NewYork-Presbyterian Hospital trains more than 2,000 residents and fellows across 10 campuses, in more than 150 ACGME-accredited programs operated jointly with Weill Cornell Medicine and Columbia University Vagelos College of Physicians and Surgeons, per the hospital’s Facts and Figures page.
The longest subspecialty fellowships at NYP run 7 to 9 years from Match Day to first attending paycheck, the longest training arc in American academic medicine.
A disability policy purchased and priced at the start of that arc, when a PGY-1 stipend at Weill Cornell sits at approximately $92,700, leaves a resident in an income lurch when training ends and the policy schedule still reflects who she was at 28.
The Guardian Provider Choice contract sold through the GSI disability insurance for NewYork-Presbyterian residency programs is built for that arc, with four separate features that grow the policy as the resident’s income grows.
Those four features sit alongside a separate provision that addresses a different exposure entirely.
The contract sits within the broader hospital-sponsored disability coverage for residents and fellows Set for Life Insurance offers nationwide.
The first is the Future Increase Option Rider, which lets the resident apply for additional benefit at policy anniversaries without medical underwriting.
“An Increase Option may be exercised during an Option Period if You are Gainfully Employed Full Time. We must receive the application for an Increase Policy during an Option Period. Each time We issue an Increase Policy, the remaining Total Increase Option Amount available under this rider will be reduced by the amount of the Increase Policy. All or part of the remaining Total Increase Option Amount may be applied for until You attain Age 45.”
Future Increase Option Rider, Form ICC16 FOID, attached to Guardian Provider Choice Policy Form ICC16 18ID, Berkshire Life Insurance Company of America
The clause is structured around the resident’s actual career stages. A Weill Cornell PGY-1 who applies for the rider at $92,700 of income and locks in a Total Increase Option of, for example, $5,000 of monthly benefit, can convert that option into actual coverage as her income rises through fellowship and into attending practice. The conversion does not require any answers about her health. It requires evidence of income, employment, and any disability insurance currently in force. Insurability is presumed because she purchased it once. The same contract carries the act of violence endorsement at NewYork-Presbyterian campuses, which waives the elimination period when disability results from an intentional violent act on shift.
The Benefit Purchase Rider does parallel work on a different cycle.
“On each Review Date, We will review Your eligibility for an Increase Policy. To keep this rider in effect and to determine eligibility for an Increase Policy, We will require an application and other evidence that demonstrate that You are insurable under Our then current underwriting guidelines, except that You do not have to provide evidence of Your medical insurability.”
Benefit Purchase Offer, Benefit Purchase Rider Form ICC16 BPID, Guardian Provider Choice Policy Form ICC16 18ID, Berkshire Life Insurance Company of America
The Benefit Purchase Rider attaches at no premium charge and operates on a 3-year cycle starting with the third Policy Anniversary. The Special Benefit Purchase Option Offer also triggers when the insured experiences at least a 50 percent income increase during the first three years after the policy is issued, which captures the typical income jump from senior resident to attending practice. A Weill Cornell-trained interventional cardiologist whose income roughly triples between the end of fellowship and her first attending year qualifies under this clause. The rider absorbs the income event without medical underwriting.
The Automatic Benefit Enhancement Rider does the third piece of the work, on annual cadence.
“This rider provides for up to six annual Automatic Increases as follows: On each Policy Anniversary, unless refused, We will increase the Monthly Benefit by the Automatic Increase. To determine the Automatic Increase, We will multiply the Automatic Increase Rate by the Monthly Benefit in effect immediately prior to the Policy Anniversary, excluding any Monthly Benefit added pursuant to any cost of living adjustment rider, if attached to the Policy. We will not require any evidence of insurability for an Automatic Increase.”
Automatic Benefit Enhancement Rider, Form ICC16 ABID, Guardian Provider Choice Policy Form ICC16 18ID, Berkshire Life Insurance Company of America
The rider runs at no premium charge and adds up to six annual Automatic Increases at the rate shown on the Schedule Page (typically 4 percent), each accepted by default and billed at the prevailing premium rate. A Weill Cornell PGY-1 in 2026 who accepts each Automatic Increase from PGY-1 through PGY-6 has a policy that has compounded its monthly benefit by roughly 27 percent before any Future Increase Option exercise.
NewYork-Presbyterian Disability Coverage Stays Locked Once Issued
The income trajectory features only matter if the policy itself does not change underneath them. The Provider Choice contract addresses that on the cover page.
“NONCANCELLABLE AND GUARANTEED RENEWABLE TO YOUR AGE 65 OR AGE 67. The Policyowner may renew the Policy at the end of each Premium Term until the Expiration Date. During that time, We cannot change the premium or cancel the Policy.”
Renewal provisions, Guardian Provider Choice Individual Disability Income Insurance Specimen Contract Policy Form ICC16 18ID, Berkshire Life Insurance Company of America
The clause is structurally important for any NYP resident planning to leave New York City after training. Berkshire Life cannot raise the premium, change the policy terms, or refuse to renew the policy as long as the premium is paid. A Weill Cornell-trained physician who finishes fellowship and takes an attending position in California, Texas, or any other state retains the contract she purchased in New York at New York pricing. The state of practice does not affect the contract.
“Non-cancellable has nothing to do with canceling the contract. It’s terrible policy language. What it means is, once you have your policy, they can never raise your premiums. They can’t come back and say all surgeons in California need a rate increase. You’re grandfathered in.”
Jamie K. Fleischner, CLU, ChFC, LUTCF, president of Set for Life Insurance, in a recorded working session
Long NewYork-Presbyterian Fellowships Need Disability Coverage That Climbs
The Retirement Protection Plus rider closes a separate income loss that occurs during disability.
“When You are Totally Disabled and not Gainfully Employed, We will pay the RPP Monthly Benefit into the Trust as follows: You must become Totally Disabled while the rider is in force; Any documents that may be necessary to establish the Trust and to facilitate payment of the RPP Monthly Benefit must be executed; You must satisfy the RPP Elimination Period; After You have satisfied the RPP Elimination Period, the RPP Monthly Benefit will be payable at the end of each month while You are Totally Disabled and not Gainfully Employed.”
Retirement Protection Plus Disability Benefit Rider, Form ICC16 RPID, Guardian Provider Choice Policy Form ICC16 18ID, Berkshire Life Insurance Company of America
A NewYork-Presbyterian fellow who becomes totally disabled during a long subspecialty arc loses two distinct income streams. The first is the salary the base monthly benefit replaces. The second is the retirement contribution that an actively employed physician would otherwise be making each month. The Retirement Protection Plus rider directs payments into an irrevocable trust during disability, replacing the contributions the disabled physician cannot make. The trust assets are distributed to the policyowner at retirement under the trust’s terms, restoring the compounding that disability would otherwise interrupt.