The Locum CPA

Leaving a W2 job for locums or 1099 work means you now have to figure out health insurance on your own. In this episode, Stephen Lee, CPA and Certified Private Wealth Advisor, talks with Allison Skopinich, Director of Sales at Solo Health. They cover the options, the common mistakes, and how to think about coverage as a self-employed physician.

In this episode:

• When employer coverage typically ends, and why you should check with HR right away
• How COBRA works, why it often brings sticker shock, and its 60-day enrollment window and 18-month limit
• The biggest mistakes physicians make: defaulting to COBRA without comparing options, or going without coverage
• How to treat health coverage as a business decision once you are your own employer
• How an EIN, LLC, or S corp can open the door to self-funded health plans
• Why ACA Marketplace plans can be a problem if you work in multiple states or your family lives elsewhere
• When a nationwide PPO makes sense, and when a high deductible plan with an HSA is the better fit
• How Solo Health works: enroll any month, no lock-in, and cancel with 5 days' notice
• Why the most expensive plan is not always the best plan
• Marketplace open enrollment runs November 1 through the end of January

Key takeaway: Start evaluating your coverage at least 30 days before your employer plan ends. Look beyond the monthly premium to your deductible, HSA eligibility, your family's needs, and where you practice.

Links:Apply for a discovery call with Stephen: https://thelocumcpa.com/book-appointment/?utm_source=podcast

Read The CPA's Guide to Locum Tenens: https://thelocumcpa.com/cpas-guide-to-locum-tenens/?utm_source=podcast

This episode is for educational purposes only and is not tax, legal, or insurance advice. Talk with a qualified professional about your own situation.

If you're a physician wondering how to start investing for your children, you'll usually hear three recommendations: open a 529, open a Roth IRA, or invest in a taxable brokerage account. The truth is, there's no single best answer because these three accounts solve three completely different problems.

In this episode, Stephen Lee, CPA and certified private wealth advisor, breaks down:

• 529 plans: Tax-advantaged education savings, beneficiary changes, and the new 529-to-Roth IRA rollover rules (including the $35,000 lifetime cap and 15-year holding period)
• Roth IRAs: Why earned income is required, how parents can fund the contribution while their child keeps their paycheck, and what counts as legitimate compensation
• Taxable brokerage accounts: The flexibility to fund goals beyond college or retirement, parent-owned vs. custodial (UTMA/UGMA) structures, and why starting early matters more than choosing the perfect account

Stephen also walks through seven real-world physician family scenarios, from newborns to teenagers with earned income, families behind on their own retirement, and parents who've already fully funded a 529. You'll get a practical starting allocation framework (like 60% 529 / 40% brokerage for young families) and guidance on when to shift as your child grows.

The biggest takeaway: your child's biggest advantage isn't picking the perfect account. It's time. Start now, automate, and adjust later.

Book a consultation with Stephen: https://thelocumcpa.com/book-appointment/?utm_source=podcast

Read the CPA's Guide to Locum Tenens: https://thelocumcpa.com/cpas-guide-to-locum-tenens/?utm_source=podcast

If you're a 1099 physician making $350K, $500K, or over $1 million this year, the next few months could have a bigger impact on your tax bill than anything you do next April. Once December 31st passes, many of your best tax planning opportunities disappear.

In this episode, Stephen Lee, CPA and certified private wealth advisor, walks through a 7-item year-end tax planning checklist specifically for 1099 and locum tenens physicians:

1. Project your full-year 2026 income
2. Review your business structure and S corp compensation
3. Maximize the right retirement plan
4. Evaluate legitimate year-end business purchases
5. Clean up your business expenses and deductions
6. Fund smaller tax-advantaged accounts like your HSA
7. Run a real year-end tax projection (not just a guess)

You'll learn why asking your CPA in March is too late, how your income level changes the strategy, what retirement plan limits apply for 2026, and how to know whether you'll owe a large tax check in January or April or whether there's still time to act.

Book a discovery call with Stephen:https://thelocumcpa.com/book-appointment/?utm_source=podcast

Read the free CPA's guide to locum tenens:https://thelocumcpa.com/cpas-guide-to-locum-tenens/?utm_source=podcast

Should high-income physicians put everything into Roth? Many doctors earning $400K, $1M+ hear the same advice: pay taxes now, let it grow tax-free, and never worry again. But for many high-income physicians, maxing out Roth could actually mean paying more tax over your lifetime.

