The Uniform Prudent Investor’s Act

A Trust Primer for Physicians

By Charles L. Stanley; CFP™ ChFCfp-book1

Since inception, the Uniform Prudent Investor Act (UPIA) has changed the financial advisory landscape. Essentially, the act modified the legal criteria of “prudent investing” for trusts.

Now, all assets owned by a trust are considered “investments” for purposes of the Uniform Prudent Investor Act. Consequently, for example, if a trust owns a life insurance policy or an annuity, it is considered an investment for purposes of the UPIA. Anointed doctors, and other trustees and their advisors, are subject to the Act.

Background

The UPIA (California Probate Code Article 2.5) was adopted by the Uniform Conference of Commissioners on Uniform State Laws in 1994. When determining whether or not certain investing is “prudent,” the standard is applied to the whole portfolio rather than to individual investments.

Risk Analysis

The UPIA radically changes the analysis of risk. The UPIA considers risk as unavoidable. For example, fixed income instruments carry the risk of loss of purchasing power, even though the principal may not be reduced in terms of real numbers. Risk is often desirable so long as it is sufficiently compensated. The UPIA seeks to compel the trustees to analyze the trade-offs between risks and returns, taking into consideration the needs and objectives of the trust.

Restrictions Eliminated

The restrictions on what type of investments can be held in trust have been eliminated. The doctor trustee, or other, can invest in anything that plays an appropriate role in achieving the risk/return objectives of the trust and that meets the other requirements of prudent investment. The trustee’s duty to diversify trust assets is codified in the UPIA. It is now recognized that proper effective diversification may enhance returns and/or reduce risk at the same time.

Delegation of Duty Permitted

The UPIA rejected the traditional trust rule that generally prohibited “delegation of duty” by trustees, especially the duty of investment of trust assets. Delegation is now permitted, subject to safeguards. Agents are now made liable if they do not follow the new law.

What Must Trustees Do?

To comply with the UPIA, trustees must review trust assets (16049) and make and implement decisions to either keep or discard assets in order to bring the trust portfolio into compliance with the purposes, terms, distribution requirements, and other circumstances of the trust. For example: 

  • The trustee must diversify the assets of the trust unless it is prudent not to do so (16048). Accordingly, it would not be acceptable for the trust to hold all cash, or all municipal bonds.
  • The trustee must either comply with the Act in full or have the trust amended to restrict the requirements to diversify trust assets.
  • The trustee must delegate if he or she believes that he or she doesn’t the expertise to perform certain functions, this is particularly anticipated in the area of investment management.
  • The trustee is expected to document all of the above and to be available for review either by beneficiaries and/or courts should they become involved. This includes a written Investment Policy Statement [IPS], as previously discussed in the Executive-Post. The act doesn’t specifically require this, but how would one prove they had been acting as a prudent trustee without documentation?
  • The trustee must periodically review the circumstances, assets, and any professional delegates whom he or she has retained to assist him or her.
  • The portfolio must be periodically rebalanced to maintain the established risk/reward characteristics identified in the Investment Policy Statement [IPS]. This is also not specifically stated, but is implied in 16047(b) and is a part of proper portfolio management according to Modern Portfolio Theory [MPT].
  • The act requires the costs of management to be “reasonable.”
  • The trustee must deal impartially with beneficiaries when there are two or more beneficiaries and must invest impartially, taking into account the differing interests of the beneficiaries.

Assessment

In most states, trust language can draft the trustee out of any and all requirements of the Uniform Prudent Investor Act. Some attorneys are doing this. So medical professionals and others should check trust language carefully. This article is not a “final answer” in regard to compliance with the Uniform Prudent Investor Act. But, we seek your thoughts, ideas, experiences, opinions and comments on the UPIA; especially from medically focused financial advisors and estate attorneys. For example, are there other compliance issues to consider?

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Corporate Minutes and IRS Tax Savings

It Pays for Doctors to Keep Good Records

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]Dr. David E. Marcinko MBA

More than a few medical professionals have ownership in small corporations outside of their medical practice, or day-job as physician-healers. More are contemplating same, as the healthcare insurance crisis grows, and the social and economic swagger of physicians decrease.

Small Corporations

But, some of these doctor-involved small corporations generally are not too formal in their day-to-day operations. Formality could even interfere with effective functioning of the emerging matrix business environment. On the other hand, doctors are notoriously stubborn, egotistical and business directors, officers and shareholders are usually the same few people. They are in contact daily. They might easily agree on a capital expenditure during a chance meeting in the stairwell, hospital, clinic, medical office or golf course,

Annual Meetings

But, if the formal procedures of large corporations seem out of place in the closely held corporation, holding an annual meeting and recording all matters in corporate minutes is not as pointless as it may appear.

Accurate and complete corporation minutes can produce real tax savings. The IRS keeps a sharp watch on closely held corporations. Corporate minutes can provide an excellent—and sometimes the only—defense against possible unfavorable tax consequences.

How Minutes Count

Corporations often enjoy a favorable tax rate compared to their owner’s personal rates. They also benefit from deductions and credits an individual or unincorporated business cannot get. But, to get all the tax benefits due you, you should make business decisions in a way that shows sound business purpose and intent. Your corporate minutes are proof of your good intentions should you ever be audited by the IRS.

Corporate Minutes

Corporate minutes have a particular format, just as the problem orientated medical record [POMR] that we are all familiar with, has its own style. For example, corporate minutes, along with receipts, invoices, and correspondence, serve as evidence in several important areas: 

Executive Compensation

Your minutes should show that any salary increase for an executive or officer has been formally approved and ratified by the board of directors. The basis for the raise should be noted in detail. Minutes should include relevant factors which can justify a raise such as: expanded job duties and/or time, contributions to company growth, and the need to match competitors’ salaries.

The minutes should also describe the scope of the job and what the increase will be. Such information is designed to satisfy the IRS and the courts that the compensation is reasonable and the increase is legitimate. With this information, the IRS is less likely to suspect that you are using a raise to disguise a dividend. Both dividends and compensation are taxable to the recipient. But dividends, unlike compensation, cannot be deducted by the corporation.

Date Protection

Dates of the minutes that support the increase can be extra protection. The minutes can show that the decision was made and implemented well before year-end earnings could be accurately projected. Large raises or across-the-board increases granted close to year end, when earnings are high, lead the IRS to see dividends in disguise.

Loan Verifications

Corporate minutes also verify that loans made to executives are loans and not taxable compensation or dividends. They also confirm the nature of such corporate largesse as gifts to individuals (such as to the surviving spouse of a deceased senior executive). Since the IRS considers intention in business actions, your minutes can show that you have sound business motives from the start.

Keep in mind, however, that loans from the corporation to employee/ shareholders must meet other criteria. Nothing you have in writing, including the minutes, will win the day if your loans appear to be dividends. If you fail to repay them, pay interest on them, provide collateral, etc., there is a good chance the IRS will rule that the advances are dividends.

Excess Accumulated Earnings

Corporations can accumulate earnings of up to certain indexed limits. Anything above that may face an excess accumulated earnings tax. Under some circumstances you may keep earnings above the limit without penalty; this is common in scientific and health technology fields. Some of the acceptable reasons for excess accumulation are:

• plans to expand or diversify

• plans to buy new equipment or build up inventory

• projected investment in business-related properties

• to maintain working capital as a hedge against borrowing

• to make loans needed to maintain business

• to provide for actual-potential lawsuits, contested tax or profit loss

• to meet profit-sharing and pension plan obligations

Your plans can be immediate or long-range. They just have to be for a reasonable business purpose. Dates when plans were made and details as to their implementation, when included in corporate minutes, supply proof of that. If you include estimates, market analysis, receipts, and other related documentation of the purpose as part of the record, you will add weight to your case.

Step Transactions

Corporate minutes can also perform the same function for step-transactions. Step transactions consist of steps taken over time toward achieving one objective. Such plans, if recorded in your corporate minutes, can justify your holding on to excess earnings without tax penalty. Even if the plan is abandoned at any “step,” you can state the reasons in your minutes and effectively forestall a penalty.

Retirement and other Pension Plans

To obtain maximum tax savings for your business and your employees, any pension, profit-sharing, or stock-option plan has to satisfy IRS rules. If it does, your employees defer taxes on your contributions and their investment earnings until those funds are distributed to them. Your corporation gets a tax deduction for its contributions.

To get IRS approval, you must submit documentary evidence supporting your plan along with your application. Your corporate minutes supply some of that evidence. They should show the date the plan was adopted and ratified, contain figures demonstrating financial ability, and show that the plan was intended to be permanent. Once you have obtained IRS approval, your annual contributions should be detailed in succeeding corporate minutes to protect your corporate deductions.

Dividends

Your corporate minutes play a part in determining the taxable nature of dividends. Generally, a dividend paid out in the form of stock isn’t taxable to the shareholder until the stock is sold. Dividends paid in cash or property is taxable income in the year they are paid. But if shareholders can choose between taking a dividend in stock or in cash or property, the dividend is taxable to them no matter which method they elect.

To settle such tax questions (and get the best tax results for you), your corporate minutes should clearly reflect the form of dividend being offered to stockholders.

Mergers, Consolidations, etc

To earn tax-exempt status, the minutes must show that a merger or other action serves a bona fide business purpose. It’s OK if the merger will save you taxes, but there must be a business reason as well. For instance, the reorganization will enable you to cut costs, or the merger will bring needed technical skills to the business. The minutes should include a specific plan for the transaction and how it is to be carried out.

Corporate Meetings

One reason for a closely held corporation to hold a “formal” annual meeting is to create corporate minutes. Tax advantages can be further ensured by holding other meetings and recording minutes whenever any major business decision is made. Neither a board meeting nor the corporate minutes recording it need be elaborate or time-consuming. There is not a required format for minutes. Their value lies in what they say, not how they say it, although accuracy and clarity count.

One company officer must be the “secretary,” responsible for calling the meeting, notifying members, drawing up the agenda, and distributing it in advance. The secretary is also responsible for recording the date, time, and place of the meeting, the attendance, and all important matters settled (although someone else can physically take the notes). After the minutes have been prepared, the secretary distributes copies to all board members (and the company attorney). Getting their signatures on the minutes isn’t necessary but can be helpful.

Assessment

Don’t waste time trying to record every point that’s brought up at the meeting. Enter only final decisions. In a closely held corporation, most of the discussion has probably preceded the actual meeting. The meeting serves only to formalize those final decisions—and essential details—for the record.

Conclusion

What is missing from the above, if anything? Your experiences and comments are appreciated.

Related Information Sources:

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Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com  or Bio: www.stpub.com/pubs/authors/MARCINKO.htm

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Debt-Based Portfolio Decisions

An Establishment Checklist

By Staff Writers

Determining the percentage of debt-based assets for any medical investment portfolio – personal, institutional or endowment – is an often difficult decision.

Too much risk may lead to default loss, while too little risk may cause under-performance in the portfolio; neither optimizing the efficient frontier.

And so, the following checklist may help initiate the discussion, or at least take it to another level.

Physician-Executive Checklist for Establishing a Debt-Based Portfolio

 

Action

 

Responsible Party

 

Due Date

 

 

Determine the portfolio 

 

 

 

 

 

portion to be invested

 

 

 

 

 

in debt-based securities

 

 

 

 

 

 

 

Determine what investment

 

 

 

 

 

vehicles are to be used

 

 

 

 

 

(e.g., individual portfolio

 

 

 

 

 

manager, mutual funds)

 

 

 

 

 

 

 

Determine investment

 

 

 

 

 

characteristics needed and

 

 

 

 

 

what strategies are to be used

 

 

 

 

 

 

 

Select a portfolio manager or

 

 

 

 

 

choose some other method of

 

 

 

 

 

investing in bonds

 

 

 

 

 

 

 

Establish doctor’s accounts

 

 

 

 

 

 

 

Communicate desired services

 

 

 

 

 

 

 

Execute program to establish

 

 

 

 

 

portfolio

 

 

 

 

 

 

 

Review the accounts and

 

 

 

 

 

confirm executed plans

 

 

 

 

 

 

 

 

 

 

 

Conclusion

How do you determined the percentage and type of debt-based assets that are appropriate for your own personal portfolio; please comment and opine – what other parameters must be considered – are you too risk-tolerant or risk-adverse? Do you even use debt at all?

Related Information Sources:

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Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com  or Bio: www.stpub.com/pubs/authors/MARCINKO.htm

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Professionally Managed Portfolios and Mutual Funds

Advantages and Disadvantages for Physician Investors

[By Staff Writers]

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The following briefly summarizes the advantages and disadvantages of professionally managed portfolios and mutual funds according to size and taxation factors.

Portfolio Size

A major factor that impacts the selection process is the size of the physician-investor’s portfolio. For example, is there a size at which it makes more sense to use managed portfolios?

Except for large portfolios [>$3 – 5 million dollars, USD], mutual fund portfolios can meet most physician investors’ needs. Investors who need substantial individual attention should also consider managed portfolios (perhaps in conjunction with funds or ETFs to add additional asset classes).

Income Tax Consideration

Professionally managed portfolios often offer the physician greater control over the timing of taxable transactions.

For example, at the end of the tax year, it may be appropriate to defer capital gains that would otherwise incur, or conversely, the doctor may wish to accelerate recognition of capital losses.

Mutual funds do not allow physicians or other individual investors to influence the timing of these types of transactions. On the other hand, private portfolio managers are often sensitive to a client’s specific income tax planning needs.

In addition, mutual funds are required to distribute 95% of capital gains recognized during the year. These gains are taxable to shareholders of record on the date of the capital gains distribution, even if the shareholder did not benefit from the gains.

For example, a doctor-shareholder who invests in a mutual fund near the end of the year may pay taxes on gains that were incurred earlier in the year when the fund manager was required to sell securities to raise cash for the purpose of redeeming shares of other investors.

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Assessment

The problem is accentuated in long-term bull markets, where the recognized gains in one year result from an income tax basis to the fund that was established in past years, when the find manager bought securities at very low prices. Private portfolios have the advantage that clients normally are not penalized for events that occurred before they invested with a portfolio manager.

MORE: Vehicles

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KISS Investment Strategies

Warren Buffett on Index Funds

Staff Reporters

Did you know that over 31,000 investors flocked to this year’s annual meeting for Warren Buffet’s Berkshire Hathaway – also referred to as “Woodstock for Capitalists?”

Assessment

And when a shareholder asked for the single-best specific investment idea that Warren Buffett could recommend to an individual in his 30s, Buffett said:

“I would just have it all in a very low-cost index fund from a reputable firm, maybe Vanguard. Unless I bought during a strong bull market, I would feel confident that I would outperform … and I could just go back and get on with my work.”  

