When purchasing individual disability insurance, it is important to meet with an independent agent who can sell you a policy from any of the “big six” insurance companies, Guardian (Berkshire), Standard, Metlife, Ameritas, Principal, and MassMutual. One of the reasons for this is that for your state, gender, and especially specialty, one company's policy may be much cheaper than a similar policy offered by another company.
Your specialty, or occupational class, is one way in which these companies stratify the financial risk they are taking insuring you. As a general rule, procedurally oriented doctors, such as surgeons and dentists, are in a lower (meaning more expensive) occupational class than a non-procedurally oriented doctor. However, as you compare the occupational classes across the various companies, you occasionally see a discrepancy, where a particular specialty is in a higher or lower occupational class than you might expect. For a doctor shopping for disability insurance, you would want to give special consideration to a company's policy which placed you in a higher classification than the other companies did.
It becomes difficult to compare apples to apples, however, because while most companies use occupational classes 3,4, and 5 for physicians, two of the companies, namely MetLife and Ameritas, put doctors in classes 4, 5, and 6. It is probably best to subtract a class from those two companies when making comparisons. Principal uses just 4 and 5 for doctors.
Some Big Caveats
This information was current when I wrote this post (August 2014) but will rapidly become out of date as companies change these classes from time to time. Plus, I may have made a mistake transcribing them. Also, where you see a blank spot in the chart, don't assume they don't offer a policy for that occupation. I simply didn't have the information, so I left it out. This information, while hardly secret, is generally considered “for producer use only” and not for public consumption. But hey, isn't lifting the hood on how the industry really works what this blog is all about? At any rate, you can't, and shouldn't, buy a policy without involving an agent, so you might as well get a knowledgeable independent one to help you compare policies. Now, without further ado, the list of specialties with their associated Occupational Class.
| Specialty | Guardian | Standard | MetLife | Ameritas | Principal | MassMutual |
| Nurse practitioner | 3M | 3A,4P | 4M | 5M | 3A | 3A |
| Physician Assistant | 4M | 3A, 4P | 5I | 5M | 3A | 3A |
| CRNA | 3M | 3P | 4M | 3M | 3A | 3A |
| Allergy | 4M | 4P | 6M | 6M | 4M | 5P |
| Anesthesia | 3M | 3P | 4M | 4M | 4M | 3P |
| Cardiology | 4M | 4P | 5M | 5M | 4M | 5P |
| Interventional cardiology | 4N | 4P | 4M | 5M | 4M | 3P |
| CV Surgery | 3M | 3P | 5M | 4M | 4M | 3P |
| Dentist | 3M | 3P | 4M | 4M | 4M | 3P |
| Dermatology | 4M | 4P | 5M | 6M | 4M | 4P or 5P |
| Emergency Medicine | 3M | 3P | 4M | 4M | 4M | 3P |
| Endocrinology | 5M | 4P | 6M | 6M | 5M | 5P |
| Endodontists | 4M | 4P | 5D | 5M | 4P or 5P | |
| Family Medicine | 4M | 4P | 6M | 6M | 5M | 5P |
| Gastroenterology | 5M | 4P | 6M | 6M | 5M | 4P |
| General Practice | 4M | 4P | 6M | 6M | 5M | 5P |
| Geriatrics | 5M | 4P | 6M | 6M | 5M | 5P |
| Gyn Onc | 3M | 3P | 4M | 6M | 4M | 3P |
| Hematology | 5M | 4P | 5M | 6M | 5M | 5P |
| Hospitalist | 5M | 4P | 6M | 6M | 5M | 5P |
| Immunology | 4M | 4P | 5M | 5M | 5M | 5P |
| Internal Medicine | 4M | 4P | 6M | 6M | 5M | 5P |
| Neonatology | 5M | 4P | 6M | 5M | 5M | 5P |
| Nephrology | 5M | 4P | 6M | 5M | 5M | 5P |
| Neurology | 4M | 4P | 6M | 6M | 5M | 5P |
| Neurosurgery | 3M | 3P | 5M | 4M | 4M | 3P |
| OB/GYN | 3M | 3P | 4M | 5M | 4M | 4P |
| Oncology | 5M | 4P | 6M | 5M | 5M | 5P |
| Ophthalmology | 4M | 4P | 5M | 5M | 4M | 3P |
| Oral Surgery | 4M | 3P | 5D | 4M | 4M | 4P |
| Orthodontist | 4M | 4P | 5D | 5M | 4M | 4P |
| Orthopedics | 3M | 3P | 4M | 4M | 4M | 3P |
| Otolaryngology | 3M | 4P | 5M | 5M | 4M | 4P |
| Pain Medicine | 3M | 3P | 4M | 4M or 5M | 4M | 3P |
| Pathology | 4M | 4P | 5M | 6M | 5M | 5P |
