By Travis Christy, White Coat Insurance
Guaranteed Standard Issue disability insurance (GSI) might sound like a mouthful, but it's actually a pretty neat type of disability insurance.
GSI policies are specifically designed to protect your most valuable asset: your ability to earn a paycheck in the event of sickness or injury. They’re also easy to qualify for, requiring little to no underwriting. You’ll find these plans in many resident physician programs across the country, and when purchasing disability insurance, they should be considered. Even if you've battled things like cancer, heart issues, or past injuries that could usually put you in the “disability insurance declined” category, GSI has your back. Even if no prior health conditions exist, GSI should be looked at as an option because of how easy it is to qualify for.
What Is Covered By Disability Insurance?
Disability insurance—including GSI, individual disability, and group disability—is all about making sure you've got cash coming in if you can't work due to sickness or injury. Even if you still can work but see a drop in income—or you become partially disabled—your disability policy can kick in. It usually covers around 60% of your income, but in some cases, when combined with group disability, that percentage can go up.
Why Is Disability Insurance So Important?
There are several important reasons to consider disability income protection as a physician in practice or training. An essential question to ponder is whether you could comfortably retire tomorrow if circumstances demanded it. If the answer is “no,” then disability insurance becomes a necessity rather than a mere luxury. Becoming disabled is really a type of “forced retirement.” This holds true even if your annual income reaches the mid- to high-six figures, as disability income protection remains crucial.
The statistics are worth noting: according to the Council for Disability Awareness, there's a 1 in 4 chance of experiencing a disability during your working years, making it more common than you might expect (other statistics say that 1 in 7 doctors actually become disabled during their career). This is why disability insurance has higher premiums compared to life insurance; it's because it's more likely to be used. As a result, insurance companies typically review your medical history carefully when deciding whether to offer coverage.
What Is the Difference Between GSI, Individual, and Group Disability Coverage?
One may ask what the differences are between group disability insurance, individual disability, and Guaranteed Standard Issue disability insurance. In essence, group disability insurance is for employees or members of organizations with limited customization. It is guaranteed coverage generally paid for by the employer and doesn’t offer the ability to take the coverage with you if leaving for other employment opportunities. On the other hand, individual fully underwritten disability insurance is highly customizable, and it offers portability and individual ownership. Fully underwritten disability insurance requires medical and financial review, and it may come at a higher premium.
GSI disability insurance aims to bridge the gap, offering accessibility to those with pre-existing conditions while providing some customization (though not to the extent of individual insurance). It is also portable, which means it can be moved from one employer to another. Each type of disability coverage has its advantages and should be selected based on individual needs and circumstances.
GSI Options Available for Practicing Physicians
Under specific circumstances, practicing physicians can access Guaranteed Standard Issue (GSI) disability insurance. It is also referred to as Multi-Life Guaranteed Issue disability insurance. This form of coverage typically requires the participation of a group of physicians, often affiliated with the same medical practice or institution. Usually, having group disability insurance already in place is a prerequisite for GSI consideration for practicing physicians. Insurance providers are more likely to support a GSI plan when there is a substantial number of eligible participants representing a diverse array of medical specialties, helping to distribute the risk.
For medical groups with more than 20 but fewer than 75 eligible participants, insurers may require full participation, which is often covered financially by the company or employer. Conversely, for larger groups with over 75 members, carriers may allow voluntary coverage, contingent on a minimum percentage of eligible individuals enrolling.
What's so great about GSI? Let's break it down:
- No medical underwriting: With GSI, there's no need for a medical exam. It's a breeze for those with a history of medical conditions, and it may be a smart option for those without medical conditions to consider.
- Group pricing perks: GSI usually comes with group pricing, which can mean cheaper premiums. In many instances, GSI policies cost less than fully underwritten policies.
- Full package: GSI plans often offer almost all the features you'd find in traditional plans with medical underwriting—with just a few differences and limitations.
- It goes where you go: GSI plans are like a trusty sidekick. You can take them with you even if you switch jobs.
