True value of USACS benefits

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alpinism

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So apparently USACS has started to justify their low rates by claiming their benefits are worth over 50/hr and thus physicians that currently work for the company have been averaging over 200/hr in total compensation yearly.

Their recruitment website for residents even claims their 150/hr W2 rates are the same as 200/hr IC rates.

Does anyone here really believe their employee benefits package is that valuable?

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So apparently USACS has started to justify their low rates by claiming theiro benefits are worth over 50/hr and thus physicians that currently work for the company have been averaging over 200/hr in total compensation yearly.

Their recruitment website for residents even claims their 150/hr W2 rates are the same as 200/hr IC rates.

Does anyone here really believe their employee benefits package is that valuable?

Do you have any pdf where the benefits are detailed? I don’t mind analyzing them
 
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Gotta love the spin. In what world is $200/hr considered a reasonable EM salary?
 
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Depends how much in benefits they pay. You could get to $80k in realistic benefits pretty easily. Whether or not they actually pay that is a different story.

Knowing USACS, I’m sure they’re including your CME, licensing, malpractice, employer payroll taxes, etc. in their calculation.
 
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Do you have any pdf where the benefits are detailed? I don’t mind analyzing them

It’s decision time.

There you are, a soon-to-graduate resident, at your disposable kitchen table in the apartment you’ve been renting for the past three or four years, with a blank yellow notepad in front of you.

You draw a line in the middle of the page and start comparing the two offers you’ve received. On the first line, you write the most obvious number to compare: Dollars/Hour.

Then you move on to the next criteria, right? Wrong.

Doing an apples-to-apples comparison by comparing hourly compensation rates is a great way to lead yourself astray. This may be your first job search ever or at least in a very long time. It is not like that hourly job you had scanning tickets at the ski valley.

How to do a real contract comparison

As the country’s largest physician-owned acute care group, US Acute Care Solutions has created a compensation and benefits package we believe is second to none. Those benefits translate into real dollars earned and saved, but it would be easy to miss that if you look too narrowly. So, let’s do the math.

Most full-time emergency medicine physicians work in the ballpark of 130 hours/month. Just for comparison’s sake, let’s say one group is offering $160/hour and another, where you would be working as an independent contractor, is offering $200/hour.

The independent contractor group obviously pays more, right? Not so fast. Let’s go to the math.

How to value a 401(k) or retirement package

US Acute Care Solutions provides a industry leading and fully company-funded 10% contribution into your 401(k) over and above your total cash compensation. So, if you make $250,000 a year, we contribute an extra $25,000 to your 401k, regardless of whether you contribute yourself or not.

If you divide that amount by the hours you work that year (approximately 1,560), that amounts to a little over $16/hour in additional compensation.

Equivalent added pay: $16/hour

Business Expense Accounts

At USACS, we provide $4,000 per year for CME and business expenses, plus an additional $4,000 during your first year, since many physicians that join us are new graduates and will be taking their boards. But for argument’s sake, let’s just take that $4,000 and divide that by the 1,560 you’ll be working each year.

Equivalent added pay: $2.50+/hour

Health insurance benefits

Since health plans vary so widely, it can be difficult to value these for the purposes of apples-to-apples comparisons. Everything from the quality of the network, to the deductible, to the premium and your family size can impact the cost of health care, and it will change every year.

But that doesn’t mean you should ignore it. If you go work for a group with and independent contractor model, you’ll be on your own for health insurance. Besides the significant amount of time spent shopping for plans, that will also be a considerable financial cost to you.

USACS, of course, provides excellent health insurance for both you and your family, with a variety of plans to choose from. Though the value of the plan will vary, for this purpose let’s assume you choose one that represents about $32,000 per year – a fairly middle-ground amount.

Equivalent added pay: $20.50+/hour

Equity

At USACS, all full-time physicians are also owners. The belief that #OwnershipMatters is fundamental to our group and a critical component of why we brought together some of the best physician-owned groups in the country to create USACS.

But let’s take it down to brass tacks. If you join USACS, you will be granted $75,000 in equity over your first five years, or $15,000/year. That translates into real dollars that can significantly grow with company success, but we like to think it adds something more: a real stake in our group, and a culture of shared promise and shared reward.

Baseline equivalent added pay: $9.50+/hour

MedMal Insurance

As an independent contractor, it’s likely that, even if your group provides insurance, it will have some gaps. As you compare contracts, it’s always important to check not just that you are being provided medical malpractice insurance, but that it also critically includes two other aspects: tail coverage, and all associated expenses.