Conclusion

What is your personal index fund strategy; do you even have one?

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Interest Rate Options

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Treasury Issues Options

[By William H. Mears; CPA, JD]

Interest rate options are usually options on Treasury instruments, Treasury bills, notes, and bonds. The face values used are $1 million for Treasury bills and $100,000 for T-notes and bonds.

Purpose

With these options, a physician or other investor will bet on the direction of interest rates. When interest rates decline, the prices of bonds increase. This phenomenon has been experienced in the United States for the most part since the late 1980s. If interest rates increase, bond prices decrease.

Assessment

The value of the underlying security (the bond itself) will determine the value of the option. The investors who believe that interest rates will increase and that bond prices will go down are bearish. As bearish investors, they will buy puts and sell calls. Bullish investors will sell calls and sell puts.

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IRs

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Conclusion

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Investing in Options

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An Appropriateness Summary

[By William H. Mears; CPA, JD]

Options trading involve a high degree of risk in that the physician or other investor may lose their entire investment when the option expires. As a result, options trading may not be suitable for all doctors or investors.

Suitability

All trading firms must have a procedure in place that requires a customer’s account to be approved for options trading prior to the execution of any options orders. The following steps must be taken before an option trade can be completed:

1. Completion of an Options Agreement. The Options Agreement attests to the client’s receipt of the Risk Disclosure Book, sent out by the broker.

2. Approval of the Options Agreement by a Registered Options Principal. The Registered Options Principal will ensure that the Risk Disclosure Form is sent and approves the client for options trading based on the client’s application.

3. Return of the Options Agreement to the broker/dealer within 15 days.

4. Receipt of Risk Disclosure Form by the customer. The most important step in the options account opening process is the client’s receipt and review of the Risk Disclosure Book.

Assessment

Generally, brokers send out the Risk Disclosure Form first, get approval for options trading by a Registered Options Principal (ROP), do the trade, and get a signed Options Agreement from a client within 15 days of the account approval.

So, have you ever invested in options; why and what were your results?

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Conclusion

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Using Option Derivatives

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Why Options Investing?

By William H. Mears; CPA, JD

Although options can be used to raise cash from a long stock position that is not salable, individual physician-investors should use options primarily as a hedging mechanism. Individuals and doctors may want to hedge their portfolios to gain peace of mind by purchasing portfolio insurance to guard against major market declines or unpredictable events.

Many Different Uses

Options can also be used by physician-investors or other individuals to lock in profits where a stock has performed well and the investor would like to capture current market value in a stock (without triggering a sale). If an individual investor has a negative outlook on a stock, because of either a short-term economic view or a sentiment about a long-term bear market cycle, the investor can protect his or her portfolio against market movements, both short-term and long-term.

Options can be useful to manage risk in a single stock portfolio. The price for the use of an options strategy can be significant or relatively minor, so it is important to understand the risks, limitations and benefits of options strategies; and to understand this information when these instruments are used.

Traditional Personality of Discomfort

Individual physicians and investors have traditionally been uncomfortable with investments in options. The risk in these instruments is a function in part of the short duration for which they are generally purchased (e.g., three months, nine months). It is difficult to determine the direction of a market for a short time period.

Time-Risk Management

However, one of many ways to hedge the time risk is to increase the duration of an instrument. As the duration of an instrument is extended (to two years, for example), it is possible to determine with greater confidence that the market is likely to move through various cycles.

Long-term Equity Appreciation Options provide the investor with an opportunity to invest in options for up to two and one-half years. During the period of the option, the investor can liquidate the option position at any time, through either an exercise or a sale of the option itself. If the option is not exercised or sold prior to the expiration at the end of the duration, it will expire worthless.

Assessment

The physician investor who understands the vagaries of the markets—and can afford to take the losses if they occur—is the right client for a sophisticated investment strategy involving options. While there are no specific rules that define the characteristics of an option investor, a broker transacting in options for a physician-client is required to make sure that the client is appropriately aware of the risks.

Conclusion

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Understanding Municipal [Muni] Bonds

State and Local Debt Issues

[By Staff Writers]

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Municipal bonds are issued by state and local governments for building schools, bridges, hospitals, and other municipal facilities. These bonds depend upon their tax base to generate the income to pay the interest and retire the debt.

Tax-Exempt Status

The most important feature of municipal bonds is their tax-exempt status. While the interest earned is free from federal income tax, state and local governments may levy taxes on that income. Therefore, because of the tax advantage, municipalities can borrow at lower rates of interest than can corporations.

The physician-investor benefits because the tax advantages associated with the interest, albeit lower than that of corporate or government bonds, may provide a higher rate of return. Municipal bonds are usually sold in increments of $5,000, $10,000 or more, although municipal bond funds may have lower minimums.

Types

Municipal bonds are available in various types, depending upon whether the debt is paid by the issuing authority or by the revenue earned from the facility.

Conclusion

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The Options Clearing Corporation

Option Positions and Exercise Limits

By William H. Mears; CPA, JD

The Options Clearing Corporation [OCC] places certain limits on the number of contracts that can be outstanding on each side of the market for individual securities. These position limits vary from underlying security to underlying security. However, they range from 4,500 to 10,500 contracts. The number of contracts allowed will vary based on the volume and outstanding shares of each issue.

Limits

Additionally, there are limits to the number of same-side-of-the-market contracts that each physician-investor or other person can exercise within a three-or-five-consecutive-business-day period depending on market condition. Long calls and short puts are on the same side of the contract because they are both bullish strategies. Long puts and short calls are bearish strategies.

Covered options

—For a call seller to be considered covered, he or she must either own the underlying stock or convertibles or produce an escrow showing that the stock is on deposit at another brokerage firm and will be delivered if necessary.

—To be covered, a put writer must have cash on deposit with the brokerage firm equal to the aggregate strike price or be short in the underlying stock.

Uncovered options

—A minimum of $2,000 must be deposited in a margin account. Additionally, maintenance margin requirements may apply in the future.

Margin requirements

Options contracts are regulated by the Federal Reserve Board under “Regulation-T” and by the rules and regulations of each brokerage firm and exchange. Options must be fully paid for within seven days of purchase and are settled on a next-day basis.

Assessment

Generally, options cannot be purchased on margin, but occasionally firms will allow clients to do so. The margin requirements for covered options are different from those of uncovered options.

Conclusion

Do you use options and what strategies do you employ; please comment?

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Options and Market Price

In, At, and Out-of-the-Money

By William H. Mears; CPA, JD

A call option is in-the-money if the market price of the stock is higher than the exercise price of the option.

If the market price of the stock was the same as the exercise price of the call option, the option would be at-the-money.

If the market price of the stock was lower than the exercise price of the call option, the option would be out-of-the-money.

Examples:

On June 1, XYZ stock has a market value of $40. The physician-investor bought one XYZ call (representing 100 shares) with a $70 strike, expiring September 16 for $3.

On September 16, at expiration, consider the following:

1. Stock price: $47

Exercise the option, because the strike price is greater than the stock price. Pay $40 for 100 shares. The gain (loss) on position = ($47 – ($40 + $3) × 100) = $400.

2. Stock price: $35

Put option

On June 1, an investor sells XYZ for $40 a share. The investor also bought one put (representing 100 shares) with a $40 strike price and an expiration date of September 16 for $2.

On September 16, consider two scenarios:

1. Stock price: $47

Do not exercise the option, because the stock price is greater than the strike price. The investor would receive $40 for the stock worth $47 if exercised.

Therefore, allow the option to expire. Gain (loss) on the position is ($0 – $2) × 100 = $200.

2. Stock price: $35

Exercise the option, because the stock price is less.

Do not exercise the option, because the stock price is less than the strike price. The investor would have to pay $40 for the stock worth $35 if exercised. Therefore, allow the option to expire. Gain (loss) on position is ($0 – $3) × 100 = $300.

Conclusion

What has been your investing success, or failure, with options?

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Secular Annuities

What Exactly is a Secular Hospital Annuity?

Your assistance is appreciated.

Thank you.

Anonymous Physician-Executive

Lake Worth, Florida

 

Query on Variable Annuities?

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Point-Counter Point Debates

Question:

Annuities are a controversial product in the financial services industry today; especially variable equity annuities. They are often touted as a solution to the retirement income question for medical professionals. Many sales consultants and financial advisors advocate their use; while others absolutely detest and abhor them. And, it has been said that annuities are often sold, but rarely purchased.

For example, insurance fee components are high, sales-loads are great, and most annuities are deferred, but few are annuitized. Some are even sold within qualified retirement plans by fear mongering salesmen/women.

And so, what is your opinion on this controversial subject and ever-evolving contentious financial product? Please omit the default “it depends on the client and situation” answer-of-choice; and clearly opine pro or con; and why.

Assessment

Parsing aside; will annuities remain a bane, or finally morph into a more transparent and efficient product in the future? And, what are some alternatives for physician investors and healthcare executives? Cogent, thoughtful and experienced repliers are appreciated; sales slogans and aphorisms are not. Please opine?

Conclusion

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High-Yield [Junk] Bonds

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Understanding Junk Bonds

[By Staff Writers]

High Yield Bonds [HYBs] are debt issued by U.S. corporations that carry less than investment-grade ratings. They are also referred to as “junk bonds.” For the purpose of high-yield bonds; below investment grade means Ba or lower; as ranked by Moody’s, and BB or lower by Standard & Poor’s.

The Market

The market for high-yield bonds is large. A high-yield security compensates the physician-investor for the added risk by offering a higher coupon [interest rate] than could be obtained from investment-grade corporate bonds.

Many Types

Several types of bonds fall within the high-yield sector, including zero coupons, split coupon, increasing rate, floating rate, pay-in-kind, first mortgage, and equipment trust certificates.

These are structured just like other bonds bearing the same name; the only difference is the investment quality of the corporation issuing the debt. Because of the higher coupon [interest rate], there is a potential for higher total returns to the bondholder or physician-investor.

Risk

Because of their inherent risk, these bonds are an alternative for more aggressive physicians and fixed-income investors. They may also be attractive to equity physician-investors who are willing to assume the risk of the lower investment quality. These investors recognize that as the underlying credit quality of the issuer improves, the value of its bonds should increase as well.

Conclusion

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Explaining Financial Options to Physicians

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A Misunderstood Derivative

By William H. Mears; CPA, JD

By David E. Marcinko MBBS DPM MBA

An option is either the right to buy or sell an asset, or the obligation to buy or sell an asset. Options are derivative instruments; i.e., they derive their value from the performance of the asset upon which they are based—the underlying asset or security. This can be a stock, an equity index, a futures contract, or a Treasury security. Types of options include:

  1. Equity options
  2. Stock index options
  3. Interest rate options
  4. Foreign currency options

Multiple Terms and Definitions

  • A call option contract gives the physician-investor or buyer the right, but not the obligation, to buy a stock at a specified price, subject to an expiration date.
  • The put option contract gives the buyer the right, but not the obligation, to sell a stock at a specific price, subject to an expiration date.
  • The right to buy or sell the underlying security is purchased for a price called the premium.
  • The right to buy or sell the underlying security occurs only for a period of time and at a specific price.
  • The time period of an option is called the duration.
  • The day that the option ends is the expiration.
  • The price at which the option can be exercised is called the strike price.
  • Therefore, the right to buy or sell a security under an option contract exists only for a specific period and ceases to exist at the expiration of the option period.
  • The seller of an option, the individual who has received consideration for granting to another a right, is obligated to perform under the option contract.
  • The seller of a call option, also called the writer, has sold the right to buy that stock.
  • The seller of a call option is obligated to sell the stock to the call option owner if the option is exercised.
  • The seller of a put option is obligated to buy the stock from the put option buyer if the option is exercised.

Option Components

Listed options are traded on an exchange and are packaged and available on stock markets and indexes with various durations at various strike prices.

Over-the-counter options are options that do not trade on an established exchange but are contractual arrangements between two parties.

Because these options are not prepackaged, they can be custom tailored as to strike price, expiration date, and manner of settlement, that is, cash settlement or settlement by delivery of stock.

All listed and over-the-counter options have an expiration date.

American-style options can be exercised at any point in time prior to expiration.

A European-style option creates the right or obligation only at the expiration of a term of an option.

When physician investors purchase or sell an option, they are interested in the cost of that option or the income generated by the sale of that option.

The option premium—the cost of the option—is comprised of the intrinsic value of the option plus its time value.

The intrinsic value of the option is the option’s in-the-money amount.

Options that are out-of-the-money are priced on the basis of time value only.

Option Market Price

The major factors that affect the market price of an option are:

  • The price of the underlying asset
  • The strike price of the option
  • The time remaining until the option expires
  • The prevailing interest rates
  • The expected volatility of the underlying asset

These factors work in the following manner:

1 As the price of an underlying asset increases, the call price goes up and the put price goes down.

2. As the strike price of the option increases, the call price goes down and the put price goes up.

3. As the time to expiration goes out, the call price goes up and the put price goes up.

4. As the risk-free rate of return on money goes up, the call price goes up and the put price goes down.

5. As the volatility in the underlying stock increases, the call price goes up and the put price goes up.

6. As the dividend payout rate of the underlying asset increases, the call price decreases and the put price increases.

When a physician-investor purchases an option, the underlying asset will have a market value. The investor may purchase a call option, which is available for exercise at the same market value (an at-the-money option), at an under-the-market price (in-the-money), or with an exercise price that is over the market value (in-the-money). The exercise price of these options is the strike price.

Option Volatility

The volatility of the underlying asset will also play a significant role in the pricing of an option. The more volatile a stock is, the more likely it is that its performance will be unpredictable and that the strike price will be reached or exceeded and, therefore, that the option will have value. Options on volatile stocks will have a higher premium.

Options contracts, once purchased or sold on an opening trade, can either be (1) traded on a closing trade or allowed to expire worthless or (2) exercised. If an option contract is traded, it will be treated like any other security that is traded. The contract will have proceeds of sale, a cost basis, and a holding period.

All options have a fixed expiration date. All listed equity options, regardless of their particular cycle, expire at 11:59 p.m. Eastern Standard Time on the Saturday following the third Friday of the expiration month. The option actually does not expire until Saturday, but customers must act by 5:30 p.m. on the Friday prior to the expiration date. As an option approaches its expiration date, it diminishes in value.

Managing a Stock Portfolio

Agreements

Options also allow individuals to act on the basis of a predetermined contractual agreement, regardless of market conditions for a specific period. Therefore, as the option approaches its expiration date, the option diminishes in value. It is during the early part of an option’s life that it is most valuable proportionately.