GSI has its drawbacks too:
- Less customization: You might not have as many choices with GSI disability insurance compared to individual fully underwritten disability insurance. Some features available through traditional underwriting may not be available under a Guaranteed Issue plan. Examples of features not available would include retirement protection, higher cost of living riders, and catastrophic disability coverage.
- Group risks: Your rates and coverage depend on the group's health/occupational profile. GSI can make coverage more accessible and cost-effective, but it may come with standard terms and limitations for the entire group.
- Some limits: GSI policies could have limitations, especially when it comes to mental health and substance abuse risk.
How Much Does GSI Disability Insurance Cost?
The cost of GSI depends on various factors like the provider, policy, and your group's health profile. While it's usually cheaper, the exact price varies based on your situation and the coverage you pick. Generally, GSI plans will be less expensive than fully underwritten options. You’ll want to check with one of our trusted advisors to find out what’s available.
Does GSI Disability Insurance Have Riders?
You can customize your GSI policy with different disability insurance riders. These are important additional features for your policy. One example is a cost-of-living rider, which adjusts monthly benefits to keep up with inflation. Partial disability coverage is another rider that protects someone in the event that it is possible to still work but only on a part-time basis or if that person experiences a drop in income due to sickness or injury. In addition, other riders—such as student loan protection and future insurability options—can be added to a GSI plan. The availability of these extras depends on your provider and policy.
Where to Buy Guaranteed Standard Issue Disability Insurance
You’ll find GSI disability insurance programs in many resident physician programs across the country. While not all resident programs may have a GSI disability plan available, it’s worth checking with an advisor to see. To see what is available, reach out to one of our disability insurance partners.
Some practices may offer GSI disability. If your employer doesn’t have an existing GSI plan, check with one of our recommended partners to see about setting one up.
Who Should Buy Guaranteed Standard Issue Disability Insurance?
GSI is something every eligible person should consider when purchasing disability insurance. For those in residency—whether you've got a pre-existing condition, a risky job, or a clean bill of health—GSI disability insurance can be a lifeline to keep your finances afloat during a rough patch.
Do You Need to Buy GSI and Traditional Disability Insurance?
It really depends on your specific situation and financial goals. GSI disability insurance and traditional disability insurance serve the same purpose: to protect income in the event of sickness or injury. GSI insurance is typically easier to qualify for, making it a good option for individuals with pre-existing health conditions and those who want to get coverage quickly. On the other hand, traditional disability insurance may offer more flexibility and customizable coverage, but it will require a more thorough underwriting process. If you have a stable health history and want tailored protection, traditional insurance might be the way to go. You can even consider doing both GSI and a traditionally underwritten plan. Ultimately, it's about assessing your needs, budget, and personal circumstances to decide which type of disability insurance suits you best. The most important consideration is to get something in place before a disability occurs.
Disability insurance, including GSI, is your trusty sidekick in the insurance world, ready to back you up. It's like a financial safety net that's there when you need it most. GSI may be the right choice for you if you're dealing with health hurdles or just want an easier underwriting process.
Have you used or do you currently use GSI disability insurance? Have you been satisfied with that plan? What else should people know about GSI disability insurance? Comment below!
Are there ever any instances where it would be appropriate for a resident to wait to get disability insurance until the end of their training? Or is it recommended to get as soon as possible after starting residency? Thank you.
The benefit of waiting is you save those premium payments. There are lots of downsides, the main one being residents get disabled all the time. So I recommend you buy it as soon as you start residency.
Thanks for all the great information.
Dose anyone know if the University of Louisville has a GSI plan
Yes, there is an Ameritas GSI plan there. I can help you with it.
Feel free to call or send an email to [email protected]
Larry
Most major residency programs provide group disability insurance so even with the contractual limitations of group policies at least there is some protection in the event of disability. A more critical issue is that due to the stress and lifestyle of residents/fellows a medical issue may develop that limits or eliminates the possibility of qualifying for individual coverage at the end of training. Since Guarantee issue individual disability insurance protects against this occurrence it is the only situation in which it may be advisable to wait until the last year of training to establish disability coverage
GSI is available at UPMC – all hospitals and all medical training programs (including T32). Also available for GME dental residency.