| Pediatric Dentist | 4M | 4P | 5D | 5M | 4M | 4P |
| Pediatrician | 5M | 4P | 6M | 6M | 5M | 5P |
| Periodontist | 4M | 4P | 5D | 5M | 4M | 4P |
| Physiatry | 4M | 4P | 6M | 5M | 5M | 5P |
| Plastic Surgery | 3M | 3P | 5M | 4M | 4M | 3P |
| Podiatry | 3M | 3A, 2P | 2M | 3A | 4P | |
| Prosthodontists | 4M | 4P | 5D | 5M | 4A | 4P |
| Psychiatry | 4M | 4P | 4M | 5M | 5M | 5P |
| Pulmonology | 5M | 4P | 5M | 5M | 5M | 5P |
| Rad Onc | 4M | 4P | 5M | 5M | 5M | 4P |
| Radiology | 4M | 4P | 5M | 6M | 5M | 5P |
| Interventional radiology | 4M | 4P | 4M | 5M | 4M | 4P |
| Rheumatology | 5M | 4P | 6M | 6M | 5M | 5P |
| General Surgeon | 3M | 3P | 5M | 4M | 4M | 3P |
| Urology | 4M | 4P | 5M | 5M | 4M | 4P |
A Few Unique Situations
Let's take a look at a few of the current discrepancies that might be useful for you.
Nurse Practitioners
The 5M class with Ameritas is markedly better than the 3M, 3A classes available by the other two companies. Be sure to include an Ameritas policy when shopping.
Allergy
Principal and Mass Mutual will put you in a higher classification than the others.
Anesthesia
Principal offers a higher occupational class than the other companies.
Cardiology
MassMutual offers a higher occupational class than the other companies, but not if you do interventional cards
Cardiovascular Surgery
Might want to avoid Principal given that it thinks you're higher risk than the other companies do.
Hike it like you stole it!
Mt. Timpanogos, UT
Dermatology
You get the highest classification only with Ameritas.
Emergency Medicine, Neurosurgery, Orthopedics, Pain Medicine, and Plastic Surgery
These doctors are usually put into the riskiest class (3 or 4 depending on the company.) But they can often get a little cheaper policy with Principal since their lowest doctor class if 4.
Endocrinology, Geriatrics, Hospitalists, Hematology, Oral Surgery, and Pediatrics
Might want to avoid Standard, which seems to think you're higher risk than everyone else does.
Family Practice, Immunology, Neurology
Beware Guardian and Standard
Gastroenterology
Beware Standard and Mass Mutual
Internal Medicine
Might want to avoid Guardian, Standard, and Metlife
Neonatology and Nephrology
Might want to avoid Standard, Metlife, and Ameritas
OB/GYN
Ameritas, Principal, and MassMutual put you into a relatively attractive occupational class compared to the others.
Oncology
Might want to avoid Standard and Ameritas
Ophthalmology
Anything but MassMutual.
Otolaryngology
That Guardian policy that you always hear “has the best benefits” is going to cost you even more to get compared to a rival policy.
Pathology
Ameritas, Principal, and Mass Mutual are worth looking at.
Physiatry
MetLife, Principal, and Mass Mutual think you're lower risk.
Podiatry
Mass Mutual seems a great place to start looking.
Psychiatry
Principal and Mass Mutual rank you one class higher than the others.
Pulmonology
Take a special look at Guardian, Principal, and Mass Mutual.
Radiology
Ameritas and Mass Mutual seem particularly attractive, especially if you don't do any interventional work.
Rheumatology
Might want to avoid Standard and MetLife
General Surgery
MetLife and Principal ought to be included in your search.
Conclusion
Disability insurance is complicated stuff. There is a lot more to buying a policy than just which occupational class the company assigns you to. However, this little exercise should give you a little more understanding into why a good agent might not even bother showing you policies from particular companies. It also demonstrates that there is no “best policy,” just the best one for your desired coverage, state, gender, health status, and specialty. Shop carefully my friends.
What do you think? Did anything in this table surprise you? Why or why not? Which company did you buy your policy from? Comment below!
Loading ...
Thank you for posting this! It is important to note that occupational class is determined at the time of application, not at the time of claim. Also, if you will change occupational classes in the future, it may change your premium for future purchases.