Option Contracts

An option contract will always trade in sizes of 100 shares. The description of an option contract will always contain the name of the underlying security first. The name of the security will be followed by the expiration month, the exercise price, the type of option, and the premium; for example, 1 XYZ MAR 5 call 2.

At maturity, a call option will have a value that will be the greater of zero or the strike price minus the strike price. At maturity, a put option will have a value of the greater of zero or the strike price minus the stock price.

If an option contract is allowed to expire worthless, it will be treated for tax purposes like any other security that has either no proceeds or cost basis. In either case, one leg of the trade will be zero. The position will either be closed in its entirety at a gain or be closed in its entirety at a loss.

If an option is exercised, the buyer of the contract decides that the contract will be exercised. After the exercise, the buyer of a call will own the underlying asset, and the buyer of a put will sell the underlying asset. If an option is exercised, the seller of the option is always obligated to act under the options contract.

Conclusion

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The Secular Trust

An Irrevocable Vehicle

By LaVerne L. Dotson; JD, CPA

A secular trust is typically an irrevocable trust designed so that creditors of a hospital employer, including bankruptcy creditors, cannot attach its funds.

Taxes

Consequently, the employer’s contributions to an irrevocable trust, often means the trust’s earnings are taxable income to the employee.

Benefits

Benefits are normally payable to the employee upon the occurrence of specific events, such as the passage of a certain number of years, retirement, disability, or death.

Assessment

Because they protect against a loss of benefits if the employer becomes insolvent, secular trusts may be preferred to a Rabbi trust by healthcare executives.

Conclusion

Your thoughts and opinions on the above are appreciated?

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Hospital Stock-Purchase Plans

What They Are – How They Work

By LaVerne L. Dotson; JD, CPA

A hospital employee stock-purchase plan qualified under Code § 423 allows eligible employees to purchase stock of an employer under special tax rules and favorable prices.

Intent and Purpose

An employee stock-purchase plan is intended to benefit virtually all employees, not just exceptional ones or limited groups.

Because the granting of options to purchase employer stock under an employee stock-purchase plan cannot discriminate in favor of key employees, usually the plan will appeal only to an employer who simply wants to provide, as a general benefit of employment, the right to buy employer stock, or believes that owning employer stock will act as an incentive to employees to perform well.

Requirements

A hospital employee stock-purchase plan must meet the following requirements:

  • Options may be granted only to employees of the employer corporation, or its parent or subsidiary corporations, to purchase stock in the employer, parent, or subsidiary.
  • The stockholders must approve the plan within 12 months before or after the date the plan is adopted.
  • The plan must provide that an employee cannot be granted an option if the employee, immediately after the option is granted, owns 5% or more of the total voting power or value of all classes of stock of the employer corporation, or its parent or subsidiary, computed using special attribution rules.
  • The plan must require that the options be granted to all employees on a nondiscriminatory basis. However, the options granted to different employees may bear a uniform relationship to the total compensation or the basic or regular rate of compensation of employees. The plan may also provide for a ceiling on the amount of stock to be purchased by any employee.
  • The exercise price must be at least 85% of the fair market value of the stock on the date the option is granted.

Wide Ownership

The broad participation requirements of employee stock-purchase plans mean that the stock is likely to be widely owned. Problems of marketing the employer stock and the securities problems inherent in issuing shares of stock to a number of employees will probably discourage employers who do not have an established market for their stock, and who do not want to face the securities problems related to public trading in their stock.

NQSOs and DSTs

Nonqualified stock options [NQSOs] and the direct stock transfers [DSTs] are both available to the employer as potentially less cumbersome means of obtaining the results of an employee stock-purchase plan.

Since a nonqualified plan is not subject to the restrictions of the qualified plan, normally the main reason for the employer choosing to implement an employee stock-purchase plan is to gain for the employees the favorable tax consequences of such a plan and thereby create a widespread base of company stock ownership among employees.

Taxation

On receipt of an option to purchase stock under an employee stock-purchase plan, the employee does not report any income, even though the exercise price of the stock may be less than the fair market value at the time; nor will the employee recognize income on the exercise of the option and acquisition of the stock at a subsequent date. Only on disposition of the stock will the employee recognize taxable income. As long as the disposition occurs two years or more after the date the option is granted to the employee, and the employee has held the stock at least 12 months after exercising the option, any profit will be treated as capital gains.

Assessment

There is a minor exception to this favorable tax treatment. Upon disposition of stock purchased under the plan, a portion of the gain will be treated as ordinary income equal to the discount of 0% to 15%.

Conclusion

Your comments and experiences with hospital stock purchase plans are appreciated?

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Accredited Investment Fiduciary Analyst™

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One Opinion on the AIFA

[By Dr. Ron Miller; CFP®, AIFA®]

There are over 5,000,000 fiduciaries around the country responsible for other people’s money and sitting on boards and investment committees. Many have had no formal training on their duties and responsibilities as fiduciaries.

The AIF™ and AIFA™

The AIF and the AIFA designations deal mainly with reviewing the fiduciary issues of the investment process, especially for Trusts, pension plans and Institutional money. For example:

  • Is the money being managed according to the basic documents (Investment Policy Statements, etc)?
  • Are fees reasonable?
  • Are the investments being monitored on a regular basis?
  • What are the criteria for the fund or manager being put on a watch list or removed? 
  • Are there any conflicts of interest or self-dealings?
  • Are the fiduciaries to the portfolios aware of their responsibilities?

AIF and AIFA™ Designation

The AIF designation is designed to give investment stewards formal training on the fiduciary issues. The AIFA designation goes a step further and permits the designee to formally certify that the organization he is hired to monitor is following the fiduciary investment process with no deficiencies or areas for improvement.

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Conclusion

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Hospital Stock Appreciation Rights

The SARs Alternative to Stock Transfer

LaVerne L. Dotson; JD, CPA

An alternative to the actual transfer of corporate securities or shares to a doctor, nurse or other hospital employee is the issuance of so-called stock appreciation rights (SARs).

A Contractual Agreement

SARs are a contractual arrangement that, when exercised, entitles an employee to receive, in either stock, cash, or a combination of the two, an amount equal to the appreciation in the employer’s stock subsequent to the date the SARs were granted (or related to such appreciation, if the SARs are valued higher than the FMV of the stock when the SARs were granted).

Tax Consequences

The grant of SARs does not constitute the constructive receipt of income even though the option is immediately exercisable, because the exercise of the option means that the grantee will not get the benefit of additional appreciation of the stock on which the value of the SARs is based.

Any declarable income with SARs occurs at the sale, not acquisition.

Income received from the exercise of SARs is ordinary, and is equal to the amount of cash received or the value of the appreciated stock received. This amount will generally be reportable in the income of the employee in the year of receipt; however, if the SARs are exercised for stock and the stock is subject to a substantial risk of forfeiture, it will be subject to tax when the substantial risk of forfeiture lapses pursuant to IRC Code § 83, discussed in the Executive-Post previously.

Hospital or Medical Employer Deduction

When the SARs are exercised, a deduction is available to the hospital or medical corporate employer.

Assessment

The income from the SARs is also subject to withholding and employment taxes on the employer and employee. As a practical matter, if the individual is an employee at the time the tax is determined, there will often be very little additional payroll taxes to pay, because he or she will already have exceeded the Social Security taxable wage base.

Conclusion

Does the above information agree with your experience with SARs; please comment and opine?

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Stock Options Query

Question:

My hospital wants to give me some stock options. I am a senior nurse manager. What are hospital stock options anyway, and why are they so popular? Should I ask for cash instead?

IOW: Show me the money! Please advise if you can.

Thank you.

PS: Great blog!

Samuel [Sam] M. Jefferson; RN

Baltimore, MD

Hospital Phantom Stock Plans

 

A Securities Granting Alternative

LaVerne L. Dotson; JD, CPA

As an alternative to granting an interest in stock or awarding stock options, a hospital or healthcare employer may establish a so-called phantom stock or shadow stock plan to its employees.

“Unit” Accounts

Under these arrangements the employee is treated as if he or she had received a certain number of shares of the company stock, but instead of actually issuing shares, the employer establishes an account for the employee.

The employer then issues “units” to the employee’s account. The number of units that the employee receives under such a contractual arrangement is pegged to the price or value of the company’s stock.

Once the units have been credited to the employee, the equivalent of dividends on these units are generally paid to the employee and are reinvested to purchase additional units or deferred with interest.

The plan normally provides for appropriate adjustment in the value of units if changes are made in the capitalization of the stock with respect to which the units are priced. Benefits under such a plan are usually deferred for a specific period of time or an event such as death or retirement. When benefits are payable, they may be paid in cash, either in a lump sum or installments, or in the form of stock.

Tax Considerations

The phantom stock is taxed like any other nonqualified deferred compensation plan. The granting of the phantom stock units is not taxable to the employee. When the cash or stock is distributed to the employee, it is taxed as ordinary income, equal to the amount of cash received or the value of the stock. If the stock distributed is subject to a substantial risk of forfeiture, it will be subject to taxation when such risk lapses in accordance with Code § 83(b).

Assessment

Because a phantom stock plan does not require the actual issuance of shares of the employer’s stock, it may enable the employer to offer much of the practical benefit of stock ownership without causing dilution of equity, securities law problems as to stock that would otherwise have been issued, or other problems such as risking the loss of S corporation status.

Conclusion

And so, what has been your experience with these so-called phantom-stock plans?

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Margin Exchange Regulations

Government, Brokerage and Margin Exchange Requirements

By William H. Mears, CPA, JD 

Under the securities laws (the Securities & Exchange Act of 1934), the Federal Reserve Board is authorized to allow brokerage firms to lend against securities positions and charge interest, up to a legal limit, as outlined in Regulation T of the 1934 Act.

Regulation “T”

Under Regulation T, physicians and clients can borrow from a brokerage firm up to 50% of the long position value of their brokerage account. Under Regulation T, only securities listed on a registered stock exchange, the NASDAQ system, or certain approved over-the-counter stocks may be used in a margin account.

A physician investor who transacts in a margin account will be responsible for maintaining the equity in the account at the legal limit, i.e., the 50% level against a stock portfolio.

For example, if a physician investor has a margin loan of $500,000 against a $1 million stock account, and the value of the stock portfolio decreases to $500,000, the doctor-client will need to immediately repay $250,000 of the loan value, because the account no longer can support a $500,000 margin loan.

If the doctor-client is holding bonds in a margin account, the client may borrow under Regulation T up to 80% of the current market value of the securities. U.S. government and municipal bonds have even higher borrowing power.

Example:

Jim Hojo MD, owns a private healthcare equipment company that his father built into a $10 million business, would like to sell some of the equity of the company to long-time employees.

Jim is advised to sell 30% of his privately held company to an Employee Stock Ownership Plan. Jim was told that under Internal Revenue Code §1042, he will be afforded a tax deferral opportunity on the sale of a portion of the stock of the company to the employees. The delay in the recognition of the capital gains on the sale of a portion of the company to the employees is contingent upon compliance with certain criteria outlined in Code §1042.

Jim takes advantage of this transaction and, as advised, purchases domestic-issue floating rate bonds. He then borrows against the floating rate bonds in a margin account.

Because the bonds have a higher Reg T lending capacity, Jim is allowed to borrow 80% of the market value of the bonds. He takes his loan proceeds and invests in a diversified portfolio of equities.

If he had invested initially in stocks, his borrowing capacity against the stock position would have been limited to 50% of the market value of the account.

Failure to Maintain Regulation T Equity

If a doctor-client fails to maintain the Regulation T-required equity in an account, the client will get a “Reg T call” or a “margin call” from the brokerage firm. The Reg T call will require the doctor to meet the margin requirement through a deposit of cash or securities.

However, if the amount of the margin call is immaterial ($500 or less), the brokerage firm is not required to collect the additional margin requirement. Each brokerage firm will have house rules that further restrict the use and/or the availability of margin accounts.

Since securities in a margin account are held in a street name, a brokerage firm has the right to sell the securities if a Reg T or margin call is not met. Securities held in a street name are simply held for a customer’s account in the name of the brokerage house. If a margin call is not met, a customer will lose the securities in the account that are on margin.

Brokerage Credit Agreements

When opening a margin account, the physician investor must sign a credit agreement, which is not very different from any loan documentation, and a hypothecation agreement, giving the stock-broker the right to pledge the securities to a bank in order to provide for lending capacity. The loan consent agreement allows a brokerage firm to lend securities in a stock loan transaction.

Borrowing Capacity

To determine how much a physician-client can borrow, a series of complicated calculations must be made, and a number of key terms must be identified.

First, the doctor client’s equity in the account must be determined. The equity in the account will be the market value of the account less the debit balance (any outstanding debt). The long market value is the current market price of the securities in the account. The amount available for borrow will be limited by the Reg T restrictions, for example, 50% for securities. Whenever the market value of the securities in a margin account increases, the client will have increased borrowing capacity.

Next and conversely, whenever the value of the securities in a margin account decreases, the client will have a margin call. Excess cash in an account (cash from dividends, interest, or proceeds of sale of securities) will be included in the calculation of the margin call. An account holding cash will have increased buying power that cannot be reduced because of decreases in the market value of the account.

Finally, accounts that fall below the Federal Reserve Board requirements will be restricted in the execution of transactions. Stock exchanges also promulgate rules and regulations that must be complied with. The New York Stock Exchange and the National Association of Securities Dealers require an initial minimum equity of $2,000, or 100% of long market value, and a minimum maintenance requirement of 25% of the long market value [minimums may change without notice].

Assessment

The rules outlined above are for a long [owned securities] margin account. The rules for a short account [borrowed securities] are similar in that an uncovered (or naked) short margin requirement is still 50%, but a covered short sale has a Regulation T limit of 95%.

Conclusion

Have you, or a physician-client, ever been caught in one of these regulatory traps or “margin-calls”, and what was the outcome?

***

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Margin Call Models

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Characteristics of the Physician-Investor

[By William H. Mears, CPA, JD]

Generally, a brokerage firm will regulate the use of a margin account by managing the physician client’s risk, and by studying the doctor’s assets and credit history. Margin accounts at brokerage firms are watched carefully to make certain that the brokerage firm does not lose money on the individual. But, when investing on a leveraged basis, physician clients should be aware of the magnification of the market impact on their account, whether favorable or unfavorable.