GSI is available at Allegheny Health Network (AHN) for medical trainees.
Thanks for your input. Welcome any others who have GSI programs to contribute as well. Would like to make this the first place residents/fellows visit when they begin their search for disability insurance.
Hi Andy,
We have the GSI program at UCLA and happy to provide plan information and details to any resident/fellow interested!
Thanks!
Janet Mendence
[email protected]
310-480-7154
CA License No. 0733267
Hi Andy, I represent the GSI program at University of Illinois at Chicago – UIC. Thanks!
[email protected]
844-862-1003
Hello –
Just yesterday I applied for my disability insurance and today I came across this article. I do not know if my residency has GSI; but if I wanted to pause the medical underwriting that is just getting started is there a way to do this? They have not yet contacted me for any additional info. I see above that you say you cannot apply for GSI if you have been given exclusions. I’m not sure if I am going to be given exclusions; but I guess there is a chance since I take a regular prescription medication and have had a procedure in the past 10 years. So I just wanted to see if there is any way to freeze this process so that I could find out about GSI. Maybe I’m a day late (and going to be more than a couple dollars short?!)
Thanks for all of the info!
Probably, call your agent. Maybe the app is still on his desk.
Hayley, It is not too late, did you sign anything? If not don’t, otherwise simply email your agent and withdraw your application. You can do that any time during the underwriting period and it will not effect your eligibility for a GSI policy as long as no formal underwriting decision has been made. What is your training program and we or someone out there will know if you have a GSI program.
Jackson Memorial Hospital in Miami, FL.
Many carriers also offer “survey application” options which allow you to request an insurability offer without affecting your application history or medical information bureau (MIB) report. Make sure your agent or broker reviews the underwriting guide with you so they’re not shooting in the dark. Most carriers outline what offers they’re willing to make based on an array of preexisting conditions, and this information is readily accessible to agents and brokers. The person helping you obtain coverage should be just as thorough with your health questionnaire at application time as they are shopping your pricing and carrier policy language. Remember, true underwriting takes place at claim time, not when you’re applying.
Hayley, I have checked our sources and could not find a GSI at your hospital so unless anyone else is aware you probably should continue the application process.
Finity group offers guaranteed standard for the University of Washington.
Does anyone know who offers guaranteed standard for Mayo Clinic?
Which location; Florida, Arizona, or Minnesota?
Arizona
Bumping this. Does anyone know who offers it for mayo arizona?
I have a couple brokers in Arizona checking into it, but nothing yet. If anyone else has any leads, please let us all know.
Appreciate it!
Unfortunately, we haven’t been able to find anything. I would ask around to see what insurance agent/broker works with the largest number of physicians at your hospital. If anyone has the GSI policy, it’s likely them. It may also be the same people that offer the group policy for the residents/fellows and/or attendings (sometimes they’re different groups). Usually someone in GME or a program coordinator knows who has it if there is one. Sorry we couldn’t be of more help.
Starting 2/15/23 there will now be a GSI option available to all Mayo Clinic residents and fellows (MN, AZ and FL) through Guardian. More information is available here – https://www.disabilityquotes.com/mayoclinic
There are no GSI plans currently with Mayo. There was one several years ago with Standard Insurance Company but it was terminated.
Larry
Now there is:
https://www.disabilityquotes.com/mayoclinic
I could be totally wrong but I don’t think the location of the specific Mayo clinic should matter. They have all of the same benefits, pay, etc. Their general health, life, and disability insurance are all the same.
That all depends on how the GSI is offered. If the GSI is within the benefits package, the benefits department and employees typically know about it. Often, it is granted by an insurance company to a specific agent/broker who writes enough business at a particular location to give them the law of large numbers to be able to offer GSI.
Does anyone know who offers GSI for Mass General?
Yes, there is an Ohio National GSI for Partners.
Steve Johnson has it. The website is http://www.residentgsi.com.
Larry
Does anyone know who offers GSI for Mayo Clinic Arizona?
Does anyone know who offers GSI for residents at Temple University Hospital in Philadelphia?
