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Outrunning the Surtax: Retirement Plan Strategies for High-Earning Physicians

About this event

The traditional retirement-savings playbook points high-earning physicians toward maxing out a 401(k) and calling it a day. It's a solid start, but for physicians whose income is trending toward — or already past — $1 million, it can miss a fast-changing variable: the state surtax. A growing number of states, including Massachusetts, Washington, and Maine, now layer an extra tax on income above $1 million, and more are considering similar measures. That changes the math on how much a well-designed retirement plan is really worth.

Join Jorge Sanchez, MD, of Physician on Fire, and Nick Gizzarelli, CPFA™, CBS™, QPA™, QKA®, Senior Advisor & Retirement Plan Specialist at Earned, Tuesday, September 29 at 2:30 PM ET / 11:30 AM PT. Nick will show how cash balance plans, 401(k) profit sharing, and smart plan design can cut taxable income — keeping high earners under surtax thresholds where possible, and helping every physician save more pre-tax regardless of income.

You'll learn how to:

  • Spot which states tax income above $1 million — and how those thresholds hit W-2 wages, practice income, and capital gains
  • Estimate how much a cash balance and 401(k) profit sharing combo can shelter at your income and age
  • Find the plan design gaps quietly costing you deferral room and tax savings

Hosted by

  • Team member
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    Nick Gizzarelli

    Nick has more than 15 years of experience in the retirement industry, working with some of the largest retirement plans at Earned. As a key leader in building the enterprise retirement business, he helps expand Earned’s services to new medical groups, offering comprehensive wealth and tax advice to more doctors. An active member of the American Retirement Association, Nick holds multiple designations from the National Association of Plan Advisors and the American Society of Pension Professionals and Actuaries.

  • External speaker
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    Jorge Sanchez, M.D. Physician On Fire

    After donating his kidney to his mother, Jorge Sanchez became a physician. He was a clinical professor at Rutgers University Medical School. As an internist, he practiced hospital medicine and worked with underserved Latino populations and rural healthcare systems. Previously, he co-founded a hospitalist company spanning South Florida, which he successfully exited. He co-founded Alertive.com with Dr. Nirav Shah and sold it to Carbon Health, allowing him to reach FIRE.

Earned

You care for our health. We help you build your wealth.

Earned is a fully integrated, technology-driven financial services firm built specifically for healthcare professionals, their families, and their practices. With a tech-forward, human-led approach, Earned is purpose-built to address the unique financial challenges doctors face — such as high taxes,