For example, if you purchase your policy while practicing general pediatrics or internal medicine, the policy will be issued based on that class, as will pricing. If you later do a sub specialty such as cardiology, the policy will pay you if you can’t work in that sub specialty (cardiology) even if your premiums are based on the original specialty (internal medicine).
When you go to increase the policy as a cardiologist, most companies (with the exception of Principal) will issue a new policy for the increase based on the new occupational class. The Principal policy is adjustable so you would be paying rates based on the original class (pediatrician).
Dr. D,
You’ve mentioned buying own occupation while in residency prior to practicing a lower classified specialty. Do you or any of your readers know if a new policy needs to be written up if one leaves practice in one state to practice in another, such as training in residency in Massachusetts, then moving to Colorado to set up shop?
Thank you. Insurance is definitely a domain where you have ‘lifted the hood’ on my knowledge gaps.
To answer your question, you do not need to change your policy if you move to a different state. The policy is issued in the state where you preside at the time of purchase. When you increase the policy in a different state, the premiums may be slightly different.
This is an extremely helpful article. We went with Principal (Emergency Medicine), and will suggest that if you can, and the firm offers it, try to get group or “multi-life” disability, which allows you to pair up with two other docs, apply as a group of three, and receive significant discounts in premium (women receive greater discount than men, but it still makes sense for everyone if they can do it). This percentage decrease in premium, which we locked in now during residency, applies to the entire term of the policy, even as the policy ramps up during attending life.
Yes, that option was discussed in this post here:
https://www.whitecoatinvestor.com/high-quality-disability-insurance-at-a-discount-through-principal-guest-post/
As stated before, an occupational classification is only one aspect of a policy and, multi-life discounts, association discounts and Berkshire’s Preferred Occupation Discount (POD) can significantly change premium rates normally associated with an occupation class.
Therefore, some companies that might consider your medical specialty less favorable may actually look much better if any of the above discounts apply.
At the end of the day, it is all about doing your homework and making a decision based upon your individual needs, goals and budget. For this reason, it is always a good idea to “shop” the market to make sure you are making a well-informed, educated decision and the agent or broker you are working with has given you “informed consent” so you can feel good about your purchase.
I agree with Larry as far as doing homework. When I was going through my options, I emailed Jim who pointed out a simple point: the whole key is to have something in place.
Going through too many details and price squabbling (premium squabbling) eventually hits a point of diminishing return that you just have to get a policy from the big 6. Having my policies now, I would recommend the above agents’ recommendations. At the same time, I don’t really think twice as to whether my policy is better or worse than the other options (or even more expensive)
I know I have a policy in place with the riders that Suit me. And so I sleep.
For Internal Medicine, you would should not avoid MetLife as they receive the top occupation class (6M) and additional discounts are available. Guardian also recently added a Preferred Occupation Discount (POD) of 10% to that specialty.
MetLife works very well for Nephrologists as they are now in the top occupation class of 6M and additional discounts are available..
Podiatrists should look at MassMutual, as well as, Berkshire. These two carriers offer true “Own-Occupation” to this occupation for the entire benefit period while the others do not.
Pulmonologists are also class 6M with MetLife so they should definitely be added to the carriers to consider. Again, additional discounts are available.
Radiologists should look at Guardian – especially if they have been out of training for 5 years or more as they then qualify for occupation class 5M. Additionally, if they are Interventional Radiologists, Ameritas, Standard and Berkshire do not treat them less favorably compared to Diagnostic Radiologists.
Rheumatology should also consider MetLife as they are also now occupation class 6M.
This marketplace changes fast and sometimes the reference guides and not updated as quickly as change notices are distributed to agents. My posts below address some of the occupation class changes:
https://www.whitecoatinvestor.com/updates-in-the-disability-insurance-marketplace-part-3/
https://www.whitecoatinvestor.com/updates-in-the-disability-insurance-marketplace-part-8/
Thanks for the updates.
I recently purchased a MetLife policy as an Internal Medicine resident under which I am classified as 6M (also mentioned on in Larry Keller’s DI Updates Part 5 on this site), which actually made them the least expensive policy I was offered out of the Big 6. In any case, I would not dismiss any of the companies out of hand as the class each occupation is assigned to changes often, and the data you find online is often significantly out of date.
I had a policy under Ameritas. Last year they finally joined the rest of the industry in risk stratifying men and women separately. Since women are more expensive to insure, that means new application rates for men dropped (and for women, rose).