Many groups provide insurance and tail, but say that if you get sued, you have to pay some portion of the lawyer’s fees. That could run into the thousands of dollars. And how much could lack of tail coverage cost you? Well, let’s just say this: never, never take a job where the medmal insurance does not include tail coverage. That’s a check you have to write before you can leave. Don’t put yourself in that nightmare position of wanting or needing to leave a job, but not being able to afford to do so.

Equivalent potential losses from not having good medmal: unknown, but potentially thousands.

Self-employment tax

What is the self-employment tax? It is an additional tax you will have to pay if you take a job as an independent contractor. In the U.S., we owe something called the payroll tax, which is split between the employer and the employee. But, if you are effectively your own employee (as all independent contractors are), you owe both portions.

This is often an unexpected and very unwelcome hit. You may be lured into a job with seemingly high hourly compensation, but that comes back to haunt you at tax time.

Equivalent loss from self-employment tax: -$7.80/hour

Paid parental leave

If you plan to take a job at a group which does not offer paid parental leave, then you have a question to ask yourself: do you want to have children, and if so, how many weeks do you plan to take off when they are born or adopted? All that time will be lost income for you.

Let’s say you take eight weeks off. Some groups may require you to use short-term disability to take time off. Besides the rather glaring fact that having a child and starting a family is not the same as becoming disabled, that is still only worth a percentage of your pay, say 60%. Adding insult to injury, it doesn’t even begin until after a “waiting period” that can vary in length but is commonly 14 days.

In contrast, USACS provides birth mothers 8 weeks of paid parental leave at 100%, beginning from day 1, plus another optional four weeks at 50%. Fathers, partners, or non-primary parents also get two weeks paid leave at 100%.

Equivalent loss from taking eight weeks off without pay: -$46,600 per pregnancy.

A true apples-to-apples comparison

There are a few other situations we haven’t touched yet, such as nights and holidays, or even productivity pay. These are significant aspects of our compensation at USACS. We also have a ground-breaking paid military leave policy which compensates active service-members, keeping them and their families whole if and when they are deployed.

Still, just with a few calculations you can get a sense of how to truly evaluate two contract offers side by side.

If you add up all the per-hour cash equivalents hypothesized above, it turns out that a $160/hour package at a group like USACS comes out to something more like $210/hour when you count all the benefits. Meanwhile, the $200/hour offer from the independent contractor group is more like $193/hour, or even significantly less if you get sued or want to take unpaid leave for having a child or going on military deployment.

Seeing the big picture

At USACS, our recruiting team has developed an apples-to-apples comparison calculator provided to everyone who is considering a full-time offer from us (if you’re interested, search our careers page and contact one of our recruiters). We developed it to help our potential hires see what the it really means, compensation-wise, to work at a physician-owned group with a leading benefits package. When you add in the intangibles of group camaraderie and clinical excellence, it’s a winning formula you can’t ignore.
 
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Do you have any pdf where the benefits are detailed? I don’t mind analyzing them

From reading their summary of the benefits it seems they assume everyone uses 100% of the benefits.
 
Alright let’s do an apples to apples comparison:

Assumptions: 150/hr w2 vs 200/hr IC

Hours worked: 12 x 12 monthly shifts = 1728 annual hours

Usacs annual package:

W2 income - $259200
401k match - 25920
Partnership - 15000

+ health insurance, vision, life, disability insurance + one half of Fica taxes - will deduct costs of these from 1099 for a apples to apples

I’m not accounting for military and paid parental leave since it doesn’t apply to everyone.

I’m not sure if equity is given as a 15k taxable bonus each year or something that is cashed out when leaving the company, I’m going to assume the former to maximize the attractiveness of usacs numbers

Rough take home pay after taxes assuming married filing jointly with 1 dependent and assuming full 401k 22500 contribution - take home net income is - 209837 + 401k employee contribution of 22500 + 25920 employer Match plus all other benefits that I’ll account for in a bit on the 1099 side as extra expenses.

Hourly net take home - $149/hr ((210k + 22500 + 25920) /1728) + generic benefits (health dental vision etc)


1099 annual package:

Gross revenue: 200 x 1728 = 345200

Extra expenses:

Health insurance - $13000-18000 (on healthcare.gov I’m looking at a reasonable 8k family deductible plan with out of pocket max of 12000 for $1080/month for a family of 3 through anthem). Does usacs pay 100 percent of premiums? I would assume not. This expense can be significantly lower if the other spouse works but let’s assume no. I’ll pick $15000 annual expenses for comparison.