Margin Investor Awareness

The physician or executive margin-investor should:

• Be sophisticated

• Be of high net worth

• Be aware of the risks

• Be told the horror stories involving leverage, and

• Be aware of the increased returns and liquidity created by margin

Model Tax Rules on Margin Transactions

Investment interest expense can be deducted as an itemized deduction by an individual physician investor only to the extent that the individual has investment income defined as taxable interest, dividends, and short-term capital gains.

Long-term capital gains cannot offset investment interest expense. To the extent that a physician-investor has excess investment interest expenses for a year, these expenses can be carried forward to future years.

If the proceeds of a loan are used to invest in tax-exempt debt, the interest expense incurred to carry that debt will not be deductible for tax purposes.

If the proceeds of a loan are used to invest in tax-exempt debt, such as municipal bonds, the interest expense incurred to carry the debt will not be deductible for tax purposes.

Assessment:

Where you aware of these tax implications on margin before reading this post?

What has been your experience with margin calls, and did you originally fit the criteria above? Please opine and comment?

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Margin Accounts for Physicians

What They Are – How They Work

By William H. Mears; CPA, JD

Margin is defined as the capacity to purchase securities with a loan against an existing position.

A Method of Leverage

Using margin, a physician-investor can increase exposure to potential gains and increase returns.

Conversely, by leveraging current investments, a physician investor can increase exposure to market risk.

Where an investor can reinvest margin proceeds and earn a return in excess of the borrowing cost, the investor has increased total return.

Assessment

However, if a physician investor borrows against a position to invest in securities that decline in value, that investor’s loss is in effect doubled (if the investor had margin up to the legal 50% limit).

Example:

Dr. Prince Price, a dentist who has a $1 million portfolio of low-cost basis securities, would like to invest in a new initial public offering (IPO). He feels certain that the stock of this new initial public offering company will skyrocket.

Prince asks his wife if he can take a home equity line of credit against their house to purchase the stock, but his wife, a financial planner, advises against this strategy. She recommends that Prince take a margin loan against his stock portfolio if he really must invest in the IPO. The margin limit on his account is $500,000, or 50% of the current market value of the portfolio.

Prince decides to invest $500,000 in the new IPO. He purchases 50,000 shares of the $10 stock on the offering.

The new stock closes the first day at $20. In 90 days, the stock is worth $50 a share. Prince sells his stock for $50 a share, taking a short-term capital gain of $40 a share. His financing cost on the margin loan, the 7% for 90 days on a loan principal of $500,000, is his opportunity cost and reduces his net economic gain.

Assessment

At the end of the transaction, Prince calculated his net profit as follows:

Gross proceeds:  $2,500,000

Cost basis:            $500,000

Cost of capital:          $8,749

Net profit:            $1,991,251

Conclusion

What has been your personal experience using, or recommending, margin accounts; please comment?

***

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Of Financial Footnotes and Fine-Print

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Financial Statements Review for Physicians

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]

Of course, it is important to read the fine-print and understand the footnotes when reviewing all four consolidated financial statements or studying an annual business report.  

And, these four consolidated statements are:  

 

  1. Balance sheet
  2. Net-income statement
  3. Cash Flow Statement
  4. Statement of Retained Earnings 

However, it is seldom done by the physician, financial manager or healthcare executive. Yet, the footnotes to financial statements and fine print of annual reports are often packed with meaningful information. 

Footnote Highlights 

The following are some usual footnote highlights for healthcare entities: 

  • Significant accounting policies and practices – Public healthcare companies are required to disclose the accounting policies that are most important to the portrayal of the company’s financial condition and results. These often require management’s most difficult, subjective or complex judgments.
  • Income taxes – The footnotes provide detailed information about the healthcare company’s current and deferred income taxes. The information is broken down by level – federal, state, local and/or foreign, and the main items that affect the company’s effective tax rate are described.
  • Pension plans and other retirement programs – The footnotes discuss the healthcare company’s pension plans and other retirement or post-employment benefit programs. The notes contain specific information about the assets and costs of these programs, and indicate whether, and by how much, the plans are over-or-under funded.
  • Stock options – The notes also contain information about stock options granted to officers and employees, including the method of accounting.

Conclusion

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Statement of Retained Earnings [Shareholder’s Equity]

Financial Statement Review for Physicians

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Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]DEM Thinking

The Statement of Retained Earnings or Shareholder’s Equity [Statement of Changes in Unrestricted Net Assets] is only one of four financial statements. 

The four consolidated financial statements are:  

  1. Balance sheet,
  2. Net-income statement,
  3. Cash flow statement, and
  4. Statement of retained earnings. 

The Statement of Shareholder’s Equity is the newest statement that lists changes that occurred the previous year.  

The major elements of stockholders’ equity include capital stock, paid-in capital, retained earnings, treasury stock, unrealized loss on long-term investments, and foreign currency translation gains and losses. 

Assessment 

Shareholders equity sometimes called capital or net worth. It represents money that would be left if a company sold all of its assets and paid off all of its liabilities.  

This leftover money belongs to the shareholders or the owners of the hospital, clinic, practice or other healthcare entity. 

Conclusion 

And so, do you understand and review your financial statements regularly; why or why not?

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Statement of Cash Flows [SCFs]

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Financial Statement Review for Physicians

Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief ]

Did you know that the Statement of Cash Flows [SCFs] is only one of four financial statements? Yep; it is true. 

 

The four consolidated statements are: 

  1. Balance sheet,
  2. Net-income statement,
  3. Cash flow statement and,
  4. Statement of retained earnings. 

The SCF summarizes the affects of a medical practice or health entity on cash balances and/or liquidity from these three activities:

  • Operating activities: Including cash inflows (ARs, receipts, donations, accrued expenses, interest, and dividends) and outflows (inventory, prepaids, supplies, and loans) – this is where the majority of hospitals or medical practices generate most of their revenues from patient services and to a lesser degree from grants or other contributions, etc; 
  • Investing activities: Including the disposal or acquisition of non-current assets, such as equipment, loans or marketable securities; and,
  • Financial activities:  Generally including the cash inflow or outflow effects of transactions and other events, such as issuing capital stock or notes involving creditors, owners, or shareholders. 

Assessment 

Prior to 1988, the formal SCF was known as a Statement of Changes in Financial Position and projected estimated cash flows by month, quarter, and year, along with the anticipated timing of cash receipts and disbursements.  

Conclusion

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***

 

Net Income [P&L] Statements

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Financial Statements [A Review for Physicians]

By Dr. David Edward Marcinko; MBA, CMP™

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The Net Income [Profit-and-Loss Statement] Statement [NIS] is only one of four financial statements. 

The four consolidated statements are: balance sheet, net-income, cash flow and retained earnings. 

The NIS reflects the following in a medical practice or healthcare business entity: 

  • Income from patient services, plus revenue from research grants, educational programs, gift and cafeteria sales, office space and parking lot rental, and investment income; and,
  • Expenses including general overhead, non-operating expenses like salaries and wages, fringe benefits, supplies, interest, professional fees, bad debts, depreciation, and amortization.  

Increases in working capital, current assets, the retirement of debt, and investment in new fixed assets are not considered in the Net Income Statement [NIS]. 

Assessment of Accounting Differences 

Definitional differences do occur, however, in the income statement. 

For example, the NIS may report physician compensation and benefits in the expense category, during a period of time.

Small physician practices, on the other hand, may report income and expenses on a “cash accounting” basis reflecting income actually received and expenses actually paid.  

The “accrual method” of accounting records expenses when they are incurred and income when earned, not when paid or received as in the cash method.

The cash method is easier, but the accrual method is more accurate and most healthcare entities use this method. Accrual accounting will increase going forward because of the nature of discounted contracts, capitated contracts, or other fixed reimbursement arrangements.  

Conclusion

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Balance Sheet [Statement of Financial Position]

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By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]

biz-book1The Balance Sheet [BS] is one of four financial statements that report a medical practice or healthcare entities financial position in terms of its assets, liabilities, and shareholder/owner equity, at a specified point in time.  

The four consolidated statements are: balance sheet, net-income, cash flow and retained earnings. 

Included on the Balance Sheet are the following line items:

  • Fixed assets include property, buildings, furniture, and equipment. 
  • Current assets include those that can be converted into cash within a short period of time, typically within a year; such as Accounts Receivable (AR), checking accounts, cash equivalents and investments, money funds, inventory and pre-paid expenses; other long term assets like intangibles (and goodwill). 
  • Current liabilities and Accounts Payable (AP) are to be paid within the fiscal year, and include short-term debts, salaries and wages, accrued expenses and other notes. 
  • Short-term liabilities are loans repaid over one year.
  • Long-term liabilities are loans repaid over many years. 

Assessment 

Ownership is shown in the form of retained earnings or medical practice equity and represents the difference between the total assets and total liabilities of the unit. 

Working Capital is a key concept in cash flow analysis. Working Capital is the difference between current assets and current liabilities [WC = CA – CL].  

An increase in working capital implies (-) cash flow; a decrease implies (+) cash flow.

Cash position, or liquidity, is measured by changes in working capital, not the level of working capital.

Conclusion

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FINANCE: Financial Planning for Physicians and Advisors
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Richard D. Helppie; CEO

FORWORD

Financial Planning for Physicians and Advisors

fp-book

Medical management is already one of the most complex businesses, with advances in science, technology, and consumer awareness often eclipsed by regulation, rights, and financial restrictions.

Navigating a course where sound practice management is intertwined with personal financial security requires a blue print designed by subject matter experts. Financial Planning for Physicians and Healthcare Executives [third edition] provides that blueprint.

The timeliness of this book is underscored by the current state of the health care industry in the United States. Healthcare in the United States is, by design, a system of independent and interrelated organizations. Demand for health care services is escalating due to the demographics of an aging population, advances in medical technology and new courses of treatment. Concurrently, financial resources allocated to health care services are not rising as rapidly as the demand for services.

As a consequence of the unusual economics of today’s health care industry, physicians and health care professionals must plan financially successful professional practices and construct financial security in a manner that is markedly different from that of other businesspersons and professionals.

Financial planning for physicians and health care professionals is not intuitive, nor is it a logical extension of professional pursuits. Physicians are usually motivated by a need to serve humankind and by scientific and intellectual curiosity. Economics and finance are secondary to the pursuits of clinical excellence, service and scientific expansion.

Consider some of the financial aspects unique to health care providers: unlike most other businesses or professions, doing more does not necessarily translate into earning more; providing superior quality service does not necessarily translate into better prices for those services; and abandoning service lines or “markets” with inferior financial yield is anathema to the health care professional’s commitment to patients.

Peak earning years may also be shorter for health care providers than other professionals. Consider that physicians typically enter careers at later ages, often with larger debts from training. Some specialties may not lead a case until 10 years of practice, and many specialties have limited longevity. Financial survival skills are paramount for converting the limited earnings time period to personal financial security.

Financial Planning for Physicians and Healthcare Executives confronts the reality that business management in health care is decidedly more complex than most other businesses or professions. To illustrate, in what other industry can participants debate the simple question, “who is the customer?”

The same business management intricacy gives rise to an information model that is exclusive in its complexity. The fragmented-by-design health care delivery system, rising consumer expectations, and rampaging information technology advances all serve to compound the degree of difficulty in effective use of information technology.

The industry’s track record regarding information systems in terms of increased efficiency, ease-of-use and improved margins has been short of expectations. Information systems aimed at improving workflows, connecting to trading partners and taking advantage of new technologies are still in development. The opportunity remains attractive to information technology providers, as evidenced by a near-continual flow of business venture announcements from technology companies and various industry participants. While the information systems puzzle remains unsolved, the need for skillful management of information systems is an immediate imperative.

This book provides a description of communication systems, data storage and retrieval systems, and health care-specific data sets. Chapters declare that patient safety and quality of care depend on accurate, complete information. Moreover, information systems must reflect that the real-world events that are digitally stored are longitudinal in nature and that privacy and security requirements are paramount.

Government and payer-led initiatives to control health care costs and manage care have resulted in a multifarious regulatory environment. New legislation under consideration covering such areas as patient rights could create new liabilities for physicians and other health care providers. This book describes a medical office compliance program to help avoid the perils of non-compliance.

Of particular note is the new section on HIPAA. When fully implemented, HIPAA will require standard transaction sets, as well as privacy and security mandates. HIPAA legislation is rife with penalties for non-compliance. This book enlightens and instructs by providing a framework for operating in the expected HIPAA world.

Selecting a personal financial strategy requires contracting with other professionals. Just as patients are becoming more informed about a growing range of diagnosis and treatment options, physician providers are learning of a growing range of financial vehicles available to them.

In medicine, the “right” course of diagnosis and treatment is one that balances the risk, cost, time horizon, outcome and personal preferences of the patient. In the world of personal finance, the physician plays the role of patient to the professional advisor who may be from one of many sub-disciplines in the financial world – advisor, broker, insurance agent, attorney or accountant.

The physician must be more informed about the growing range of analysis and investment options in order to choose the “right” course that balances risk, cost, time horizon, outcome and his or her own personal style.

Richard D. Helppie
Former: CEO and Founder
Superior Consultant Company, Inc.
[SUPC-NASD]

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Securities Short Selling

Money Making in Down Markets

[By Julia O’Neal; MA, CPA]

fp-book2When a physician-investor buys a stock, he or she is said to be “long” the stock. “Shorting” is selling a stock a physician-investor does not own. 

Investing or Betting? 

Like buying a “put”, short selling is a bet that the stock will go down in price. The short seller sells a security he or she does not own, in anticipation of the price falling, and borrows the security to deliver to the buyer.  

Covering-Up 

When the short seller has to “cover” the borrowed stock, he or she will have to buy it. The short seller hopes to buy back the stock at a lower price to repay the loaned stock. If it must be bought back at a higher price, the short seller loses money. 

Unlimited Loss Potential 

Because there is no limit on how high the stock could go if the short seller is wrong, there is no limit on how much could be lost. (The physician-investor who is “long” a stock can lose only the entire cost of the stock.) 

“Shorting Against the Box” 

A physician-investor may sell a stock short simply because he or she believes it is going down, but may also “sell short against the box” to protect a long position.  This is a strategy used particularly when income tax rates for long-term capital gains are lower than ordinary income or short-term capital gains.  

For tax reasons, the physician-investor does not want to sell some stock that is owned.  

However, he or she believes the stock is going down and wants to be protected. The physician-investor will profit from a short-term decline in value, but can still hold the security for a possible long-term gain.  

The Short-Sale rule 

Short sales can be made only after a plus tick (ticks are movements of 1/8 or more for listed stocks and can be increments as small as 1/64 for NASDAQ or OTC stocks) or a zero plus tick.  

