If you bought a Guardian GSI policy during training, you made the right decision. But the policy you bought as a resident is not the policy you need as an attending.

A resident earning $65,000 qualifies for $5,000 a month in disability coverage. An attending earning $400,000 may want significantly more. The GSI policy you already own was designed to grow with you. The Benefit Purchase Option or Future Increase Option on your policy gives you the right to increase your coverage without any medical underwriting. No health questions. No exams. No possibility of being declined. The same guarantee that got you in during training still applies.

But that growth does not happen automatically. You have to act. And the sooner you act after starting your attending role, the better your options are.

The First Thing to Do After Graduation

The moment you have an attending contract in hand, send it to your Guardian agent. Do not wait until you start the job. Do not wait until you are settled in. The contract is what we need to begin planning your coverage increase, and having it early means everything is ready to execute when your income starts.

Some new attendings send their contracts right away. Others take months to get around to it. The ones who act early lock in their coverage at the best possible rates and avoid gaps in protection during the highest-risk transition of their career.

If you are continuing to fellowship rather than starting an attending role, the process is different. Your coverage stays where it is during fellowship. What matters is that your agent knows your new expected graduation date so the increase process is ready the moment fellowship ends.

The $8,000 Increase Without Financial Documentation

For a full comparison of group LTD vs. individual own-occupation coverage, see Is Your Employer’s Disability Insurance Enough?

If your training policy was $2,500 or $5,000 per month, this increase takes you to $8,000 with nothing more than a simple form. The same guaranteed issue process that gave you the original policy applies here. No medical underwriting of any kind. You get a second policy with the same discounted rates that layers on top of your existing GSI policy. Quick and easy. For an explanation of why increases appear as a separate policy, see Why Disability Insurance Increases Create a Second Policy.

Going Above $8,000

Once the $8,000 base is in place, we look at whether you can go higher. The maximum GSI coverage including increases is $15,000 per month. Getting there depends on two things: your attending income and your employer-provided group long-term disability coverage.

Guardian’s issue and participation limits determine how much individual coverage you can carry relative to your total income and existing group LTD. In some cases, a new attending earning $350,000 with a strong group LTD plan may not qualify for the full $15,000 immediately. In other cases, an attending earning $500,000 with minimal group coverage can max out right away.

This is where the employment contract matters. Your income, and your group LTD benefit structure, factor into the calculation. We review this with every new attending and design the increase to capture the maximum coverage available.

Above $8,000, financial documentation is required. That means income verification. But the medical underwriting guarantee still holds. No health questions. No exams. Your health is irrelevant to the increase, just as it was to the original policy.

Why You Do Not Wait for the Three-Year Window

If your policy has the Benefit Purchase Option, you might assume the first opportunity to increase coverage is the three-year BPO window. That is not correct.

The BPO has an income trigger. If your income increases by more than 50%, the option to increase coverage activates immediately. Every physician who moves from a training salary to an attending salary crosses that threshold on day one. The BPO triggers the moment your attending income starts, not three years later.

This means you can increase coverage in your first year of practice. There is no reason to wait, and several reasons not to. Every year you delay means a higher premium on the additional coverage, because the new coverage is priced at your current age. A 30-year-old converting gets a better rate than a 33-year-old converting for the same coverage. Waiting also means you are underinsured during the most significant income jump of your career. The day your attending salary starts, your training-level coverage no longer matches your financial reality. If something happens to you in year one of practice, the difference between $5,000 a month and $15,000 a month is not a rounding error. It is the difference between covering your mortgage, your loans, and your family’s expenses or falling short. The financial case for acting early is real. But the protection case is the one that actually matters.

Converting Graded to Level Premiums

If you started with graded premiums during training, converting to level premiums after graduation is a financial priority. This is covered in detail on our cost page, but the key point bears repeating here.

Graded premiums increase every year. The longer you stay on the graded schedule after your attending income starts, the more you pay permanently. The attained age level premium locks in at the age you convert. Every year you delay adds cost to the policy for the rest of your career.

There is one critical timing constraint. The graded-to-level conversion can only happen on your policy anniversary date. If you bought your GSI policy in March and graduated in June, you cannot convert until the following March. This is why we discuss conversion timing when we increase your coverage after graduation. We want the conversion scheduled for the next available anniversary so it does not slip through the cracks. This is one of the things we manage for every physician we work with. Our system tracks your policy anniversary date and sends you a notification when the conversion window opens. The notification includes the exact cost difference between staying on graded and converting to level for the remainder of your career. If you want to convert, you click a link, complete a short form, and the change is processed. No phone calls required. No paperwork to chase down. The conversion happens because the system is designed to make sure it does, not because you remembered to ask about it.

What the Process Looks Like

Here is what happens when you are ready to increase your coverage after graduation:

1. 1

   You send us your attending employment contract. We review it and identify the maximum coverage increase available based on your income, group LTD, and current GSI benefit.

2. 2

   We prepare the increase application. If you have already sent your employment contract, we use it to determine whether you should target $8,000 per month or go higher. In many cases, the $8,000 no-documentation path is the right first move, especially when a robust employer-provided group LTD plan limits how much additional individual coverage Guardian will issue. For increases above $8,000, income verification is required, but your contract typically satisfies that requirement.

3. 3

   The increase is submitted to Guardian. No medical underwriting. No health questions. Approval is typically fast.

4. 4

   We schedule your graded-to-level premium conversion for the next available policy anniversary date. You’ll get our automated emails at the correct time to make this change.

5. 5

   Your coverage is in place. You now have an individually owned disability policy protecting your full attending income, not your training income.

The entire process can be completed in a matter of days once we have your contract.

Already have a GSI policy and want to understand what it covers? See What Your GSI Policy Includes.

Want to understand how graded and level premiums work before converting? See How Much Does GSI Cost?

8834520.1 Exp 3/28  |  Guardian is not an official vendor associated with, authorized, sponsored, or endorsed by any GME program.