INCENTIVE STOCK OPTIONS: Defined

Posted on July 15, 2025 by Dr. David Edward Marcinko MBA MEd CMP™

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Incentive stock options (ISOs)

Also called “qualified” or “statutory” stock options, ISOs are considered tax-advantaged stock options based on U.S. tax law. With ISOs, the spread (the difference between the award price and the fair market value) will count as income for the alternative minimum tax (AMT) in the year you exercise your options.

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Example: If you exercise and hold the shares for more than one year past the exercise date and more than two years past the original grant date, the sale of the stock becomes a qualifying disposition, and any realized profit is typically taxed at the long-term capital gains rate. If you sell earlier, the spread will be taxed at your ordinary income tax rate.

ISOs vs. NSOs: What’s the difference?

There are two types of employee stock options: statutory and nonstatutory. They can also be referred to as qualified and nonqualified, respectively. ISOs are statutory (qualified) and differ from nonstatutory (nonqualified) stock options (NSOs) in a few key ways:

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  • Eligibility. ISOs are issued only to employees, whereas NSOs can be granted to outside service providers like advisors, board directors or other consultants. Typically, mainly senior executives or key employees are given ISOs, as a company is not required to offer ISOs to all employees.
  • Tax perks. ISOs have more compelling tax treatment compared with NSOs.

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Exercising Healthcare Employee Options

Posted on March 29, 2009 by Dr. David Edward Marcinko MBA MEd CMP™

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Vital Information for Medical Professionals and Heathcare Workers

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To a large degree the decision to exercise a stock option will depend on whether the medical professional, hospital or other healthcare services employee is going to hold the stock following the exercise or is going to sell the stock immediately.

A Bifurcated Decision Point

1. If the employee intends to sell the stock, then he or she should try to time the exercise so that the stock is at its highest value.

2. If the employee is going to hold the acquired stock for future investment, then he or she should exercise the option as late as possible under the terms of the option agreement; the employee thus enjoys all upside potential without any investment and has nothing at risk.

Exceptions

There are two exceptions to the general rule:

1. First, if the rate of dividends is sufficient to cover the financing cost, or is at least equal to other investment returns, then exercise of the options makes sense.

2. Second, if the option is an Incentive Stock Option [ISO], the potential application of the alternative minimum tax (AMT) rules may force the employee to stagger the exercise.

Assessment

For more terminology information, please refer to the Dictionary of Health Economics and Finance.

Conclusion

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