That means short sales can be made only after the stock has sold for either a higher price or the same price, but the last price difference was up. Ironically, the short interest theory holds that large short positions are bullish for a stock.   

Assessment 

Even though many physician-investors are obviously anticipating that the price will fall, the buying pressure (“short squeeze”) engendered by all of their need to buy the stock to cover their borrowing is expected to raise the price of the stock. 

Conclusion

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Inflation Risk and Investing

fp-book4Understanding Purchasing Power Risk

[By Julia O’Neal; MA, CPA]

Purchasing power risk refers to the effects of inflation and disinflation on the future purchasing power of the income and principal from an investment.

Seeking “Total Returns” 

The typical physician investor seeks an investment that at minimum returns the same number of dollars as originally invested.  In addition, he or she hopes to achieve current income flow and/or capital appreciation on the security due to favorable results at the underlying company.

This is called “total return.”

Although a physician or other investor may realize a positive nominal (actual) return, however, once the effects of inflation are factored into the return, there is a chance that the real return could be negative.

For example, if it takes 20 years for an investment to return 75%, during which time the price level has risen 100%, the investor is receiving a smaller amount of purchasing power than was originally invested.  

Assessment 

  • Over the very long term, common stocks have provided an effective hedge against inflation.
  • Over shorter periods of time, however, physician investors have been disappointed in stocks as a hedge against inflation, as the rate of inflation has often exceeded the gain in common stock prices.

And so, are you a long-term physician-investor; and how long-is long-term, anyway? 

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Conclusion

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Investing and Interest Rate Risks [IRR]

Understanding Inverse Relationships

By Julia O’Neal; MA, CPA  

 

Interest Rate Risk [IRR] refers to the tendency of all investments to rise as interest rates decline and fall as interest rates rise. This inverse relationship is common among all investments, although not to the same degree.  

Pure Interest Rate Movements 

A U.S. Treasury security best demonstrates the pure interest rate move. 

The risk is present with other investments as well, since the discount rate—the required rate of return used to place a value on an asset—in part consists of the return available from a default-free investment. 

History shows that when the average level of interest rates rises, absolute volatility also rises. 

Assessment 

When looking at interest rate risk and other investments, it becomes important for physician-investors to look at the other component of the discount rate or the required risk premium over and above the risk-free rate.  

For example, in the case of high-grade bonds or utility equities, the default rate dominates the total discount rate, making interest rate risk more influential.  

For other investments, such as junk bonds or growth equities, the risk premium required has a much greater influence, somewhat reducing pure interest rate risk. 

Conclusion 

Are you willing to accept interest rate risk in your investing portfolio; how much IRR and for how long? 

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Pervasive Investing Risks

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Understanding Pandemic Risks

[By Julia O’Neal; MA, CPA]

Pervasive risks are those perils associated with all investments, such as purchasing power risk.  

In other words, this is the risk that because of the influence of price inflation or deflation, the investment return achieved is worse or better than expected.  

Another pervasive and hard-to-control risk is political risk. Typical political risks include the prohibition against exchanging domestic currency for foreign currency, failure to meet debt service, expropriation of assets, differences in taxes, and restriction on expatriating funds. 

Conclusion

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Investing Sector Risks

Understanding Industry Risk

 By Julia O’Neal; MA, CPA

fp-book3

Often also called industry risk, sector risk is the risk of doing better or worse than expected as a result of investment in one sector of the economy instead of another.

Economic Classifications 

A typical economic classification includes capital goods, consumer durables, consumer nondurables, financial, energy, utility, basic materials, technology, retail, and service. There are many more; of course.

Conclusion 

Which sectors do you invest in, and do you appreciate the associated industry risks? 

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About American Depository Receipts

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Physician Investing Basics

[By Julia O’Neal; MA, CPA]

caution

American Depository Receipts [ADRs] are shares of foreign stocks held by U.S. banks abroad that are sold on exchanges in the United States.

Often, foreign governments do not allow stocks to be sold to non-citizens, and ADRs allow U.S. investors to purchase foreign securities.  

ADRs usually exist on only the largest foreign publicly held companies, but their numbers are rapidly growing. They are traded in dollars, and dividends are paid in dollars. (Morningstar, Inc., in Chicago, publishes regular research reports on ADRs.) 

Assessment

Do you own ADRs, and why or why not? 

Conclusion

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Types of Common Stock

Physician Investing Basics

 [By Julia O’Neal; MA, CPA]

fp-book1There are several different types of common stock listed below, and more. 

Utilities: Utilities are companies in public-service businesses, such as electric utilities, natural gas delivery, or telephones, which pay high dividends and are often used by investors for income. 

Blue chips: These are high-quality, well-known, large-capitalization, dividend-paying companies with long track records of steady, secure earnings.  

Capitalization: Market price × Number of shares outstanding. Usually market cap of less than $500 million is considered “small capitalization,” but in recent years, companies between $500 million and $1 billion are also being considered “small caps.” 

Growth: Companies with earnings growth in excess of industry or market averages. Although these companies have strong earnings, they usually reinvest them into research or expansion rather than pay them out as dividends. 

Emerging growth: Smaller capitalization companies with even stronger earnings potential. Smaller companies are on the early part of the growth curve. While the start-up phase is the riskiest, the expansion phase follows, where growth is the fastest. Small companies may be in new businesses or new markets, and they often have the advantage of being able to react quickly to change. Some investors look especially for smaller companies that are “under-owned by institutions”—that have not been discovered by the big professional investors. 

Cyclical: Companies in businesses providing basic materials or products that are subject to the economic cycle; profits are based on increased consumer demand for high-cost items that can be deferred in tough economic times. Some examples are steel, autos, and building materials. These may be big, strong, mature companies that pay dividends, but they are not blue chips because the possibility exists that earnings may slump drastically and dividends may disappear during economic downturns. 

Defensive: Companies that continue to produce earnings in all economic cycles because they provide a necessary product or service (for example utilities, healthcare and food companies). 

Assessment 

Of course, stocks are further subdivided by industry type, from retailing (department stores and other direct sellers to consumers) to restaurants to technology to steel. The list is long, and sectors are often classified differently.

New areas, such as bio and nano-technology and networking software, are constantly being added. 

Conclusion 

And so, do you prefer common stocks, mutual funds, index funds or ETFs, and why?

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What is Common Stock?

Physician Investing Basics

By Julia O’Neal; MA, CPAfp-book1

Common stock is fractional company ownership and does not have to pay a specified dividend. It is assigned a par value only for bookkeeping purposes on the balance sheet. (Additional value of book equity is called paid-in capital or capital surplus.) 

Par Value not Market Value

Par value has no relation to market value. Some types of preferred stock do not carry voting privileges, but common stockholders must vote on certain corporate matters, such as the election of the board of directors.

Classes  

Moreover, there are some companies that offer two, three or more different classes of stocks under Common Stocks. They often call these as Class A, Class B and Class C, etc. Class A stock holders have literally more voting rights than Class B stock holders, and so forth.

Company stocks that have more than one class is not a common stock and most physicians and investors refrain from buying company stocks with more than one class; unless carefully evaluated.

Stockholders are invited to attend the annual meeting to vote, but may also vote by mail, in a proxy vote.  

Conclusion

And so, how much common stock do you own?

 

What is Preferred Stock?

Physician Investing Basics

By Julia O’Neal; MA, CPA 

fp-book3

Preferred stock is designed to resemble bonds and usually has a par value of $100. Dividends are stated as a percentage of par—6% preferred would pay $6 annually. The stated dividend is the minimum that the company will pay out. If there are not enough earnings to pay the dividend, the company will pay out whatever is available for dividends. 

Preferred Stock Differences 

There are different types of preferred stock, which are based on the method of dividend payment. 

Cumulative preferred carries a provision that all prior dividends due on preferred stock must be paid before dividends can be paid on common stock.  

Participating preferred may earn dividends in excess of the stated percentage if they are available after dividends are paid on common.  

Convertible preferred is also issued at $100 par. The stock may be converted into (exchanged for) a designated number of common shares. The conversion ratio and conversion price are determined at the time the stock is issued. 

Conversion ratio = Par value / Conversion price

When the stock reaches its conversion price, the cumulative preferred stock is said to be “at parity” with the common stock.  

Cumulative preferred stock usually sells “at a premium to” (above) its par value because of the added value attached to the conversion feature. Most of the time, cumulative preferred stock is callable, which means the corporation has the right to “call” or buy back the preferred stock at a specified price, sometimes after a set date. 

Cumulative convertible preferred stock is popular. Investors appreciate the ability to combine the attributes of both stock and bond ownership in one vehicle and, because they are so popular, corporations can market these securities easily, often with a lower coupon than a straight bond would require. 

MORE: C v P

Assessment: Is preferred stock best for personal or corporate portfolios?

Conclusion: Your thoughts are appreciated.

***

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What is an Initial Public Offering [IPO]?

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Physician Investing Basics

[By Julia O’Neal MA, CPA]

When companies first go public they issue stock in an initial public offering (IPO). Most of the time these stocks are sold in large blocks to institutional investors and it is only after they begin trading on the exchanges that individuals, like physicians, can buy them. Sometimes these issues are very desirable—they may rise significantly even on the day of issuance. 

However, over the longer term the excitement tends to dissipate, and it is much easier to evaluate a company once it has settled into a “trading range.” 

Outstanding Stock 

Once stock is sold to the public it is called outstanding.  

Primary Offerings 

A company’s corporate charter usually has authorized more stock for future issuance. When this stock is issued it is called a primary offering (as distinguished from the IPO).  

Secondary Offerings 

A secondary offering is the re-issue to the public of a large block of shares that has been previously held by a large investor. A primary offering is issued by the company itself and a secondary offering is handled for an outside investor by investment bankers. 

Rights Offerings 

More shares of stock in a company with the same assets dilute the value of the currently outstanding shares. When more stock is offered to the public, existing common shareholders have a right to buy enough shares to maintain their proportionate share in the company—they are offered the opportunity in a “rights offering,” and usually the shares to be purchased with preemptive rights are offered at a subscription price below current market price. 

Rights, like warrants, allow an investor to buy a certain number of shares or portions of shares at a certain price and may be traded.  Unlike warrants, rights expire after a certain period of time. When offered rights, an investor should examine the offering prospectus to determine what the newly raised capital will be used for. 

Stock Buy-Backs and Treasury Stocks 

Outstanding shares are attributed their pro rata portion of earnings. When companies buy back their own stock in a “stock buyback,” it is called “treasury stock” and does not participate in earnings or dividends.  This action reduces the number of shares and makes existing shares more valuable while allowing them to receive a larger portion of earnings.

It is positive for a company to buy back stock and negative for it to issue more stock—more outstanding stock is dilutive to earnings and to the value of existing stock.  It is also positive when management of a company (“insiders”) buys stock—it usually means that those closest to the company believe it is undervalued.

Warrants 

Warrants are attached to bonds in order to allow the bond issuer to make the securities attractive with a lower-than-market coupon. Warrants also have a subscription price that is usually lower than the market price of the stock, so once they are separated from the bonds they have an intrinsic value. Warrants may remain effective for several years or in perpetuity. Dividends are not paid on warrants.

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Conclusion

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Equity-Based Securities Terms and Definitions for Physicians

A “Need-to-Know” Glossary for all Medical Professionals

[By Staff Writers]HDS

ADRs (American Depository Receipts): Securities that allow trading of shares of foreign stocks on U.S. exchanges. ADRs are issued by U.S. banks in place of foreign shares that the banks hold in trust. 

Advance/decline ratio (A/D ratio): The number of stocks that have advanced divided by the number that has declined over a certain time period. Ratios plotted one after another show the direction of the market, and the steepness of the line shows the strength of that direction.

Alpha: The measure of the amount of a stock’s expected return that is not related to the stock’s sensitivity to market volatility.

Arbitrage: Profiting from differences in price by simultaneously buying and selling the same security on different exchanges or using different types of contracts on the same security (buying rights and selling the stock, for instance). 

Asset allocation: Apportioning investments among different categories of assets (cash, stocks, and bonds, for example, or different subcategories like cyclical stocks, small capitalization stocks, blue chips, and defensive stocks). An important financial planning tool used to control both risk and return.

Beta: The measure of a stock’s volatility relative to the market. A beta lower than 1 means the stock is less sensitive than the market as a whole; higher than 1 indicates the stock is more volatile than the market. 

Book value: Determined from a company’s balance sheet by adding all current and long-term assets and subtracting all liabilities, including outstanding bonds and preferred stock. This total net-asset figure is divided by the number of common shares outstanding to arrive at book value per share. 

Callable: Preferred stock or bonds that may be redeemed by the issuing corporation before their stated maturity at a pre-stated “call price” that is higher than the original issue price. 

Capitalization ratios: Analysis of the components of a company’s capital structure, including debt (bonds), stock, and surplus, which show the relative importance of the sources of financing. 

Common stock: Units of ownership of a public corporation that usually carry voting rights; common stock is sometimes called “capital stock” when the company has no preferred stock. Common stock is the last to be paid off at liquidation but generally has the most potential for appreciation. 

Convertible securities: Preferred stock or bonds that are exchangeable for a stated number of shares of common stock at a pre-set price (“conversion price”). The “conversion ratio” is determined by dividing the par value of the convertible security by the conversion price. The amount by which the conversion price exceeds the current market price is the “conversion premium.” 

Coverage ratios: The number of times income will meet the fixed charges of bond interest and preferred dividends.

Cyclical stock: Stocks that tend to rise or fall quickly, corresponding to the same movements in the economic cycle. Automobiles and housing, for instance, are more in demand when consumers can afford high-ticket durables. Lumber, steel, and paper are more in demand when manufacturing production is high.

Defensive stock: Stocks from companies that make necessities, such as food, drugs, and utilities that are in demand regardless of the economic cycle. These stocks tend to respond less negatively to down market cycles. 

Dilutive effect: The lowering of the book or market value of the shares of a company’s stock as a result of more shares outstanding. A company’s initial registration may include more shares than are initially issued when the company goes public for the first time. Later, an issue of more stock by a company (called a “primary offering,” distinguished from the “initial public offering”) dilutes the existing shares outstanding.  Also, earnings-per-share calculations are said to be “fully diluted” when all common stock equivalents (convertible securities, rights, and warrants) are included. “Fully diluted” numbers are used in analysis when there is a likelihood of conversion or exercise of rights and warrants.

Earnings per share (EPS): The amount of a company’s profit available to each share of common stock. EPS = Net income (after taxes and preferred dividends) divided by Number of outstanding shares.

Efficient market theory: Belief that all market prices and movements reflect all that can be known about an investment. If all the information available is already reflected in stock prices, research aimed at finding undervalued assets or special situations is useless. 