Disability: $250/month (own occupation policy better than most employer policies) - $3000

Life insurance - $600/yr
Dental insurance - $600/yr
Vision - $300/yr

1/2 of Fica taxes - 15000

Taxable 1099 income assuming max 66k 401k contribution through solo 401k - 244700

Take home income after federal taxes - 211917 + 66k + benefits

Hourly post taxes = 160/hr + benefits.

So a small difference.

The only thing is that 1099 jobs are usually around 225-275 per hour. W2 jobs are usually 200-250/hr. So based on the numbers they are assuming, which is 200/hr, yes their benefits are roughly similar with my back of the napkin math for 1099.

My math isn’t exact, done on my cell phone so could have some small errors but it should give a reasonable comparison. The above also assumes that usacs pays all premiums and you don’t have any payments at all. It also assumes you’re not deducting other business expenses that would reduce taxable income. It’s a ball park estimate
 
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Benefits are expensive, I do agree with USACS on that point.

It is actually complicated for me to explain to new hires in our group; We are functionally P&L, eat what you kill, without buy in (we float you a salary for the first year until you cover your start up period, then you get any excess funds including for 6-9 mo AFTER you leave…).

But explaining that a doc generating raw $500k in professional income in a year needs to give $25k to coding and billing, $20k to malpractice, $20k to “employer” side health benefits, $35k to “employer” side 403b “match”, $4k to their own CME fund, $15k to dental, vision, umbrella, whatever… before we even talk about (1) Salary or (2) any money taxed for group priorities… e.g. scheduling, admin work, committee work, contract work, legal work, whatever…. People don’t all naturally understand this.

Anyway, the key is completely open books so you can show where every penny that rolls in under your name goes… :)
 
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Usacs sucks and so does $200/hr.

Many of their benefits are a joke. God bless the young ins’ and oldins’ that have to work for that crooked ass company.
 
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The only thing is that 1099 jobs are usually around 225-275 per hour. W2 jobs are usually 200-250/hr. So based on the numbers they are assuming, which is 200/hr, yes their benefits are roughly similar with my back of the napkin math for 1099.

This is the key point to hone in on. 1099 jobs aren't paying $200/hr. My W-2 in a major metro pays way more than this. My side-job 1099 pays closer to $325/hr. The whole thing is based on a false premise. Translation for the youngins... gaslighting.
 
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Lesson to be learned from anyone doing business moving forward.

If someone is pitching you something that appears very complicated, there is a reason and a big RED FLAG.

USACS pitch sounds alot like Universal variable life insurance. I was suckered into UVL when I was younger, learned that lesson, and never made the same mistake. If it takes you this long to explain something, AND it still does not make much sense then they are likely hiding something.

Too complicated. Walk away.
 
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*** *** ***
The single most important SDN EM thread should be stickied #1 and have a continually updated list of hospitals (or regions) of median pay for ER docs. All the thread probably needs is
- general location / region
- pay model (hourly, RVU, hybrid)
- pay type (W2, 1099)
- median pts / hr
- median hourly pay

We need to expose USUCKS, TH, Envision, Apollo, and companies on their predatory practices and how they take your hard earned money and instead give it to shareholders, admin, and debt holders.

This thread makes me sad. There are sucker ER residents who are going to believe the filth USUCKS throws at them. $150/hr vs $200/hr. It's just terrible. These are terrible reimbursement rates.
*** *** ***
 
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...

Health insurance - $13000-18000 (on healthcare.gov I’m looking at a reasonable 8k family deductible plan with out of pocket max of 12000 for $1080/month for a family of 3 through anthem). Does usacs pay 100 percent of premiums? I would assume not. This expense can be significantly lower if the other spouse works but let’s assume no. I’ll pick $15000 annual expenses for comparison.

So o guess the two are fairly similar.

The only thing is that 1099 jobs are usually around 225-275 per hour. W2 jobs are usually 200-250/hr. So based on the numbers they are assuming, which is 200/hr, yes their benefits are roughly similar with my back of the napkin math for 1099.

My math isn’t exact, done on my cell phone so could have some small errors but it should give a reasonable comparison. The above also assumes that usacs pays all premiums and you don’t have any payments at all. It also assumes you’re not deducting other business expenses that would reduce taxable income. It’s a ball park estimate

Good quick comparison. And yes I would bet USUCKS doesn't pay 100% premiums.
 
