TL;DR
New York nurses typically have a 403(b) TSA account and may have a defined benefit pension through their employer. The 403(b) can be rolled into an IRA after separation from service. Social Security is typically available to nurses in the private sector. The retirement income plan coordinates all three sources.
| Decision Area | With ABC Wealth | Without a Fiduciary |
|---|---|---|
| Advisor obligation | Legally bound to your interest | May prioritize commissions |
| IRA rollover guidance | Tax-optimized, timed correctly | Often rushed or generic |
| Social Security timing | Coordinated with income plan | Claimed too early by default |
| ROTH conversion window | Modeled before RMDs begin | Missed or ignored |
| Ongoing access | Direct to Doug — no handoffs | Junior advisors or call centers |
403(b) Accounts for Healthcare Workers
Most New York hospital and healthcare system employees have access to a 403(b) Tax-Sheltered Annuity (TSA) account. These accounts are often invested in variable annuity products through insurance companies, which carry surrender charges and mortality and expense fees that significantly increase the cost of the plan. After separation from service, the 403(b) can be rolled into a Traditional IRA via a direct rollover — typically reducing fees, expanding the investment menu, and simplifying the overall account picture. Doug reviews the surrender charge schedule and the investment quality of the current 403(b) before recommending a rollover.
NYC Health + Hospitals Pension
Nurses employed by NYC Health + Hospitals are enrolled in NYCERS and have a defined benefit pension. The pension benefit is calculated based on years of service and final average salary. NYC H+H nurses also have access to the NYC Deferred Compensation Plan's 457(b) account, which provides penalty-free access after separation from service. Doug coordinates the NYCERS pension, the 457(b), and Social Security into a unified retirement income plan.
Private Hospital and Healthcare System Nurses
Nurses at private hospitals and healthcare systems — NYP, Mount Sinai, Northwell, Montefiore, and others — typically have a 403(b) as their primary retirement savings vehicle, often with an employer match. Some private healthcare systems also offer a defined benefit pension, though these have become less common. Social Security is available to private sector nurses and is calculated normally — not subject to WEP or GPO. The retirement income plan coordinates the 403(b)/IRA, any pension, and Social Security.
Income Planning for Nurses with Variable Schedules
Many nurses work variable schedules — overtime, per diem shifts, and agency work — that create variable income from year to year. This variability affects the optimal contribution strategy (maximizing contributions in high-income years), the ROTH conversion analysis (converting in low-income years), and the Social Security benefit calculation (which is based on the highest 35 years of earnings). Doug builds retirement plans that account for income variability and identify the optimal strategy for each income scenario.
What should you know about Retirement Planning?
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$250,000 in investable assets or $200,000 combined household income. No obligation. No junior associates.