Emerging growth stocks: Shares of companies participating in new markets or niches with greater future expectations than those in established industries or services. Companies are usually smaller and do not yet have steady earnings streams or pay dividends. They may be more highly priced relative to the rest of the market.

Ex-dividend:  When dividends are declared by a company’s board of directors, they are payable on a certain date (“payable date”) to shareholders recorded on the company’s books as of a stated earlier date (“record date”). Purchasers of the stock on or after the record date are not entitled to receive the recently declared dividend, so the ex-dividend date is the number of days it takes to settle a trade before the record date (currently three business days). A stock’s price on its ex-dividend date appears in the newspaper with an X beside it. 

Form 10-K and Form 10-Q: Annual and quarterly reports, respectively, required by the Securities and Exchange Commission (SEC) of every issuer of a registered security, including all companies listed on the exchanges and those with 500 or more shareholders or more than $1 million in gross assets. Audited financial statements for the fiscal year must include revenues, sales, and pretax operating income, a 5-year history of sales by product line and a sources and uses of funds statement comparative to the prior year. The quarterly report is not required to be as extensive, nor must it be audited, but it should contain a comparison to the same quarter in the prior year. As a matter of public information, these reports are available to the general public and are required to be filed on a timely basis. 

Free cash flow: Cash flow after operating expenses; a good indicator of profit levels. 

Fundamental analysis: Equity research aimed at predicting future stock prices based on financial statements. FA considers past records of sales, earnings, markets, and management to attempt to determine future performance. Technical analysis relies on charting patterns of price and volume movements; it does not take financial fundamentals into account.

Growth stock: A stock that has a record of relatively fast earnings growth—usually 1½ to 2 times the average for the market as a whole. If the growth is expected to continue, the stock carries a higher price/earnings multiple (see price/earnings ratio) than the average for the market. 

Hedging: Offsetting investment risk by using a security that is expected to move in the opposite direction. Options and short selling are commonly used to hedge stock positions.

Index: Stock indexes measure changes in groups of stocks. They range from broad to narrow, measuring the overall “market” or small industry sectors. Some indexes are averages; others are weighted based on market capitalization. The most often quoted major stock indexes are the Dow Jones Industrial Average (DJIA) and the Standard & Poor’s 500 (S&P 500). 

Initial public offering (IPO): A corporation’s first offering of stock to the public (sometimes called “going public”). 

Insider: Technically, an officer or director of a company or anyone owning 10% of a company’s stock. The broader definition includes anyone with non-public information about a company.

Leverage: Financial leverage is the amount of long-term debt in a company’s capital structure relative to shareholders’ equity. Operating leverage measures the sensitivity of a company’s profits to sales levels. 

Limit order: An order to buy or sell a security at a set price or better. 

Liquidity ratios: Financial measurements of the ability of a company to meet short-term obligations quickly. Helps analysts determine a company’s credit quality.

Listed stock: Stock that trades on one of the registered securities exchanges. “Listed” usually implies listing on the two major exchanges—the New York Stock Exchange (NYSE) and the American Stock Exchange (AMEX). “Unlisted” company’s trade “over the counter,” usually through the National Association of Securities Dealers Automated Quotation System (NASDAQ). Listed stock symbols are three letters; unlisted symbols are four or more letters. 

Maintenance call: Sometimes called a “margin call”; a demand on a customer with a margin account to deposit cash or securities to cover account minimums required by regulatory agencies and the brokerage firm. Because these minimums are based on the current value of the securities in the account, maintenance calls can occur as a result of movements in the market price of securities.

Margin account: Brokerage account established to extend credit to the customer. Market capitalization: Current stock price multiplied by number of common shares outstanding. The higher the market capitalization is relative to book value, the more highly the investment community values the company’s future.

Market timing: Buy and sell strategy based on general outlook, such as economic factors or interest rates, or on technical analysis. 

Multiple: See price/earnings ratio. The “relative multiple” is the company’s P/E ratio relative to the multiple of the market, usually the S&P 500, but sometimes the price/earnings ratio of an index that more closely mirrors the company’s sector. 

Naked option: An uncovered option position. When the writer (seller) of a call option owns the underlying stock (said to be “long” the stock), the option position is a “covered call.” If the writer (seller) of a put option is short the stock, then the position is a “covered put.” Writing a covered call is the most conservative options strategy, but writing a covered put is the most dangerous because there is no limit to how high the stock can go and thus to how great the loss can be on the short sale.

Odd-lot theory: Supposition that small investors, who tend to buy in smaller units than the standard round lot of 100 shares, are always wrong. The idea is to buy when odd-lot investors are selling and sell when they are buying. The theory has not proved to be correct in modern times and is no longer very popular. 

Options: Contracts to buy (call option) or sell (put option) a security at a stated price within a stated time period. Puts and calls are “types” of options. All the same type options of the same security are said to be of the same “class.” Options of the same class may have different exercise prices (the stated buy or sell price, called the “strike price”) and different dates. All options of the same class with the same strike price and expiration date are called a “series.” The price of an option is called a “premium.” The price of a premium is made up of “intrinsic value” (the difference between the current price and the strike price) and “time value” (the difference between the premium and the intrinsic value). An option is said to be “covered” when the investor has another position that will meet the obligation of the option contract. When option rights are used they are “exercised”; unexercised options are said to “expire” after their set time period is up. A buyer of an option is called a “holder” and a seller is called a “writer.”

(NOTE: Companies often offer employees “incentive options” as part of their compensation. These operate more like rights or warrants and allow the employee to purchase stock in the company at a specified price for a certain number of years). 

Par value: For common stocks, the value on the books of the corporation. It has little to do with market value or even the original price of shares at first issuance. The difference between par and the price at first issuance is carried on the books of a corporation as “paid-in capital” or “capital surplus.” Par value for preferred stocks is also liquidating value and the value on which dividends (expressed as a percentage) are paid—generally $100 per share. 

Penny stocks: Stocks selling for under $1; usually highly speculative.

Pink sheets: Daily publication of wholesale prices of over-the-counter (OTC) stocks that are generally too small to be listed in newspapers. 

Preferred stock: A class of stock with a higher claim on the company’s earnings than common stock. Preferred stock usually is entitled to dividends and does not carry voting rights. Also, dividends on preferred stock must be paid before any dividend can be paid on common stock. “Cumulative” preferred stock accumulates dividends, and all past dividends owed must be paid before common stock can receive dividends. “Convertible” preferred stock is exchangeable for a set number of shares of common stock, and “participating” preferred stock allows shareholders to collect dividends above the set level, sharing in the profits allocated to common stock. 

Price/earnings ratio (P/E ratio): Often called a stock’s “multiple.” PE is the current price per share divided by earnings per share. Earnings can be “forward” (predicted) or “trailing” (actual last four quarters).

Quantitative analysis: Financial analysis, based on measurable mathematical actualities, that ignores considerations of quality of management. Advanced quantitative analysis has produced historical measures of stocks’ volatility relative to their own past history and the market’s. 

Quote: Current buy and sell prices of a security. The lowest price any seller will accept at a given time is “asked,” and the highest price any buyer has offered for a stock at a given time is the “bid.” The difference between bid and asked is the “spread.” 

Random-walk theory: A direct refutation of technical analysis, this theory posits that markets cannot be predicted because they move in a random manner like the walking pattern of a drunken person.

Retained earnings: That part of a company’s profits that is not paid out in dividends but used by the company to reinvest in the business. 

Rights: Granted to existing shareholders when a company issues more shares in a new issue. Usually the rights last for only a short time and the shares are offered at a lower price than they will be offered to the public. “Preemptive rights” are sometimes mandated by state laws to allow existing shareholders to maintain a proportionate share of ownership, thus preventing “dilution” of their existing shares.

Risk tolerance: The ability of an investor to tolerate the chance of loss on an investment. Risk measurement attempts to quantify these chances, which can result from inflation, interest rates, market fluctuations, political factors, foreign exchange, etc. 

Round lot: Standard unit of trading. For stocks, a round lot is usually 100 shares, although 10 shares may make a round lot for inactive or highly priced stocks. 

Secondary offering: A sale of a large block of securities already issued by a corporation and held by a third party. Because the block is so large, the sale is usually handled by “investment bankers” who may form a “syndicate” and peg the price of the shares close to current market value.

Sector: A group of stocks in one industry. 

Sell discipline: An investor’s criteria for selling a stock. A value investor, for instance, may sell when the price/earnings ratio of the security is a certain percentage higher than its historical level.

Shareholders’ equity: Total assets minus total liabilities of a company divided by the number of common shares outstanding. Theoretically, this is the value of the company to the shareholder at liquidation.

Short interest theory: When short interest positions in a stock are high (see short sale), although it is an indication that many investors feel the stock price will drop, the theory is that the phenomenon is bullish for the stock because the short sellers will all have to purchase the stock in the near future to cover their short positions. 

Short sale: An investor anticipates that the price of a stock will fall, so he sells securities borrowed from the brokerage firm. The securities must be delivered to the firm at a certain date (the “delivery date”), at which time the investor expects to be able to buy the shares at a lower price to “cover his position.” 

Small capitalization stocks: Publicly traded company with a market capitalization (see market capitalization) of $500 million or less.

Stock buyback: A corporation may repurchase shares outstanding on the open market and retire them as “treasury shares.” This anti-dilutive action increases earnings per share, which consequently raises the price of the outstanding shares. Companies often announce a “share repurchase plan” when insiders feel the company is undervalued; the action strengthens the company and helps preclude a takeover.

Stock dividend: Payment of a dividend in stock rather than cash, usually as a percentage of existing shares held. A dividend may be stock in the original company or that of a subsidiary. A stock dividend is a way for a corporation to maintain its cash position without being subject to the accumulated earnings tax, since it reduces retained earnings and increases capital stock on a company’s books. A stock dividend also carries a tax advantage for the shareholder, since a dividend would be subject to ordinary income tax but the tax on capital gains is not payable until the shares are sold. 

Stock split: The division of the outstanding shares of a company into a larger number of shares, while the overall equity in the company remains the same. Shareholders have more shares but the same proportionate interest in the company. Unlike a stock dividend, a stock split does not affect the books of the company. After a split, the shares will immediately fall to a proportionate market value (that is, in a 2-for-1 split, $30 shares will fall to $15 each). A split makes the stock cheaper and helps to broaden ownership in the company. A “reverse split” (1-for-10) allows a company with low share value to be noticed by institutional investors who may be restricted from considering low-priced stocks. 

Stop order: An order to buy or sell at the market price once a security has traded at a set price, called the “stop price.” A stop order to buy is placed above the market price and is used to protect a profit or limit a loss on a short sale. A stop order to sell is placed below the market price and is used to protect a profit or limit a loss on a stock that is already owned. Although stop orders are designed to be used to protect investors from market movements, there is no guarantee that the order, when it is executed, will be at the stop price. The buy or sell order could be triggered by a temporary market movement that was no longer in effect when it was executed. For this reason, stop orders are sometimes combined with limit orders (see limit orders). 

Style: Investment style is attributed to sophisticated institutional investors. Major styles include “value,” “growth,” and “contrarian” (going the opposite way of most investors at the time). “Bottom-up” and “top-down,” respectively, refer to picking stocks based exclusively on their individual characteristics or as a part of a broader economic view that predicts certain sectors will do better than others. 

Subscription price: The price at which a right or warrant is offered. 

Technical analysis: Research based on price and volume movement “patterns” in an attempt to predict stock movements based on supply and demand. When a stock shows a “breakout” above a “resistance level,” it is said to be “oversold”; this is considered a good time to buy. When a stock shows a “breakout” below a “support level,” it is said to be “overbought”; this is considered a good time to sell. An “accumulation area” is a place on a technical analyst’s chart where the stock does not drop below a certain price range, indicating that buying is occurring. A “distribution area” shows that the stock is weak—selling is occurring. Technical analysis usually focuses on short-term stock movements and does not consider the financial situation of a company. It may be applied to the overall market as well as to individual stocks. 

Tick: Move up or down in price as a security trades, which may also apply to the overall market when index movements are measured in ticks. Zero-minus and zero-plus ticks are ticks at the same price as the preceding trade when the last preceding trade took place at a lower or higher price, respectively.

Total return: Measure of performance that includes capital appreciation (or depreciation) and reinvestment of dividends. 

Turnaround: Positive reversal in the performance of a company. 

Undervalued: Company that has an asset or a business niche that is not recognized for its true worth or value by the rest of the investment community.

Value stock: Stock trading below its own historical value for market, economic, or other reasons. If the stock is a large capitalization stock in a viable industry that has a relatively stable history, it usually can be expected to revert back to its prior value.

Warrants: Certificates that allow the holder to buy a security at a set price, either within a certain time period or in perpetuity. Warrants are usually issued for common stock, at a higher price than current market price, in conjunction with bonds or preferred stock as an added inducement to buy. 

Note: Feel free to send in your own related terms and definitions so that this section may be updated continually in modern Wiki-like fashion.

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Debt-Based Securities Terms and Definitions for Physicians

A “Need-to-Know” Glossary for all Medical Professionals

Staff Writers

 

Accrued interest: Interest that has been earned but not received; when a physician purchases a bond from a bondholder, the physician owes the bondholder interest for the period of time the bondholder held the bond. Because interest is paid semi-annually, the period of time that has elapsed is the accrual period. 

Basis point: One one-hundredth of a percent; a measure for interest rates and bond yields. Bearer bond: A bond with coupons attached, evidencing ownership. 

Call feature: The provision in the indenture allowing the issuer to redeem the bond prior to its maturity date.

Convertible bond: A bond that promises that the holder can convert it into stock within a specified period of time at a specified price and specified ratio (a bond equals a given number of shares of stock). 

Coupon rate: The specified interest rate paid by a bond issuer.

Credit rating systems: The classification systems used to indicate the risk associated with a particular bond issue.

Debenture: A debt security that is not secured by a mortgage on a specific asset. It is backed only by the earnings of the issuer, known as full faith and credit.

Default: The failure to pay interest or principal on debt securities when those payments are due. 

Discount: The sale of a bond below its par value. 

Duration: The measure of volatility, expressed in years, taking into consideration all of the cash flows produced over the life of a bond. For example, if the duration of a bond is four years, then the price of the bond changes 4% for every 1% change in interest rates.

Indenture: A formal agreement between the issuer of a bond and the bondholders that specifies the maturity date, interest rate, and other terms.

Interest: The payment the issuer makes to the physician bondholder for the use of the bondholder’s money. 

