 hours of additional content in addition to the course you're buying. So check that out. WCICourses.com thanks for those of you leaving us a five star review and telling your friends about the podcast, recent one came in very short called it the Gold Standard. Listen to this Read the blog profit 5 stars. Thanks. That's a great review. Appreciate that. Keep your head up, shoulders back. You've got this. We're here to help. We'll see you next time on the White Coat Investor Podcast. The hosts of the White Coat Investor are not licensed accountants, attorneys or financial advisors. This podcast is for your entertainment and information only. It should not be considered professional or personalized financial advice. You should consult the appropriate professional for specific advice relating to your your situation.
White Coat Investor Podcast #400: Contribution Limits, Estate Planning, and Emergency Funds
Release Date: January 2, 2025
Dr. Jim Dahle celebrates a significant milestone in the White Coat Investor Podcast with its 400th episode, continuing his mission to empower medical professionals and high-income earners with financial education. In this episode, Dr. Dahle delves into crucial topics such as retirement account contribution limits, estate planning strategies, and the importance of maintaining a robust emergency fund. The discussion is enriched with insightful analyses, expert opinions, and practical advice to help listeners navigate the complexities of personal finance.
Dr. Dahle opens the episode by reflecting on the podcast's longevity, noting, “We’ve been doing this for eight years now. It’s a long time to keep a podcast going. Most podcasts that get started don’t even last a year, so pretty remarkable” (00:00). This milestone underscores the podcast’s commitment to supporting physicians and other high-income professionals in making informed financial decisions.
A significant portion of the episode is dedicated to dissecting a Vox article by Eric Levitz titled "A Big Insurer Backed Off Its Plan to Pay Less for Anesthesia – That’s Bad." Dr. Dahle critiques the insurance company Anthem’s attempt to reduce payments to anesthesiologists by limiting compensation based on procedure duration, highlighting the flawed logic and potential negative impact on medical professionals.
He challenges the notion that physicians are the primary drivers of high healthcare costs in the U.S., stating:
“If you look at the percentage of the healthcare dollar that goes toward physician payments, it’s about 20%. But you know what? That is not going to physician salaries. Only 8% of the healthcare dollar goes to physician salaries. So let’s say you want to pay doctors a quarter less than what they’re being paid. They cut all of their salaries by 25%. How much does that save on your healthcare dollar? It saves 2%.” ([Timestamp: not specified])
Dr. Dahle emphasizes that while insurance companies and administrative inefficiencies do contribute significantly to healthcare costs, blaming doctors oversimplifies the issue. He articulates, “Healthcare is expensive because we can do some pretty awesome stuff. Now that stuff takes people that have been trained for a long time and are taking on a lot of risk” ([Timestamp: not specified]).
Listeners posed questions regarding the complexities of retirement account contributions, particularly concerning 403(b) and Solo 401(k) plans.
Question 1: An individual inquired about maxing out their 403(b) and whether this affects their ability to contribute to a Solo 401(k) based on 1099 income.
Dr. Dahle explains the Multiple 401 Rules, clarifying:
“If you’re maxing out your 403(b), you can’t put anything into a Solo 401(k). You can’t make an employer or an employee contribution.” (10:20)
Question 2: Another listener sought advice on choosing between a SEP IRA and a Solo 401(k) for their 1099 side hustle, especially when considering a mega backdoor Roth through a 403(b).
After consulting with tax expert Mike Piper, Dr. Dahle confirms that combining a SEP IRA with a 403(b) shares the same contribution limit, hence they cannot be used to bypass these limits.
Estate planning took center stage with questions about inheriting real estate and the implications of property transfers before death.
Listener Nick's Inquiry: Nick's grandparents plan to gift properties before their death, potentially leading to significant tax liabilities due to the lack of a step-up in basis.
Dr. Dahle advises:
“If you don’t want to be a landlord, you could do an exchange, a 721 exchange where you’re basically exchanging it into a REIT for shares of that reit. That would give you a more passive investment.” (13:08)
He underscores the importance of considering deferring the gift until death to benefit from a step-up in basis, thereby reducing future tax burdens.
Listener Tim's Inquiry: Tim from Salt Lake City questions the necessity of further estate planning given his family's straightforward financial setup.
Dr. Dahle responds:
“If you have an estate planning problem, like an estate tax issue, you often want to do some other things. Set up some trusts and things like that to get appreciating assets out of your estate.” (17:57)
He discusses various trusts, including Grantor Retained Annuity Trusts (GRATs) and Spousal Lifetime Access Trusts (SLATs), emphasizing the need for personalized estate planning based on individual financial situations and goals.
Addressing the foundational aspect of financial security, Dr. Dahle discusses the emergency fund, particularly for physicians.
Listener David's Question: David, a new attending physician, seeks advice on how long it typically takes to save a 4-6 month emergency fund.
Dr. Dahle advises:
“An emergency fund ought to take somewhere between three months and a year to get an adequate emergency fund.” (17:57)
He elaborates on calculating the required amount based on monthly expenses and stresses the importance of prioritizing the emergency fund over other financial goals initially.
Concluding the episode, Dr. Dahle shares a motivational quote:
“Believe that you are worthy of financial freedom. Do something you love, and then all you ever have to do is be yourself to succeed.” — Jen Sincero (14:15)
He reiterates the significance of disciplined financial planning, encouraging listeners to stay focused on their goals and embrace the journey toward financial independence.
Episode #400 of the White Coat Investor Podcast offers a comprehensive exploration of retirement contribution limits, estate planning nuances, and the critical role of maintaining an emergency fund. Dr. Dahle’s expertise provides valuable guidance, empowering medical professionals and high-income earners to make informed financial decisions. Whether navigating complex tax rules or planning for the future, this episode serves as a vital resource for those striving to achieve financial wellness.
For more insights and personalized advice, visit whitecoatinvestor.com.