For me, as I was considering exercising a future increase option this year, it was actually cheaper to get a new policy with the new rates (since I’m a man and not much older than when I got the initial policy) than to exercise the option on the old policy, YMMV but it may be worth a phone call.
It’s not so much that Ameritas lowered their rates.
They had two discount pals available. One was a multi-life discount with 15% off of unisex rates.
The other was a 15% discount off of gender neutral rates.
Since they both had the same percentage discount, if one was given a choice, the men would use the association discount (to “net” the full 15%) and the women would take advantage of the multi-life discount (to save 40-50%) with unisex rates.
Another one to avoid is Standard if you are an Anesthesiologist purchasing coverage under their Protector Platinum policy series as you are classified as a 2P. This specialty carriers a 25% surcharge compared to all of the others. This is due to the full coverage for claims related to mental/nervous and/or substance abuse disorders.
The exception would be a Pain Management Physician as they are classified as a 3P occupation.
Pharmacist is not mentioned? What company/riders would one need to look for?
The occupational classes for Pharmacists are as follows:
Berkshire: 5M
MetLife: 6S
Ameritas: 6A
Standard: 5A
Principal: 5A
MassMutual: 3A (if retail) 4A (if clinical)
Pharmacists and veterinarians were not mentioned. For both, it pays to shop around and spreadsheet all of your options. Similar to the above mentioned, look for a policy that will cover you in your occupation, covers partial (residual) disabilities and allows you to increase benefits in the future without further medical underwriting.
I should also add the MetLife just upgraded Non-Invasive Cardiologists to class 6M this month. This makes them extremely competitive for this occupation and should be strongly considered.
Could someone provide up to date occupational class for Physician Assistant. TY
Principal – 4AM
Berkshire (Guardian) – 4M
Standard – 4P
Ameritas – 5M
MassMutual – 3A
Could anyone please provide an up to date list for Nurse Practitioner that includes Ameritas?
Best way to get up to the minute info is to call an independent agent:
https://www.whitecoatinvestor.com/websites-2/insurance/
I’m also wondering if being a Psychiatric Nurse Practitioner, as apposed to any other type of nurse practitioner, accounts for anything. I essentially function exactly as a Psychiatrist for all intensive purposes. I saw in this article https://www.whitecoatinvestor.com/updates-in-the-disability-insurance-marketplace-part-10/ that Ameritas has Psychiatrists/Psychologists (with a PhD) classified as 6M if using the EZ App process. I’m wondering if I fall into this category being that Psychiatrists/Psychologists are my colleges. Could I please see an updated occupational class for a Psychiatric Nurse Practitioner?
No. You would be viewed as a Nurse Practitioner (Psychiatric or otherwise). If you want to chat, I would be happy to help you. There are more variables that go into what is the right policy for you besides occupation class.
Larry
In any case, here are the occupation classes
Principal – 4AM
Berkshire (Guardian) – 3M
Standard – 4P
Ameritas – 5M
MassMutual – 3A1 (for Radius Choice)
What are the occupational classes for Gyn Onc? I’ve gotten quotes from multiple agents and the occupational classes are all over the place.
I bet some companies lump it in with OB/GYN and others see it as a separate occupation. That probably explains the distinction. Either way, get quotes from each company from an independent agent and take the best deal.
To clarify, the quotes I’ve received had different occupation classes for the same company, depending on the agent. For example, one agent would have Principal as 4A-M, another agent would have Principal as 3A-M, etc. Something is amiss. Does anyone know what’ll happen if I were to go with the cheapest policy but it ends up having the wrong occupation class?
I’ve run into a similar situation- I have seen policies from MassMutual offered from two different agents- one who classified my specialty (Urology) as 4P as in the chart above, and one that had me listed as 5P. The one who classified me as 5P is also offering a discount associated with my residency program which makes the quote significantly cheaper for what appears to be the same policy ($246 vs $151 per month for $5k benefit). The $151 quote I received was similar to the lowest premium offered by the other agent (with Principal), so don’t think the total price is out of line but it still seems strange that the same policy would vary so wildly between two agents… Riders appear to be the same, Radius choice plan.
I asked the 5P agent how this was possible and he responded that through his discount program he also has access to an “occupational class upgrade” which explains the difference and allows him to offer an even lower rate (in combination with his program discount). Any agents out there who can say if an occupational class upgrade that may be available to some agents but not others is a legitimate thing or should this be a red flag?
Interesting. I haven’t heard of that one. But I’d take it if it was offered!