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*** *** ***
The single most important SDN EM thread should be stickied #1 and have a continually updated list of hospitals (or regions) of median pay for ER docs. All the thread probably needs is
- general location / region
- pay model (hourly, RVU, hybrid)
- pay type (W2, 1099)
- median pts / hr
- median hourly pay

We need to expose USUCKS, TH, Envision, Apollo, and companies on their predatory practices and how they take your hard earned money and instead give it to shareholders, admin, and debt holders.

This thread makes me sad. There are sucker ER residents who are going to believe the filth USUCKS throws at them. $150/hr vs $200/hr. It's just terrible. These are terrible reimbursement rates.
*** *** ***

AMEN BROTHER!
 
*** *** ***
The single most important SDN EM thread should be stickied #1 and have a continually updated list of hospitals (or regions) of median pay for ER docs. All the thread probably needs is
- general location / region
- pay model (hourly, RVU, hybrid)
- pay type (W2, 1099)
- median pts / hr
- median hourly pay

We need to expose USUCKS, TH, Envision, Apollo, and companies on their predatory practices and how they take your hard earned money and instead give it to shareholders, admin, and debt holders.

This thread makes me sad. There are sucker ER residents who are going to believe the filth USUCKS throws at them. $150/hr vs $200/hr. It's just terrible. These are terrible reimbursement rates.
*** *** ***


Well….. let’s start it.
 
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How do you do that??? I just started a thread. Should i delete the thread lol?

No idea. I thought I recalled an old subforum on SDN that was private. They occasionally reference some kind of private forum over on the rad onc side.
 
Alright let’s do an apples to apples comparison:

Assumptions: 150/hr w2 vs 200/hr IC

Hours worked: 12 x 12 monthly shifts = 1728 annual hours

Usacs annual package:

W2 income - $259200
401k match - 25920
Partnership - 15000

+ health insurance, vision, life, disability insurance + one half of Fica taxes - will deduct costs of these from 1099 for a apples to apples

I’m not accounting for military and paid parental leave since it doesn’t apply to everyone.

I’m not sure if equity is given as a 15k taxable bonus each year or something that is cashed out when leaving the company, I’m going to assume the former to maximize the attractiveness of usacs numbers

Rough take home pay after taxes assuming married filing jointly with 1 dependent and assuming full 401k 22500 contribution - take home net income is - 234337 + 401k employee contribution of 22500 + 25920 employer Match plus all other benefits that I’ll account for in a bit on the 1099 side as extra expenses.

Hourly net take home - $163/hr + generic benefits


1099 annual package:

Gross revenue: 200 x 1728 = 345200

Extra expenses:

Health insurance - $13000-18000 (on healthcare.gov I’m looking at a reasonable 8k family deductible plan with out of pocket max of 12000 for $1080/month for a family of 3 through anthem). Does usacs pay 100 percent of premiums? I would assume not. This expense can be significantly lower if the other spouse works but let’s assume no. I’ll pick $15000 annual expenses for comparison.

Disability: $250/month (own occupation policy better than most employer policies) - $3000

Life insurance - $600/yr
Dental insurance - $600/yr
Vision - $300/yr

1/2 of Fica taxes - 15000

Taxable 1099 income assuming max 66k 401k contribution through solo 401k - 244700

Take home income after federal taxes - 211917 + 66k + benefits

Hourly post taxes = 160/hr + benefits.

So o guess the two are fairly similar.

The only thing is that 1099 jobs are usually around 225-275 per hour. W2 jobs are usually 200-250/hr. So based on the numbers they are assuming, which is 200/hr, yes their benefits are roughly similar with my back of the napkin math for 1099.

My math isn’t exact, done on my cell phone so could have some small errors but it should give a reasonable comparison. The above also assumes that usacs pays all premiums and you don’t have any payments at all. It also assumes you’re not deducting other business expenses that would reduce taxable income. It’s a ball park estimate
Ahh thats awesome thanks

How'd you get the net income for USACS after taxes?
 
Alright let’s do an apples to apples comparison:

Assumptions: 150/hr w2 vs 200/hr IC

Hours worked: 12 x 12 monthly shifts = 1728 annual hours

Usacs annual package:

W2 income - $259200
401k match - 25920
Partnership - 15000

+ health insurance, vision, life, disability insurance + one half of Fica taxes - will deduct costs of these from 1099 for a apples to apples

I’m not accounting for military and paid parental leave since it doesn’t apply to everyone.

