Stephan Shipe Welcome back to the Scholar Wealth Podcast. This week we start with a question about 529 superfunding and how it interacts with an existing annual gifting strategy for a family with a $40 million estate. Then we look at how to evaluate private club memberships, fractional aviation cards, and family office services after a liquidity event, and what framework actually helps you decide what's worth it. And in our From the Field segment, we're joined by Jasmine Bhatti, founder and CEO of NaviNurses, for a conversation about the personalized healthcare landscape and what's available now for families who want more than the standard of care. So let's go ahead with our first question. My wife and I have four grandchildren and an estate around $40 million. We've been considering superfunding 529s to help with estate planning, but we already have an annual gifting strategy in place. And I'm not clear on how the two interact and whether 529s are really the right tool at our level. Great question. And it's actually really simple, but there are a couple of caveats to it. So the idea of 529 superfunding is you're allowed to gift to a 529 the annual limit every year. So the $19,000 per person per donor — you and your wife could give $38,000 over to a 529. What this allows for is that the government allows you to take five years and basically go forward and say, what if we were to make all the future five years' contributions right now and superfund that account. So it allows you to put a lot more money earlier in that account so that way it can start growing, which makes a lot of sense for 529s and where this rule came from. Because the 529 has a relatively short time horizon. When you're planning for something like retirement or anything else, you have decades. But when you're funding a 529, you're stuck with 18 years at best. So in that case, we don't have a ton of time for compound interest. By superfunding, it allows you to put a lot of money — over a hundred thousand dollars — in the account now, so that way it can continue to grow for those five years, as opposed to waiting every year for the tax. Now, the issue you run into with this, and I say this only because you're talking about it as an estate planning decision, is that when you're comparing this to just continuing your normal annual gift to your grandkids, there's not going to be a difference. In other words, whether you give them $19,000 or you put $19,000 into a 529, the impact to your estate is the same. With superfunding, it does allow you to put five years in at once. And some people say, well, I could put five years in now so I can get ahead of it. It's kind of true. I'm not going to knock it. But if you were to die during that five years, then some of that may be clawed back into the estate. So it's not necessarily a true five-year funding where you don't have to worry about anything. It's really just taking your next five years of contributions and allowing that to go into the account right now. A bigger concern I have based on this question is about funding this much into 529s. Where we see this go wrong is funding this much money into a 529 really early, and then everything goes right, the stock market goes up, and now you have a 529 that has six, seven, $800,000 in it. That is likely going to overfund you for most college options, unless you're going to a really expensive private school for four years plus continuing with really expensive grad school — that's really the only way to get there. So you lose a lot of optionality where everything is stuck in these 529s and you can't really get it out very easily. There are lots of concerns over taxes if you're trying to get the money out and it's not used for college expenses. So it may be a scenario where, if you're already doing contributions and gifting, you continue that. There are different types of trusts that are available to you where you could gift into those. You could just give directly to the kids, and that's always a good option as well. But I don't know that superfunding the 529 is a slam dunk from an estate planning perspective. It can be great if you're just looking for a way to fund it all now, let it ride, and never have to fund the 529 again for your grandkids. But just know that doesn't affect next year's gift or anything else. In other words, you can't fund the 529 for all five years now and then continue to gift your grandkids for the next four years — or else you would be filling out a gift tax return and going over that limit, which you have to do anyway with the superfunding. So now for our second question. I sold my company last year. I'm 37, cleared about $18 million after tax. And in the last six months I've been approached about a golf club at $85,000 initiation, a city club downtown, a social club with a long wait list that seems more about deal flow than anything else, a private aviation card, and a family office intro service. Is there a framework for how to actually evaluate these things? Absolutely, there's a framework. The framework is you need to know what you actually want and not let all these people tell you what you need. And that is going to be the greatest option and framework for how you handle this stuff. Because this happens all the time where there's a major transaction — a lot of times the transactions end up being public somewhere, the legal documents are filed, there's been a change, and your name is on a list clearly being bought by the aviation card company, the city club, the social club. And they're hitting you up for all of these different things. Everybody's going to want a piece of the $18 million that you just received. So you have to avoid that at all costs. And I say that not in a you're not allowed to spend any of the money kind of way, but more so along the lines of, you're saying that this was six months ago. This is all very fresh. Assuming that you don't already have your golf club or city club downtown or private aviation, I'm assuming that this $18 million is a fresh $18 million, and this is not $18 million stacked onto an already existing $50 