In this episode of The Locum CPA, CPA and Certified Private Wealth Advisor Stephen Lee breaks down when Roth makes sense, when traditional pre-tax contributions are the better play, and why most high-income physicians probably want both. You'll also learn why choosing traditional inside your 401(k) doesn't necessarily mean you should stop doing a backdoor Roth IRA.

The real question isn't whether taxes will go up. It's: what tax rate are you avoiding today versus what tax rate will you likely pay later? Your income level, retirement timeline, Roth conversion opportunities, and deferred compensation all matter. Don't make a 30-year tax decision based solely on "taxes are going up."

Book a consultation: https://thelocumcpa.com/book-appointment/?utm_source=podcast

Free guide, The CPA's Guide to Locum Tenens: https://thelocumcpa.com/cpas-guide-to-locum-tenens/?utm_source=podcast

Navigating the financial side of locum tenens work can feel overwhelming. The Locum CPA Podcast is here to change that. Hosted by a CPA who understands the unique challenges of locum tenens professionals, this show breaks down everything from taxes and retirement planning to entity structuring and contract considerations, all in plain language.

Whether you're a physician, CRNA, NP, or PA doing locum work, each episode delivers practical, actionable guidance to help you keep more of what you earn, stay compliant, and build long-term wealth. No jargon. No fluff. Just real strategies from a CPA who works with locum tenens providers every day.

New episodes cover topics like:

• Tax planning specifically for 1099 and W-2 locum income
• Retirement options for self-employed healthcare professionals
• Business entity setup and when it actually matters
• Deductions and write-offs unique to travel and locum work
• Bookkeeping habits that make tax season painless

Ready to take control of your financial future?

Book a consultation: https://thelocumcpa.com/book-appointment/?utm_source=podcast

Read the free guide, The CPA's Guide to Locum Tenens: https://thelocumcpa.com/cpas-guide-to-locum-tenens/?utm_source=podcast

Welcome to The Locum CPA podcast, your go-to resource for tax strategies, financial planning, and business insights tailored specifically for locum tenens healthcare professionals.

Navigating the financial side of locum work can be overwhelming. Between multiple assignments, varying state tax filings, self-employment considerations, and retirement planning, you need guidance from someone who truly understands the unique challenges of locum tenens life. That's exactly what this show delivers, practical, no-nonsense advice from a CPA who specializes in working with locum providers.

Each episode breaks down real-world tax scenarios, money-saving strategies, and financial best practices to help you keep more of what you earn, stay compliant, and build long-term wealth, all without the jargon and confusion.

Book a one-on-one appointment:

https://thelocumcpa.com/book-appointment/?utm_source=podcast

Read the CPA's Guide to Locum Tenens:

https://thelocumcpa.com/cpas-guide-to-locum-tenens/?utm_source=podcast

New episodes drop regularly. Subscribe so you never miss one, and have a question or topic you'd like covered? Reach out, this podcast is built around what you need to know.

If you're a 1099 physician earning $350,000 or more, tax deductions are only the beginning. The real opportunity is in how your entire tax structure works together, your entity, your S-Corp salary, your retirement plan, your quarterly estimated payments, your state tax footprint, and how money actually flows through your business.

Hosted by Stephen Lee, CPA and founder of The Locum CPA, this show is built specifically for high-income self-employed and locum tenens physicians who want a proactive tax strategy, not just a tax return prepared after the year is already over.

Each episode breaks down the key pillars of a real tax plan:

• Income structure, understanding how you get paid, from one locums company or five, with or without W2 or K1 income

• Entity selection, LLC vs. S-Corp, and why your tax classification matters more than your legal structure

• S-Corp evaluation, reasonable compensation rules, payroll tax savings, and when the administrative cost is worth it

• Retirement planning, solo 401(k), advanced plans, and how your retirement strategy ties back to your entity and salary

• Tax cash flow systems, reserving for taxes, covering expenses, and making owner distributions intentional instead of guessing

• Multi-state tax, filing and planning across states where you live, work, and earn income

• Clean reimbursements, separating personal and business expenses for stronger substantiation

• Year-round planning, adjusting salary, estimated taxes, and retirement contributions as your income changes throughout the year

Because none of these decisions should be made in isolation. Your salary affects your payroll. Your payroll affects your retirement strategy. Your entity affects your administration. Your state footprint affects your liability. It all needs to work together, and that's what a tax plan actually is.