Maturity: The time at which a debt issue becomes due and the principal must be repaid. 

Principal: The face value of the bond, also known as par value. 

Refunding: The act of issuing new debt and using the proceeds to retire existing debt.

Registered bond: A bond that has its ownership registered with the commercial bank that distributes interest payments and principal repayments. 

Sinking fund: A fund in which money to pay off the debt accumulates; bond issues that have a sinking fund are considered less risky than those without one.

Trustee: The entity, usually a commercial bank that is appointed to ensure that the terms of a bond’s indenture are met. 

Yield: The potential return offered to the bondholder. 

Yield curve: The relationship between yields and dates of maturities of debt securities as plotted on a graph. 

Yield to maturity: The yield earned on a bond from the time it is purchased until it is redeemed. 

Zero coupon bond: A bond that pays both principal and interest at maturity. 

  • Related info: www.HealthDictionarySeries.com 
  • Note: Feel free to send in your own related terms and definitions so that this section may be updated continually in modern Wiki-like fashion.  

ETF Portfolio Diversification and Cost Reductions

A Multi-Dimensional Investment Product

By JD Steinhilber

 Certified Medical Planner  

Most physicians and their financial advisors and/or Certified Medical Planners™ [CMP™] believe that effective diversification is most readily achieved by combining poorly correlated asset classes within an investment portfolio.

And, when combined with low costs, a winning combination may be achieved for most any physician-investor’s wealth achievement and management goals.

Diversification Impact

One of the most basic examples of proper diversification is two poorly correlated assets like stocks and bonds. Over time, the returns of these two asset classes have a very low level of correlation. Over shorter time periods, the degree of correlation between stocks and bonds can vary widely.

From January 1999 to November 2002, for example, stocks and bonds had a negative, or inverse, correlation. Real Estate Investment Trusts [REITS] and international stocks are examples of other asset classes that tend to be poorly correlated with US stocks. And, volatility is expected to increase beyond 2008.

Because exchange-traded funds replicate the performance of entire asset classes, which themselves are diversified among numerous securities, it is possible to construct well-diversified, high-performing portfolios with only 5-10 ETFs. Accordingly, ETFs provide a highly efficient means of diversification.

Reduction of “Style Drift

Mutual funds also facilitate diversification, but actively managed mutual funds are susceptible to “style drift” and their portfolio holdings at any particular time are unknown. This presents a challenge to diversification efforts.

In contrast, ETFs offer asset class purity, meaning their holdings are totally transparent, disclosed daily and not subject to style drift. Actively managed mutual funds are also more expensive and less tax-efficient than ETFs.

Cost Impact

Exchange-traded funds have some of the lowest expense ratios of any registered investment product. In fact, ETFs have a cost advantage, on average, in excess of 100 basis points relative to actively managed mutual funds. This can have a significant impact on a portfolio’s performance over time.

For example, assume that investor A and investor B each invest $10,000 and earn the same gross annualized return over a 20 year time frame. After expenses, assume that investor A earns a net return of 10% and investor B earns a net return of 9%. After 20 years, investor A would have $67,275, while investor B would have $56,044, representing a difference of $11,231.

Trading Cautions

It is important to point out that physician-investors have to pay commissions when they buy or sell ETFs.As a result, the cost advantages of ETFs relative to mutual funds diminish the more actively an ETF portfolio is traded. ETFs are therefore not appropriate vehicles for active traders; they are more suitable for investors.

Of course, physicians and all investors tend to be more conscious of investment costs when portfolio returns are low or negative.Given that costs are among the few controllable variables in a portfolio’s returns, investors and advisors should always be evaluating portfolio costs relative to the benefits received.

Assessment: 

Exchange-traded funds may provide an opportunity to enhance net returns by reducing investment expenses and increasing returns through improved diversification.

Conclusion

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Exchange Traded Funds (ETFs)

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A New Type of Index Fund Hybrid

[By JD Steinhilber]

ME-PExchange-traded funds (ETFs) are perhaps the most exciting and innovative investment products to be developed by the securities industry in the past 20 years. ETFs, which are essentially index funds that trade on the major exchanges, can enable the physician-investor or financial-advisor to add value to client relationships, by addressing the key issues of diversification, tax efficiency and investment costs.

Definition 

More formally, ETFs are defined as securities that combine essential elements of individual stocks and index funds. Like stocks, ETFs are traded on the major U.S. stock exchanges and can be bought and sold through any brokerage account at any time during normal trading hours.

Also like index funds, ETFs are pools of securities that seek to replicate the performance of specific market indices, or benchmarks, in a low-cost, tax-efficient manner. ETFs give physician investors the opportunity to buy or sell an interest in an entire portfolio in a single transaction.

In short, ETFs provide the advantages of traditional index mutual funds, including low annual fees, diversification and tax-efficiency, with the liquidity and ease of execution of stocks. 

ETFs trade throughout the day and allow investors to buy and sell them at stated market prices, unlike traditional open-end mutual funds, which are only bought and sold at their net asset value (NAV) determined at the end of each day. ETFs can also be bought on margin and sold short. 

ETFs were developed by large institutions, such as: Barclays Global Investors, State Street Global Advisors and Vanguard.In 2003, approximately $90 billion was invested in U.S. exchange-traded funds; that figure has more than doubled by 2008. 

ETF Asset Classes

ETFs provide exposure to a wide range of asset classes defined by various equity and fixed income indexes. At launch, available ETFs fell into multiple major categories, including:

  • Small-, mid- and large-capitalization
  • Growth, value and core
  • International (broad-based and country- or region-specific)
  • U.S. industry sectors
  • Fixed income

Of course, there are many more tranches or slices today, and for almost any asset class type imaginable. The indexes upon which ETFs are based are from Dow Jones & Company, Inc., Frank Russell Company, Goldman, Sachs & Co., Lehman Brothers, Morgan Stanley Capital International (MSCI), Standard and Poor’s, Cohen & Steers Capital Management, Inc. and the NASDAQ Stock Market, Inc; etc; among many others asset class benchmarks.

Sponsors and Types

The two principal initial sponsors of sector ETFs were State Street Global Advisors and Barclays Global Investors. State Street’s sector ETFs are termed Sector SPDRs (Standard & Poor’s Depositary Receipt), because they are based on the S&P 500. 

The nine original Sector SPDRs collectively encompassed all 500 companies of the S&P 500. Barclays’ iShares sector funds differ from the Sector SPDRs in that they are based on the Dow Jones classification system, which segments the U.S. economy and stock market into 10 sectors encompassing 1,625 companies.

There were iShares ETFs for each of these 10 sectors as well as certain industries, such as biotechnology which are components of broader and/or narrower sectors.  Today, they are almost TNTC.

Assessment 

Continuous information about sector and industry ETFs is available at www.ishares.com.  Information about Sector SPDR ETFs is available at www.spdrindex.com.

Conclusion

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Investment Policy Statement Construction

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Developing a Sample IPS Document Template

 [By Clifton McIntire; CIMA, CFP®]

[By Lisa McIntire; CIMA, CFP®]fp-book

Here is an abbreviated sample Investment Policy Statement [IPS] template for a healthcare entity, clinic, private physician or hospital endowment account; posted by “Ask-a-Consultant” subscriber request. 

Introduction

An IPS typically contains the following sections, at a minimum. It may be a 5-15 page document for a single physician investor, or a 50-100 page tome for a hospital endowment fund.

Statement of Purpose

The purpose of this section is to guide and direct physician managers in the investment of hospital endowment funds. You want details about goals and objectives, as well as the performance measurement techniques that will be employed in evaluating the service rendered by the physician managers. 

Realizing that your overall objective is best accomplished by employing a variety of management styles, you will adjust your asset tolerances and permissible volatility to incorporate specific doctor-manager styles. 

Statement of Responsibilities

To achieve overall goals and objectives, you want to identify the parties associated with your accounts and the functions, responsibilities, and activities of each with respect to the management of fund assets. 

Physician managers or financial consultants [FC] are responsible for the daily investment management of Plan assets, including specific security selection and timing of purchases and sales. 

The custodian is responsible for safekeeping the securities, collections and disbursements and periodic accounting statements. The prompt credit of all dividends and interest to our accounts on payment date is required.  The custodian shall provide monthly account statements and reconcile account statements with manager summary account statements. 

The physician executive or financial consultant [FC] is also responsible for assisting us in developing the investment policy statement and for monitoring the overall performance of the Plan. 

Investment Goals and Objectives

The asset value of the funds, exclusive of contributions or withdrawals, should grow in the long-run and earn through a combination of investment income and capital appreciation a rate-of-return in excess of a specified market index for each investment style, while occurring less risk than such index. 

It is recognized that short-term fluctuations in the capital markets may result in a loss of capital on occasion, commonly expressed as negative rates of return. The amount of volatility and specific frequency of negative returns shall be detailed for each investment style. We will provide specific numeric targets by which we will measure whether or not objectives have been met.  

The investment policy of the Plan is based on the assumption that the volatility of the portfolio will be similar to that of the market.  A specific index or combination of indexes will be assigned to each manager based on the class of securities and style of selection to be employed. The physician consultant or FC will determine an overall index for volatility and asset allocation within the Plan as a whole.

It will be the duty of the physician or FC to monitor this section closely and advise us of necessary changes to comply with our overall policy. We expect that the accounts in total will meet or exceed the rate of return of a balanced market index comprised of the S&P 500 stock index, Lehman Brothers Government/Corporate Bond Index and U.S. treasury bills in similar proportion to our asset allocation policy. 

Recognizing that short-term market fluctuations may cause variations in the account performance, we expect the combined accounts to achieve the following objectives over a three-year moving time frame:   

  1. The account’s total expected return will exceed the increase in the Consumer Price Index by 7.0 percentage points annually.  Actual returns should exceed the expected returns about half the time.  Expected returns should exceed actual returns about half the time (i.e. if the CPI increases from 5.0 percent to 7.0 percent, then expected return should exceed 9 percent).
  2. The total annual return of the account is expected to exceed the average CPI for the year by an absolute of 3.0 percentage points (i.e. if the average CPI is 5.0 percent, then the expected annual return should exceed 8.0 percent).
  3. The average total expected return will exceed 10 percent annually. 

Suggested Performance Comparison Indexes

Style Index
Small Cap Growth Russell 2000 Growth
Medium Cap Value Russell Medium Cap Value
Small Cap Value Russell 2000 Value
Growth Russell 1000 Growth
Value Russell 1000 Value
Tax-Free Bonds Lehman Brothers Municipal
Taxable Bonds Lehman Brother Govt/Corp
Blended Account S&P 500/ Lehman Brothers Govt/Corp

Proxy Voting Policy

The physician manager or FC shall have the sole and exclusive right to vote any and all policies solicited in connection with securities held by us.

Trading and Execution Guidelines

Trading shall be done through a brokerage firm.  However, this request should in no way at any time affect the performance of accounts.

Instruction to execute transactions through a brokerage firm assumes that their service is equal to, and the rates are competitive with, other nationally recognized investment firms.

Additionally, it is understood that block transactions or participation in certain initial public offerings might not be available through a primary broker. In this case the manager should execute those trades through the broker offering the product and service necessary to best serve our account. 

Social Responsibility

No assets shall be invested in securities of any organization that does not meet the standard for socially and morally responsible investments we establish and communicated separately in writing to our physician investment manager. 

It is the responsibility of the physician or FC to maintain a list of such prohibited investments with us and to inform the respective managers of this list. 

Asset Mix Guidelines 

It shall be the policy of the foundation to have the assets invested in accordance with the maximum and minimum range for each asset category stated below.

This section applies to our overall account as monitored by the physician consultant.  Separate asset category guidelines will be provided for multiple physician managers, according to specified style and standard deviation tolerances.  

ASSET MINIMUM TARGET MAXIMUM REP
CLASS
WEIGHT
WEIGHT WEIGHT INDEX
         
Equities 50 60 70 S&P 500/FRC 2000 Index
Fixed Income 25 40 55 LB Muni/LBGC Inter
Cash & Equiv 0 0 30 90 Day Treasury

Portfolio Limitations

The following are general requirements of the account as a whole.  These specific limitations would be adjusted for a different medical manager or FC whose performance expectation would make it necessary for us to expand on our definitions. 

Equities: 

Equity securities shall mean common stock or equivalents (American Depository Receipts plus issues convertible into common stocks). 

Preferred stocks with the exception of convertible preferred share are considered part of the fixed income section. 

The equity portfolio shall be well diversified to avoid undo exposure to any single economic sector, industry group, or individual security. No more than 5 percent of the equity portfolio based on the market value shall be invested in securities of any one issue or corporation at the time of purchase. No more than 10 percent of the equity portfolio based on the market value shall be invested in any one industry at the time of purchase.

Capitalization/stocks must be of those corporations with a market capitalization exceeding $250,000,000. Common and convertible preferred stocks should be of good quality and listed on either the New York Stock Exchange [NYSE], American Stock Exchange [AMX] or in the NASDAQ System with requirements that such stocks have adequate market liquidity relative to the size of the investment. 

Fixed Income Investments: 

Types of securities of funds not invested in cash equivalents (securities maturing in one year or less) shall be invested entirely in marketable debt securities issued either by the United States Government or agency of the United States Government, domestic corporations, including industrial and utilities and domestic bank and other United States financial institutions.  

Quality: only fixed income securities that are rated BBB or better by Standard and Poor’s or Baa by Moody’s shall be purchased.  

Maturity: the maturity of individual fixed income securities purchased in the portfolio shall not exceed thirty years.

No more than 30 percent of the fixed income portion of the portfolio may be placed in these lower rated issues.  The average quality rating of the fixed income section shall be grade A; or better. 

Restricted Investments:  

Categories of securities that are not eligible without prior specific written approval of the physician investor, healthcare entity, clinic or hospital foundation include:     

  • Short Sales
  • Margin purchases or other use of lending or borrowed money
  • Private placements
  • Commodities
  • Foreign Securities
  • Unregistered or Restricted Stock
  • Options
  • Futures

Administration

The custodian will be responsible for settling trades executed by the physician manager in our accounts. From time to time, we will request disbursements from the accounts. Checks covering these requests must be mailed to us on the date of the request providing telephone notification is received before 2:00 pm; EST. 

Performance Review and Evaluation

 Performance results for the physician manager or FC will be measured on a quarterly basis. Total fund performance will be measured against a balanced index posed of commonly accepted benchmarks weighted to match the long-term asset allocation policy of the Plan.

Additionally the investment performances specific for individual portfolios will be measured against commonly accepted benchmarks applicable to that particular investment style and strategy.