million. So if this truly is fresh money coming in and this is the first time you have this amount of money, this is a common issue, and you're going to have to get good at saying no and realizing that there are opportunities that sound like once-in-a-lifetime that probably aren't. And we can break those down into the different ones that you're talking about, because each of them have their own idiosyncrasies that we'd want to address. The easiest ones are the clubs — the city club, the golf club. These are the most common that you're going to see. And honestly, based on this list, probably some of the least risky of them, if you actually play golf or find any value in what they're offering. And I say that because there's a lot of pressure to say, well, I have to join this type of club because that's what you're supposed to do when you get $18 million. And that is a myth you have to get rid of. There are no rules that say once you cross $10 million you have to do these things. Now, are there certain things that people do once they cross that level? Of course, but it doesn't mean you have to. And I know way too many people who go and join golf clubs and country clubs who hate golf and can't figure out why they never go up there. That's going to be the same scenario with you. I would look first at this and say, is this something you're going to enjoy? Are you going to derive value from it? If the answer is yes, then the first framework is, does it match your values, what you're wanting to do? You might say you just had all this money come in and it's time for you to do a bunch of travel. Well, if that's the case, why spend $85,000 now to get into a country club where you're not going to be in the country. So we want to first figure out where you want to spend the money, what creates joy in your life, and start putting money toward that, not letting other people dictate what's supposed to bring you joy. So that's how we're going to handle the country club and the city club scenarios. The other one, the social club with the long wait list that seems more about deal flow than anything else — my guess is that wait list doesn't actually exist, especially if it's more of a deal-flow-focused club. And you're probably fine holding off on that one until you find out whether or not you actually need any deal flow. That gets tossed around a lot as an option of, you're going to join this because you're going to get access to these deals. The first question you need to ask is, do you need access to those deals? Is that actually a part of your personal financial plan, strategic plan? And if the answer is no, or not right now, then that makes it easy, right? If for some reason you say, absolutely, Stephan, I'm in crazy need of deal flow for whatever purpose, then maybe you evaluate it. But if they've got a long waitlist, throw your name on the waitlist as long as it's a free option and you can wait on it for years. Or maybe they call you in a week and miraculously you've moved up in the waitlist. But I would take that with a grain of salt. Private aviation card — this one is actually probably the easiest to evaluate based purely on cost. And what I mean by that is when you look at the clubs, whether it's the downtown club or the golf club, those are going to have this very intrinsic, personalized aspect to it where you're going to say, the cost is $85,000, but how much value do I derive from it? And the value you derive from it is all personal. So that's going to be really difficult to put a number on. The aviation card, when you get into these types of evaluations, is relatively easy to put numbers on. How much travel are you going to do? How many miles are you going to have on this card? What kind of access are you going to have? Are you going to be able to travel at the same times that you plan to travel? So the framework here is to first look at what your schedule looks like for the next couple of years. How often are you going to travel? How far are you going to be traveling? Then go price out business class tickets for all of that and determine what the cost is going to be. Then look at the economics of the aviation card to see whether or not that makes sense. Ownership may be in there depending on whether you're doing a lot of short trips, but the reality is the aviation card is probably the best of the options — own it, use an aviation card, or do short-term charters. But only if you're going to use it. A lot of times when I've done the math on these for clients, it never comes back as a slam dunk to go with one of these. Ownership is difficult because you're likely going to be traveling a lot further than what the plane you'd buy at the $18 million level would get you, especially with the ongoing maintenance. So you're going to be stuck with either chartering one or two times a year or dealing with some aviation card that gives you some flexibility, but I bet you go price out business class tickets to all the places you're going and it's going to work out a lot better that way, especially if you're considering international travel. The easiest on this list is the family office intro services — you don't need a family office for $18 million. So I wouldn't worry about those whatsoever, especially because you just cleared $18 million after tax. So tax consequences are relatively easy at this point because you have fresh cash going into accounts and you're younger. Even if you put an estate plan in place, $18 million sounds like you want to spend on some lifestyle stuff, which is great. You're not worried about this from an estate planning perspective right now. It'd be relatively easy for you to set up some basic estate planning documents with an attorney. So I would be a little hesitant on what a family office would actually be able to provide you at this point, besides what is probably investment management, which I'd argue you could probably handle yourself at this level of net worth given that it's mostly cash. Stephan Shipe All right, next in our From the Field segment, we look at how the concierge healthcare space has evolved from