I’m not sure if equity is given as a 15k taxable bonus each year or something that is cashed out when leaving the company, I’m going to assume the former to maximize the attractiveness of usacs numbers

Rough take home pay after taxes assuming married filing jointly with 1 dependent and assuming full 401k 22500 contribution - take home net income is - 234337 + 401k employee contribution of 22500 + 25920 employer Match plus all other benefits that I’ll account for in a bit on the 1099 side as extra expenses.

Hourly net take home - $163/hr + generic benefits


1099 annual package:

Gross revenue: 200 x 1728 = 345200

Extra expenses:

Health insurance - $13000-18000 (on healthcare.gov I’m looking at a reasonable 8k family deductible plan with out of pocket max of 12000 for $1080/month for a family of 3 through anthem). Does usacs pay 100 percent of premiums? I would assume not. This expense can be significantly lower if the other spouse works but let’s assume no. I’ll pick $15000 annual expenses for comparison.

Disability: $250/month (own occupation policy better than most employer policies) - $3000

Life insurance - $600/yr
Dental insurance - $600/yr
Vision - $300/yr

1/2 of Fica taxes - 15000

Taxable 1099 income assuming max 66k 401k contribution through solo 401k - 244700

Take home income after federal taxes - 211917 + 66k + benefits

Hourly post taxes = 160/hr + benefits.

So o guess the two are fairly similar.

The only thing is that 1099 jobs are usually around 225-275 per hour. W2 jobs are usually 200-250/hr. So based on the numbers they are assuming, which is 200/hr, yes their benefits are roughly similar with my back of the napkin math for 1099.

My math isn’t exact, done on my cell phone so could have some small errors but it should give a reasonable comparison. The above also assumes that usacs pays all premiums and you don’t have any payments at all. It also assumes you’re not deducting other business expenses that would reduce taxable income. It’s a ball park estimate
So in that case for a single healthy resident the health benefits would be worth less and the IC would be around 10/hr better rate.
In addition if they already receive health benefits and decide to not use the health benefits the IC would be around 20/hr better rate.
 
*** *** ***
The single most important SDN EM thread should be stickied #1 and have a continually updated list of hospitals (or regions) of median pay for ER docs. All the thread probably needs is
- general location / region
- pay model (hourly, RVU, hybrid)
- pay type (W2, 1099)
- median pts / hr
- median hourly pay

We need to expose USUCKS, TH, Envision, Apollo, and companies on their predatory practices and how they take your hard earned money and instead give it to shareholders, admin, and debt holders.

This thread makes me sad. There are sucker ER residents who are going to believe the filth USUCKS throws at them. $150/hr vs $200/hr. It's just terrible. These are terrible reimbursement rates.
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The problem is that all these new grads want to live in USACS controlled markets and will happily accept these 200/hr rates with benefits.
 
Ahh thats awesome thanks

How'd you get the net income for USACS after taxes?

Actually i just realized i messed up. Going to edit and fix it.

Federal taxable income = ( 259200 + 15000 ) minus 22500 401k contribution

Throw it in an income tax calculator and you get 41860 of federal income tax. Didn’t go into state and local taxes since those are different for everyone. Didn’t really bother subtracting the first half of fica since both 1099 and w2 employees pay more or less very similar amounts of that.

But basically you get taxable income of 251200 minus 41860 resulting in ~ 210k plus 22500 401k employee contribution plus 25920 employer contribution.

I messed up earlier

Edit: fixed the math.
 
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*** *** ***
The single most important SDN EM thread should be stickied #1 and have a continually updated list of hospitals (or regions) of median pay for ER docs. All the thread probably needs is
- general location / region
- pay model (hourly, RVU, hybrid)
- pay type (W2, 1099)
- median pts / hr
- median hourly pay

We need to expose USUCKS, TH, Envision, Apollo, and companies on their predatory practices and how they take your hard earned money and instead give it to shareholders, admin, and debt holders.

This thread makes me sad. There are sucker ER residents who are going to believe the filth USUCKS throws at them. $150/hr vs $200/hr. It's just terrible. These are terrible reimbursement rates.
*** *** ***
I personally think cyanide12345678’s post on why EM sucks is the best post I’ve ever seen on the EM forums and should also be stickied.
 
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Don’t forget those “ownership” shares will be worthless when usacs gets their note called by Apollo PE and has to declare bankruptcy
 
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No idea. I thought I recalled an old subforum on SDN that was private. They occasionally reference some kind of private forum over on the rad onc side.
Not an easy option. There are a handful of private subs on SDN and southerndoc and I asked about making one for the EM forum at some point. There are apparently some administrative difficulties involved in setting it up and then a constant occasional annoyance in maintaining it. Additionally, it's not something that southern or I could volunteer to handle as it needs to be done by admins and not by mods and the admins understandingly don't want to create extra work if it isn't strictly necessary.
 