I am the broker with GSI programs for: Temple, Einstein, Jefferson, Cooper, Rowan, Drexel, PCOM, HSS, Mayo (Internal Medicine and Orthopaedic Surgery) and also have reciprocal agreements with other agents throughout the country. If you would like to discuss, please complete our questionnaire at http://www.PGY1.com.
I have access to a GSI plan at Thomas Jefferson University Hospital with Standard Insurance Company along with several other hospitals.
Larry
Standard insurance has a GSI for both University of Utah and University of Colorado as well as about 18 others throughout the country.
The list of discounted premium Guarantee Standard Issue, GSI, programs across the country from Standard insurance. Each program is controlled by one or two insurance brokers. For those programs not listed, Standard just announced as of 4/2/21 the discount on underwritten individual policies has increased from 10%-15%. We are working on obtaining the GSI programs for other insurance companies.
Institution City State
Scripps Clinic/Scripps Green Hospital La Jolla CA
Scripps Mercy Hospital San Diego CA
University of California San Diego Medical Center San Diego CA
Stanford Health Care Stanford CA
University of Colorado School of Medicine Aurora CO
Denver Health Medical Center Denver CO
Saint Joseph Hospital, Inc Denver CO
Christiana Care Health Services Inc Newark DE
University of Florida College of Medicine Gainesville FL
University of South Florida Morsani College of Medicine Tampa FL
Rush University Medical Center Chicago IL
McGaw Medical Center of Northwestern University Chicago IL
University of Kansas School of Medicine Kansas City KS
University of Michigan Health System Ann Arbor MI
Henry Ford Macomb Hospital Clinton Township MI
Henry Ford Hospital Detroit MI
Children’s Hospital of Michigan Detroit MI
Detroit Medical Center Corporation Detroit MI
Henry Ford Allegiance Health Jackson MI
Sparrow Hospital Lansing MI
Michigan State University College of Human Medicine Lansing MI
Henry Ford Wyandotte Hospital Wyandotte MI
Duke University Hospital Durham NC
Vidant Medical Center Greenville NC
University of Nebraska Medical Center College of Medicine Omaha NE
Sidney Kimmel Medical College at Thomas Jefferson University Philadelphia PA
Vanderbilt University Medical Center Nashville TN
University of Texas Southwestern Medical Center Dallas TX
University of Utah Health Salt Lake City UT
The University of Washington School of Dentistry Seattle WA
Dear Andy, do you have any information on GSI programs at the University of California, Irvine?
Fairly certain they now (finally) have a GSI policy available through University of Kentucky. I believe it’s with Guardian.
Dear Andy, do you have any information on GSI programs at the University of California, Irvine?
Hi Abhi,
Andy just contacted me regarding your question about UCI. We do offer a GSI plan for all UCI residents and fellows. Please feel free to visit our website and reach out to us (www.rivettifinancial.com).
We also offer GSI plans for the USC and Harbor-UCLA residency programs as well.
Abhi, i believe there is a GSI program for UCI. We are in the process of confirming it is still in place and will have an answer soon and direct you to the proper person.
My partner (PGY2 resident) bought an individual policy through Guardian separate from our institution/employer issued group one. I recently found out our employer has a GSI that is also through Guardian. Given that our individually purchased disability insurance is only going to pay out couple thousand dollars a month if he becomes disabled at this time as a resident and that we can default back to the GSI after training (which could be the identical policy that I purchased now through Guardian) when he will be at an attending physician salary, I am considering just stopping our individually purchased policy to save the monthly premiums even though we underwent medical underwriting and he was approved. I’m mainly concerned about his salary when he is an attending since the disability payout now would still be very low compared to an attending physician salary. Am I thinking about this wrong? I understand there is the risk that he could still be disabled in residency
I’m not sure I’d let the presence of a GSI policy possibility talk me out of a regular policy that I could take with me when I leave residency. You’re not going to take the employer provided one with you, you’ll want either the GSI or the regular policy you have, hopefully with a future purchase option. You can compare the two and take the cheaper one if you want, but if he qualifies, I’ll bet the one he has is the cheaper one.
