Why the Scripps Clinic Medical Group 401(k) and Market Rate Cash Balance Plan Stand Out as Two of the Strongest Physician Retirement Benefits in the Country

Every so often, I come across a retirement package that feels like it was built with physicians’ realities in mind—not just the long hours and high income, but the need for flexibility, control, and long-term tax efficiency. The Scripps Clinic Medical Group 401(k), paired with its Market Rate Cash Balance Plan, is one of those rare combinations. Over the years, I’ve reviewed many physician group retirement structures, and few offer this level of thoughtful design.

The Strengths of the Scripps Clinic Medical Group 401(k)

One of the foundational strengths of the plan is its partnership with Charles Schwab. In the world of 401(k) custodians, Schwab is widely respected for keeping costs low and systems easy to navigate. For high-earning professionals—whose long-term wealth is heavily influenced by after-fee performance—those small cost differences compound meaningfully over time.

Another standout feature is open architecture. Rather than confining physicians to a limited, preselected list of funds and advisors, the Scripps Clinic Medical Group 401(k) allows participants to work with their own financial advisors within the plan. This is uncommon—and valuable. It lets each physician build a retirement strategy that fits seamlessly with their broader financial plan, while also allowing advisory fees to be paid from retirement assets instead of from personal cash flow.

The plan also includes a self-directed brokerage account, giving physicians access to a broad universe of investments that extends far beyond the standard lineup. For those who want more precision—whether through specialized ETFs, sector strategies, or certain fixed-income positions—this flexibility is a major advantage.

Even the core investment menu deserves praise. Instead of loading up on high-fee mutual funds, the plan uses a lineup of low-cost ETFs from Schwab, Vanguard, and iShares. For busy physicians who want simple, diversified, low-fee portfolios, this is exactly the type of structure that helps long-term compounding work in their favor.

An Area of Improvement for Scripps Clinic Medical Group 401(k) - one of the few areas where the plan trails its peers

The one area where Scripps could improve is its vesting schedule: 20% per year, fully vested after five years. In our experience working with large employers and medical groups, a three-year schedule is more common nationally, unless turnover between years three and five is unusually high. A shorter vesting timeline would make a strong plan even more competitive.

The Scripps Clinic Market Rate Cash Balance Plan: A Compelling Complement

Alongside the 401(k), Scripps offers another powerful tool: the Scripps Clinic Market Rate Cash Balance Plan. This plan is particularly notable because it guarantees at least a 5% rate of return on contributions, regardless of market conditions, based on the information available. For physicians seeking stability in a portion of their retirement savings—especially during volatile markets—that type of guaranteed floor is meaningful.

Cash balance plans at for-profit employers always come with one caveat: assets are technically subject to the employer’s creditors. That’s simply how the structure works. But the guaranteed return, if it continues to be accurate, is a strong reason to consider participating. For many physicians, the trade-off is well worth it: tax-deferred growth, significant contribution potential, and a stable, predictable crediting rate that doesn’t depend on the market cooperating.

When paired with the flexibility of the 401(k), the cash balance plan rounds out a retirement package that serves both the growth-oriented and risk-averse sides of a physician’s long-term financial picture.

How to use the Scripps Clinic Medical Group 401(k) and Market Rate Cash Balance Plan together to secure a comfortable retirement

As one of the best retirement plans in the entire country for physicians (minus the issue with the long vesting schedule of 5 years when 3 years would be the norm for a good employer.

A recent study cited in physicians weekly showed that physicians typically stay only about 2 years at their first job, and given that Scripps Clinic Medical Group tends to contribute about $25k a year to retirement per physician to our knowledge, it is reasonable to have a steeper vesting schedule over the first 2 years to deal initial high turnover which is typical in the industry.

However, the median private sector employee only stays on the job about 3.5 years according to the BLS: https://www.bls.gov/news.release/pdf/tenure.pdf and the typical large company vesting schedule getting employees to 100% vested in employer 401(k) contributions in 3 years helps match the typical employee tenure in America.

Generally a vesting schedule, in our view, should match when an employee becomes profitable to the group. In the first year, the employee may not be that profitable because of recruiting costs and getting them set up. In very physician friendly groups the vesting schedules are more likely to resemble the IRS cliff vesting schedule or 3 years or some variation of that as opposed to the 5-6 year vesting schedules that I see more commonly with private equity owned groups or less physician friendly groups. Below is some information on IRS vesting schedules for reference: https://www.irs.gov/retirement-plans/issue-snapshot-vesting-schedules-for-matching-contributions

So for physicians at Scripps Clinic Medical Group it can be beneficial to gently push for a shorter vesting schedule of 3 years to 100% vesting and opposed to the current 5 year schedule. Moreover, in exchange for a shorter vesting schedule that gets you to 100% vesting earlier, it is reasonable to assume that first year employees may not vest at all in employer contributions and second year employees may have a more limited vesting amount. 401(k)s are really designed to assist long term employees save for retirement and financial security and they are just naturally not well equipped to handle frequent employee turnover when employer contributions to the retirement accounts are generous as they are at Scripps Clinic Medical Group.

Finally, Scripps Clinic Medical Group has all the tools in the plan to save for retirement from a great mix of low cost ETFs to a self directed brokerage account, to generous employer matching, to the ability to use a variety of financial advisors, not just the standard 1 firm option you sometimes see in less good plans.

So the key is generally to save enough for your specific goals, to invest in a way that makes it likely that you will achieve those goals, in our view, and to plan your drawdowns in a tax efficient way.

D.R. Harris & Co. works with physicians throughout the United States and in San Diego save, invest and plan for a succesful retirement. We typically work with physicians who are 55-65 and/or within 10 years or their planned retirement and our typical client in these situations has at least $1-$2m million saved up for retirement by the time we talk to them.

Retiring is a little bit like jumping (or gliding) off the cliffs at Torrey Pines Gliderport - you leave the safety of a fairly steady paycheck and you have to use your investments to provide comfort and security for yourself for the rest of your life. You want to make sure that you are prepared, that you have a good approach, and a reasonable plan to make this transition.

Often times it can be beneficial to talk to or work with a fiduciary financial advisor before you make this transition in order to make sure that your plans are reasonable or if you don't have much of a plan right now, a fiduciary financial advisor at D.R. Harris & Co. can help you set one up.

While our first year client fees are competitive, they are within industry averages, so you should be comfortable paying an industry average advisory fee before reaching out to us.

Finally, we do work with some younger physicians (new attendings and mid career physicians) on a more limited basis. For new attendings our engagements are designed to be more short term (1-2 years at most to get you up to speed on financial education and on your way) and for mid-career physicians we work with those who don't like dealing with all this investing stuff and want to delegate some of those tasks to someone else who can help them make informed decisions. While we do not make trades for clients, we provide investment and financial advice for clients and clients make their own trades.

If you are interested in having a conversation with a fiduciary financial advisor you can fill out the following form to request a 10 minute introductory phone call. In this 10 minute introductory phone call we will get to know each other a little bit, hear about your goals and see whether it makes sense to talk further.

If you'd like to learn more about Daniel Harris or D.R. Harris and Co. you can do so by clicking here.

Disclaimer: This article is written for educational pruposes only. Neither Daniel Harris nor D.R. Harris & Co. are your financial, legal or tax advisor unless you have a signed written advisory agreement with us. You should do all your own research and talk to your own professional advisors before acting on any information you read about in this article. While we believe the information in this article is correct as of the time it was written on 12/1/25, we encourage you to verify any information in this article with your employer or your own professional advisors before acting on any information you read.