The physician investor or FC will be responsible for complying with this section of our policy statement.  The managers or FCs shall report performance results in compliance with the standards established by AIMR (Association for Investment Management and Research); now the CFA Institute.  Reports shall be generated on a quarterly basis and delivered to us with a copy to us within four weeks of the end of the quarter. 

Communications 

Copies of all transactions will be maintained on a daily basis and will conform to our Investment Policy Statement. Monthly statements for each of the accounts will detail each transaction and summarize the account identifying unrealized and realized gains and losses. 

A formal meeting will be prepared quarterly by the consultant and delivered to us within six weeks from the end of the quarter.  The report will review past performance and evaluate the current investment outlook and discuss investment strategy of the physician manager.  These reports will compare the performance of the manager with the respective market benchmarks measuring return and volatility and compare the managers with their respective peer groups. 

Conclusion 

Of course, an IPS can include or exclude almost whatever you – or your institution’s governing board – may wish.

Finally, any professional financial manager or FC will be required to forward to you the SEC Form ADV Parts 1 and 2 annually, or at any interim point the ADV is substantially revised.

Remember to use a fiduciary financial consultant and/or physician-focused and/or appropriately degreed and/or licensed CPA, CFA, RIA or CMP™.  Investment results should never be guaranteed!

QUESTION: Does your hospital institution, medical practice, clinic or healthcare business entity have an ISP; more importantly – do you?  Please comment.  

Conclusion

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FINANCE: Financial Planning for Physicians and Advisors
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Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners(TM)

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ADV: Essential Form for Physician-Investors

ADV: Parts I and II Defined

Staff Writers 

An ADV is a form that is kept on file with the Securities & Exchange Commission [SEC]. It contains critical financial information about a Registered Investment Advisor (RIA), and/or an RIA representative.  

A Two-Part Form:  

Part 1: Discloses specific information about an RIA that is important to regulators (name, number of employees, form of the organization, nature of the business, etc.). 

Part 2:  This part acts as a disclosure document for clients of the business entity and includes information such as services provided and fees levied, whether the investment advisor acts as a broker-dealer and transacts securities, and so on. It is also known as the Uniform Application for Investment Advisor Registration.

To request a copy of Form ADV you can usually contact the SEC branch closest to you. Even better yet; be sure to request it before you invest with any “advisor” or firm.

And so, have you ever invested without reviewing this form; and how did it work out for you? Were you even familiar with this important form before reading this post?

 

 

Guide to Risk-Adjusted Market Performance

What isn’t Measured – Isn’t Improved

By Jeffrey S. Coons; PhD, CFA

By Christopher J. Cummings; CFA, CFP™ 

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Market performance measurement, like physician quality improvement reports, is an important feedback loop to monitor progress towards the goals of the medical professional’s investment program. 

Performance comparisons to market indices and/or peer groups are a useful part of this feedback loop, as long as they are considered in the context of the market environment and with the limitations of market index and manager database construction. 

Introduction

Inherent to performance comparisons is the reality that portfolios taking greater risk will tend to out-perform less risky investments during bullish phases of a market cycle, but are also more likely to under-perform during the bearish phase.  The reason for focusing on performance comparisons over a full market cycle is that the phases biasing results in favor of higher risk approaches can be balanced with less favorable environments for aggressive approaches to lessen/eliminate those biases. 

Can we eliminate the biases of the market environment by adjusting performance for the risk assumed by the portfolio?  While several interesting calculations have been developed to measure risk-adjusted performance, the unfortunate answer is that the biases of the market environment still tend to have an impact even after adjusting returns for various measures of risk. 

However, medical professionals and their advisors will have many different risk-adjusted return statistics presented to them, so understanding the Sharpe ratio, Treynor ratio, Jensen’s measure or alpha, Morningstar star ratings, etc. and their limitations should help to improve the decisions made from the performance measurement feedback loop. 

[a] The Treynor Ratio

The Treynor ratio, named after MPT researcher Jack Treynor, identifies returns above or below the securities market line. It measures the excess return achieved over the risk free return per unit of systematic risk as identified by beta to the market portfolio.  In practice, the Treynor ratio is often calculated using the T-Bill return for the risk-free return and the S&P 500 for the market portfolio. 

[b] The Sharpe Ratio

The Sharpe ratio, named after CAPM pioneer William F. Sharpe, was originally formulated by substituting the standard deviation of portfolio returns (i.e., systematic plus unsystematic risk) in the place of beta of the Treynor ratio.  A fully diversified portfolio with no unsystematic risk will have a Sharpe ratio equal to its Treynor ratio, while a less diversified portfolio may have significantly different Sharpe and Treynor ratios. 

[c] Jensen Alpha Measure

The Jensen measure, named after CAPM research Michael C. Jensen, takes advantage of the Capital Asset Pricing Model to identify a statistically significant excess return or alpha of a diverse portfolio.   

However, if a portfolio has been able to consistently add value above the excess return expected as a result of its beta, then the alpha (ap) should be positive and (hopefully) statistically significant.

Thus, alpha from a regression of the portfolio’s returns versus the market portfolio (i.e., typically the S&P 500 in practice) is a measure of risk-adjusted performance.  

Now, how do you measure the success or failure of your portfolio?

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Are Capital Markets Efficient?

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What is the Efficient Market Hypothesis?

[By Jeffrey S. Coons; PhD, CFA]

[By Christopher J. Cummings; CFA, CFP™]fp-book1

The Efficient Market Hypothesis (EMH) states that securities are fairly priced based on information about their underlying cash flows and that physician investors should not expect to consistently outperform the market over the long-term. 

 EMH Types 

There are three distinct forms of EMH that vary by the type of information that is reflected in a security’s price:

·  Weak Form: This form holds that investors will not be able to use historical data to earn superior returns on a consistent basis.  In other words, the financial markets price securities in a manner that fully reflects all information contained in past prices.

·  Semi-Strong Form: This form asserts that security prices fully reflect all publicly available information. Therefore, investors cannot consistently earn above normal returns based solely on publicly available information, such as earnings, dividend, and sales data.

·  Strong Form: This form states that the financial markets price securities such that, all information (public and non-public) is fully reflected in the securities price; investors should not expect to earn superior returns on a consistent basis, no matter what insight or research they may bring to the table. 

While a rich literature has been established regarding to test whether EMH actually applies in any of its three forms in real world markets – probably the most difficult evidence to overcome for backers of EMH is the existence of a vibrant money management and mutual fund industry charging value-added fees for their services. 

In fact, no less than Warren Buffett has suggested that the markets are decidedly not efficient. 

Assessment

And so, while there has been a growing move towards index funds – as well as ETFs – the strength of the money management industry may reflect investor’s concern with risk management and asset allocation – as much as any view that a manager or individual can “beat the market.”   

Conclusion

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Equity Price Influencers

How Economic and Business Cycles Influence Equity Prices 

Julia O’Neal; MA, CPA with Staff Writers

 

The equity markets react to the business cycle as it moves through standard phases.

For example, coming out of a recession, when gross domestic product (GDP) is increasing, cyclicals do best, since consumers are fulfilling “pent-up demand” for big ticket items that could be deferred during tough economic times.  Conversely, as the economy turns down – so do cyclicals – often slightly ahead of the overall economy.

As inflation heats up in a rising economy, companies can raise prices and profit at first as expenses stay constant.  But ultimately inflation raises interest rates and capital becomes more expensive, so companies have to spend more to borrow capital to finance growth. Gentle interest rate increases do not always make the stock market fall, but it will rise more slowly.  

However, high interest rates and high inflation ultimately are negatives for the stock market. 

A bull market in stocks generally consists of three consecutive phases:

Monetary: Interest rates are falling, either naturally as inflation eases or with the help of a central bank, like the Federal Reserve, which can artificially lower short-term interest rates.

• Earnings-Driven: Companies have been able to borrow capital cheaply and have spent the down-market time practicing efficiencies, so now they are geared up for growth. Consumers are buying, so earnings are beginning to flow through to the “bottom line.” 

Speculative blowout: The markets are responding to the good earnings reports—sometimes beyond what is justified. P/E ratios begin to get very high relative to a normal market, and markets are “overbought.” Wary physicians and canny medical investors may want to sell stocks to take profits. 

According to Goldman Sachs Research, the stock market may peak while the overall economy is still in a growth phase. Since 1952, the S&P 500 peak has led the overall economy’s peak by about seven months. During down markets, high-dividend-paying stocks and stocks of companies that sell necessary goods or services, like utilities and food companies tend to hold their value. These are called defensive stocks.  

Conclusion

Fundamental analysis takes into consideration economic factors such as consumers’ ability to buy a company’s goods or services or the company’s borrowing needs at current rates.

How has the recent economic and medical business cycle affected your investments?

The Financial Services Industry Explained

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Financial Services Sales Professionals   

By: Dr. David E. Marcinko; MBA, CMP™ 

[Publisher-in-Chief]

DEM 2013It has been said that there are more than 95 financial services designations in the business; and most are suspect credentials. A college degree may not even be required for most of them. 

And, the quest to find true guidance is clothed in mystery and subterfuge in the business. 

Why? It’s because the industry promotes a low standard of care, known as “suitability”; when a much higher fiduciary standard – to work on behalf of the client like a physician – should be required. 

If you don’t believe me, just look in the classified ad section of your local newspaper under “sales positions”, for job listings for these folks.  

So, when you select any type adviser, get this fiduciary standard-of-care statement in writing.  Just think of the “golden rule”, as you ponder these traditional credentials. 

What is an Insurance Agent? 

No one, especially doctors, likes to pay life and disability insurance premiums. Inadequate coverage, however, can completely devastate your family or medical practice, by quickly wiping out a lifetime of asset accumulation and business equity.

Buying and maintaining the right amount and type of coverage from solid insurance companies at a reasonable price eliminates these risks in a very efficient manner.  Unfortunately, an essential and relatively simple concept like risk transfer has evolved into an area that makes many doctors downright queasy.

The easiest way to handle this issue is to get consensus agreement from a core team of financial advisors as to the amount and types of coverage.

Once that is accomplished, appropriate insurance agents can be contacted.  The agents should be captive agents with insurance companies with policies known to be good for the coverage in question. Otherwise, independent agents with access to a large number of companies and products can be contacted.

Regardless, in addition to the usual questioning regarding competence and a background check, the agent should be aware that the core team will review all proposals.  Proposals should include what is known as a ledger statement.

A Chartered Life Underwriter (CLU) as granted by the American College, or Chartered Financial Consultant (ChFC), are two valid insurance designations demonstrating a focused expertise in the insurance business.  But, these still are typically commission sales agents who work for their respective firms, or themselves, but not necessarily you. The saying goes “insurance is sold not bought.”

As a reformed insurance agent myself, I sold all sorts of personal and other business insurance, too.  

Some years ago, the American Society of CLU and ChFC, in Bryn Mawr, Pa., reconsidered its own strategy of insurance as the organization changed its name to the Society of Financial Services Professionals to appeal to a broader base of financial practitioners beyond the insurance products it traditionally provided. 

What is a Stock Broker [Registered Representative]? 

A full service retail or discount stock broker, regardless of compensation schedule, is also known as a registered representative. Other names include financial advisor, financial consultant, financial planner, Vice President, etc. Nevertheless, they are still stock-brokers and not fiduciaries. 

Typically, the national test known as a Series #7 (General Securities License) examination and state specific Series #63 license is needed, along with Securities Exchange Commission (SEC) registration through the National Association of Securities Dealers (NASD) to become a stockbroker.  The industry touts them as rigorous; they are not as I passed mine after studying for a weekend. Since a commission may be involved – and performance based incentives are allowed – always be aware of costs.  

Again, regardless, of nomenclature derivative, the goal of these folks is to sell financial products; and earn a commission or fee. You also typically sign away your right to litigate when you enter into a brokerage contract. 

What is a Registered Investment Advisor?

This securities license, obtained after passing the easy Series # 65 examination, allows the designee to charge for giving unbiased securities advice on retirement plans and portfolio management, although not necessarily sell securities or insurance products. 

An RIA, or RIA representative, is usually a fiduciary, and should work for the interest of the client. A registered-representative, financial consultant, Certified Financial Planner™, or stockbroker does not necessarily have to be. 

What is a Certified Financial Planner™? 

Some believe that the premier personal financial planning designation of choice for the Financial Planning Association (FPA) – originally located in Atlanta, then Denver and now Washington, DC and founded in 1969 – is board Certification in Financial Planning.  This independent, designation represents a person who has completed a 24 month course of study at an accredited institution and passed the two day, comprehensive Certified Financial Planner Board of Standards Examination. This test encompasses all aspects of the financial planning process, including insurance, economic principles, taxation, investments and retirement benefits planning. 

An ethics, continuing education and confidentiality requirement is also mandated for this designation [www.FPANet.org].  But, be warned however, a CFP is not necessarily a fiduciary and does not have to act on your behalf, or with your best interests in mind.  

And, conflicts of interest do not necessarily have to be disclosed. There is much dissention in the industry regarding this situation, as I remain a former-reformed Certified Financial Planner™.

Still, the association’s marketing clout is powerful.

What is a Chartered Financial Analyst™? 

A Chartered Financial Analysis™ will usually work for a brokerage house and follow one or a few publicly traded companies. CFA analysts may manage institutional money or run a mutual fund and have ethics requirements.  This is a tough standard. I experienced it first-hand in business school. 

Unfortunately, the previously unbiased nature of some Wall Street experts has been questioned lately with the collapse of such stocks as HealthSouth and others.  Some authorities now feel that analysts have become merely promoters of the followed company, since sell recommendations are rarely made and CFAs or non-CFAs may cozy up to insiders and corporate executives as they curry their favor.

Contact the Association for Investment Management and Research (www.AIMR.org); now [www.CFAInstitute.org]. 

Q: Why is knowledge of the above important to physician-investors?

A: To avoid being ripped off!

Don’t believe me? Recall the tale of Dr. Debasis Kanjilal, a pediatrician from New York who put more than $500,000 into the dot.com company, InfoSpace, a few years ago, upon the advice of Merrill Lynch’s star analyst Henry Bloget. Is it any wonder that when the company crashed, the analyst was sued, and Merrill settled out of court? Other analysts, such as Mary Meeker of Morgan Stanley, Dean Witter and Jack Grubman from Salomon Smith Barney, are involved in similar fiascos.  Remember; forewarned is forearmed

8 Things your Financial Planner Won’t Tell You: http://articles.moneycentral.msn.com/RetirementandWills/CreateaPlan/8ThingsYourFinancialPlannerWontTellYou

Conclusion

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