I compared and since they are both Guardian they are the same price exactly for the same policy and riders. The hospital group policy is not portable but I can just opt to purchase the additional GSI at the end of residency without underwriting which I can tweak to make exactly the same as the Guardian policy we currently purchased. I thus don’t see a huge benefit in carrying my currently purchased policy through residency as even if he becomes disabled in residency, payout is only a couple thousand a month based on his current residency salary
A couple thousand is a lot more money than $0.
There are a number of factors to consider before finalizing your decision for the optimum solution to protect your medical career in the event of a disability. The first risk is if you become disabled, which apparently you are willing to absorb. The second is if you have a health change and become uninsurable. That is solved by the GSI so no reason to pay premiums to protect against this risk. Other issues are more intrinsic such as the policy benefits and contractual provisions of the GSI policy vs. your individual policy as well as future premium savings. Your GSI agent can confirm, but if the GSI has a future purchase option that is adequate to protect the future earning potential of your specialty, it may make sense to wait until end of training and utilize the GSI. Keep in mind that disability insurance premiums increase approximately 5% each year until implementation, when they are locked in. We calculate each year you wait translates to almost two full extra years of premiums paid during the typical medical career. So you are either going to save now or later.
What are the thoughts behind enhanced partial vs basic partial riders for new interns buying disability insurance? Enhanced partial comes with added monthly premiums but seems to be more forgiving.
Devil is in the details. Sounds like wording from one company in particular. As a general rule, the partial disability rider is a good place to spend money as it gets used frequently. So I’d lean toward enhanced, but I honestly don’t know the difference and it sounds like you don’t either. Get the actual contract wording for each and post it here and you’ll get better advice.
Thank you, below is how Guardian defines the enhanced partial rider:
This specialized rider from Guardian can be particularly valuable for fee-for-service professionals and business owners. It provides benefits when, solely due to sickness or injury, you suffer a loss of income of 15% or more. (Most other carriers require 20%.) For the first 12 months, benefits are equal to the actual loss of income, up to 100% of your monthly benefit; Afterwards, benefits are paid in proportion to your income loss.
After you fully recover and return to work full time, Guardian continues to pay benefits as long as you have a loss of income of at least 15% of your prior income (and the loss is solely the result of the injury or illness that caused the disability). And with Guardian’s superior Waiver of Premium benefit, monthly policy payments are suspended while you’re disabled and receiving benefits — plus another six months after recovery and benefits end.
Basic partial disability:
This pays partial benefits if you suffer an injury or illness that limits your ability to work – but doesn’t cause total disability.
Difference is about $10/month.
The enhanced disability rider usually provides a minimum 50% of the monthly benefit regardless of what the formula for partial disability benefits provides for the first 6 or 12 months of partial disability benefits. Without knowing the specifics of the contract you are referring to, generally partial disability benefits provide a percentage of the total benefit and it is calculated by the portion of your prior income you are able to generate. For example, if you are able to earn 60% of your prior earnings you will receive 40% of your disability benefit. The enhanced rider increases the amount to at least 50% for the first 6 or 12 months of partial disability. The Guardian policy will pay up to 100% of the monthly benefit, depending on your loss of income. The percentage of prior income while on claim probably does not matter during training but will when you are in practice. Since almost all disabilities are at some point partial,I recommend the enhanced.
Is anyone aware if University of Chicago has GSI?
Anyone aware of a GSI program at Dartmouth-Hitchcock in Lebanon, NH? Thanks for this post!
thanks for this article – does anyone know of GSI plans at Mount Sinai Hospital in NYC or Rutgers-Robert Wood Johnson Hospital in NJ?
I am aware of and have access to GSI plans at both institutions.
Feel free to call or email me at [email protected].
Does anyone know if Aultman Hospital in canton Ohio has a GSI plan?
Along with Janet Mendence, we have the GSI program at all four UCLA sites: Ronald Reagan, Olive View, Santa Monica and the West LA VA. All PGY levels are eligible. All Dental Depts as well.
310-491-6603