🔗 Book a complimentary discovery call with Stephen: https://thelocumcpa.com/book-appointment/?utm_source=podcast

🔗 Read the CPA's Guide to Locum Tenens: https://thelocumcpa.com/cpas-guide-to-locum-tenens/?utm_source=podcast

New episodes weekly. Subscribe so you don't miss a strategy.

If you're a 1099 physician earning $350K or more, you've probably heard advice like "just write it off" or "put the car through the business." But that's not how the tax code actually works. In this episode, CPA Stephen Lee, founder of The Locum CPA, breaks down what self-employed physicians can legitimately deduct, what usually isn't deductible, and the gray areas where physicians get into trouble.

We cover:

• Professional expenses (licensing, malpractice, CME, board certification)
• Technology and equipment — business vs. personal use
• Vehicle deductions and the commuting rules that trip people up
• Travel expenses and why your "tax home" matters for locum physicians
• Home office deductions, meals, and entertainment
• Health insurance and retirement planning strategies
• Why maximizing deductions isn't where the biggest tax planning opportunities are for high-income earners

The difference between good tax planning and aggressive tax behavior comes down to one question: Is this genuinely connected to your business? Stephen explains how to think like a business owner, not just a high earner chasing write-offs.

📅 Book a complimentary discovery call with The Locum CPA:

https://thelocumcpa.com/book-appointment/?utm_source=podcast

📘 Read The CPA's Guide to Locum Tenens:

https://thelocumcpa.com/cpas-guide-to-locum-tenens/?utm_source=podcast

If your S-Corp earns $500,000 as a 1099 physician, someone will tell you to pay yourself $80,000 and take the rest in distributions. The IRS disagrees. Your salary must be reasonable. So what should it actually be, and can you defend it in an audit?

In this episode, CPA and certified private wealth advisor Stephen Lee walks through a real-world case study of a 1099 radiologist making $500,000. He explains why percentage rules of thumb don't work for physicians, who personally generate nearly every dollar of revenue. You'll learn the five core criteria for setting a defensible salary: specialty, hours worked, scope of duties, geography, and business, and how to use W2 replacement cost as a practical benchmark instead of guessing.

Stephen also breaks down the actual math at different salary levels ($100K, $250K, and $350K), showing how each affects your distributions, payroll tax savings, and audit risk. He shares a five-step playbook for documenting your salary and warns against common mistakes like picking an arbitrary number in December or blindly copying a colleague's setup. The episode closes with the radiologist's real result, a defensible $250,000 salary backed by market data, and how reasonable compensation impacts your solo 401(k), cash balance plan, and pass-through entity tax strategy.

Resources & Links:

• 📅 Book a complimentary 15-minute discovery call with Stephen Lee: https://thelocumcpa.com/book-appointment/?utm_source=podcast
• 📗 The CPA's Guide to Locum Tenens: https://thelocumcpa.com/cpas-guide-to-locum-tenens/?utm_source=podcast

Someone told you that as a 1099 physician, you need an S-Corp — but is that actually true? In this episode, Stephen Lee, CPA and Certified Private Wealth Advisor at The Locum CPA, breaks down a real-world case study with Dr. Swanson, an anesthesiologist transitioning to full-time locums work, to reveal the exact income threshold where an S-Corp election actually starts making financial sense.

You'll learn why revenue isn't the metric that matters (net profit is), how "reasonable compensation" rules limit your payroll tax savings, the hidden costs of running an S-Corp that can wipe out your gains, and the five key questions to ask before making the switch — including how a W-2/1099 hybrid income situation changes the math entirely.

Whether you're a full-time locums physician or juggling a W-2 job with side 1099 work, this episode will help you evaluate your entity structure with real numbers instead of generic advice.

📅 Book a complimentary discovery call: https://thelocumcpa.com/book-appointment/?utm_source=podcast

📖 Read the CPA's Guide to Locum Tenens: https://thelocumcpa.com/cpas-guide-to-locum-tenens/?utm_source=podcast