So basically in summary the USACS benefits are not worth 50/hr if you actually do all of the math.

Depending on how much of them you use it comes out to be about 20/hr minimum to 40/hr maximum.
 
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This assumes you get the "ownership equity" which might possibly be worthless if the company declares bankruptcy.
 
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Don’t forget those “ownership” shares will be worthless when usacs gets their note called by Apollo PE and has to declare bankruptcy
That’s really key. I would hate to be a doc particularly near the end of working career who is counting on some mini nest egg from usacs stock. It’s not liquid and probably in 2-3 years will be worth pennies.
 
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I personally think cyanide12345678’s post on why EM sucks is the best post I’ve ever seen on the EM forums and should also be stickied.

It was so, SO good that reddit removed it because they couldn't handle the truth.

For real.
 
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They have a point that there is increased compensation with W-2 employment from all the benefits you get.

However, they fail to recognize that there are plenty of places paying $250+ per hour as W-2 employees with benefits.
 
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They have a point that there is increased compensation with W-2 employment from all the benefits you get.

However, they fail to recognize that there are plenty of places paying $250+ per hour as W-2 employees with benefits.
Mine is W2 with a CMG and the rate is above $250/hr not including employment taxes. I think it's insane that USACS advertises $200/hr including benefits and thinks this a deal anyone should take. What a joke of a company. Anyone who voluntarily works for them is economically ignorant.
 
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So basically in summary the USACS benefits are not worth 50/hr if you actually do all of the math.

Depending on how much of them you use it comes out to be about 20/hr minimum to 40/hr maximum.
But dom says so.
 
This income thread really should be easy to read and should have a table....and generally the less info the better. When there are 10+ different side notes or qualifiers about income...it becomes more difficult to read. We all just want to know how much your compensation package, or something similar.
 
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In the less than 1 year I worked for USACS, at the end of the calendar or fiscal year they gave a summary boiling everything down to an hourly rate. I forget what the number was but somewhere around $250/hr, much higher than the 170 base rate. The 401k match was very good, everything else sucked. I forget if they used the unachievable productivity bonus in the calc.

They are very skilled at that total comp argument. Most other practices a few years ago weren’t using that.
 
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Miami 😭

Bro. No it's not. Outside of South Miami Criticare (I'll name names!) you're looking at $250+ at the local Schumacher, Teamhealth, Envision, Baptist employed (not S.M.Criticare ones), and broward general sites.... AND some of them give sign on bonuses. Even those jackson employees *say* they are getting underpaid, but ask about the yearly raise and do some quick math on the length of their careers, and you realize its just a waiting game until you're bringing in big bucks *and* locking in pension.

There is an argument about it being hard to make up lost wages if you start low and wait for yearly raises to kick in.... but there is a different argument about life-long wages of being the only person with a pension.
 
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Bro. No it's not. Outside of South Miami Criticare (I'll name names!) you're looking at $250+ at the local Schumacher, Teamhealth, Envision, Baptist employed (not S.M.Criticare ones), and broward general sites.... AND some of them give sign on bonuses. Even those jackson employees *say* they are getting underpaid, but ask about the yearly raise and do some quick math on the length of their careers, and you realize its just a waiting game until you're bringing in big bucks *and* locking in pension.

There is an argument about it being hard to make up lost wages if you start low and wait for yearly raises to kick in.... but there is a different argument about life-long wages of being the only person with a pension.
There is some dude on FBpitching his new group (is it new) down in miami. do you have any idea what the pitch there is? Synergy Medical Collective? Curious your thoughts on that? Seems super scammy but idk.
 
There is some dude on FBpitching his new group (is it new) down in miami. do you have any idea what the pitch there is? Synergy Medical Collective? Curious your thoughts on that? Seems super scammy but idk.
If it’s got synergy in its name then you know it’s legit…
 
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There is some dude on FBpitching his new group (is it new) down in miami. do you have any idea what the pitch there is? Synergy Medical Collective? Curious your thoughts on that? Seems super scammy but idk.

I actually am currently working with 3 different people who all know him well but no one knows exactly what his model is. I'll check in and find out exactly what the deal is.

He has a reputation for being extremely smart and extremely ambitious.... Which could mean great new idea or pyramid scheme
 
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