private nursing to integrative physicians to longevity practitioners. Stephan Shipe All right. Today we're joined by Jasmine Bhatti, founder and CEO of NaviNurses, a registered nurse with more than a decade of experience at Barrow Neurological Institute and Mayo Clinic. Jasmine founded NaviNurses to bring personalized hospital-level nursing care directly into the home. Jasmine, welcome to the Scholar Wealth Podcast. Why don't you start off and share a little bit about your background. What got you into this business? Jasmine Bhatti Yeah, thank you, Stephan, for having me. Really excited to be here and share my story. Long story short, I actually come from a family of physicians. I'm the first nurse in my family. But I think part of that is because I didn't really know what nurses did until my grandmother got sick. We took her home, and we had been told by the doctors in the hospital that we needed to put her into a skilled nursing facility. And I remember touring a few of them with my mom, just crying, like, we cannot put her here. We're going to have to do whatever we need to do to bring her home. And we did, but we didn't realize how hard that would be. Because when we think about home health and what insurance covers, it's almost nothing. So my grandmother, who is over 65 and receiving benefits from Medicare, only qualified for a few hours of nursing support, but she was breathing through a hole in her neck. She had a trach, she had a G-tube, so she's getting food through her belly. Really complicated needs that required 24-7 nursing that was really left to my family and me to figure out. I thought to myself when I became a nurse, why don't we have more private nursing available for people to access? Because not everyone wants to go to skilled nursing and people don't know how to take care of their loved ones. So why can't we help provide hospital-level care in the home for people? Because that's where they recover best. That's where they heal and that's where they're the happiest. And then also the family feels so much better knowing that their loved one is really getting the best care possible. And so that's really what I stepped away from Mayo Clinic to build — now five years ago. And we provided 42,000 hours of care here last year in Phoenix. So there's definitely a need for this sort of care. People want to be in their home and they want the luxury of deciding how they want their care and when they want their care. Stephan Shipe I think that's a big trend that we're seeing even across all levels of healthcare right now, just looking for these personalized solutions, whether it's concierge medicine or skilled nursing and everything in between. And this is definitely a topic that has come up more and more of what types of options are available. What does that actually look like? Jasmine Bhatti So honestly, it depends on the person and their needs. Ideally, we like to catch older adults while they're still doing okay, but we want to help keep them at home longer so they're happier and healthier and we can keep them in their most prime health. And we do that with just one-hour check-ins, maybe once a week, once a month, and that will gradually increase as someone gets older all the way through requiring up to 24-7 care. 24-7 care is really designed for people who've just had a procedure and want to recover in the best way possible, because we know that private duty nursing can actually help people recover faster and get back to their best health. Or it could be that we have families that hire us for their aging parents who are just getting older and they don't want to settle for having a caregiver. They really want expert trained eyes taking care of their loved one who can catch the signs, who can really engage with them and give them what they need. So the care is really tailored around the person. And for us in the nursing space, what that means is we actually match our clients with the nurses that best suit them based on their medical needs, as well as the things that make them human, like their religion or their culture, so that they can help prepare foods and engage in culturally sensitive activities, right? So we take those things and combine them together to make sure that it's hyper-personalized nursing care in the home. Stephan Shipe What I found interesting doing some background research on your company is that a lot of times you see this focus on long-term care options. But it looks like you're also commonly dealing with people who recently had a procedure and are looking for that short window where they know there are going to be these critical few months for healing. So they're going to bring in your team to help them through that transition period back to their active lives. Is that something that you're starting to see more of as a common trend as well? Jasmine Bhatti When we look at average readmission rates, they land anywhere between 15 and 20 percent. So 15 to 20 percent of all people leaving the hospital are likely to be readmitted within 30 days. That not only costs families money and time and stress, but if we can help bring in a nurse to help prevent that readmission, then that not only sets that person up for better success, but it decreases overall stress for the entire family. Stephan Shipe Throw some numbers at me on what this actually costs. Because I know a lot of times I'm in conversations and people are maybe not thinking about it the right way — they're not as concerned about themselves as they are about their parents. And they're saying, Stephan, I want to make sure that I'm budgeting for help that my parents are going to need in the future and what options are available. And you have such a wide range online. If you were to Google what the cost is of especially long-term care, you get huge ranges, and you get some average that always seems like the one size fits all fits no one, where it's $120,000 or so a year, $150,000. How does that change when you start to go into actual care within the home, ranging from, as you said, some minor check-ins throughout the month to 24-7? Jasmine Bhatti Yeah, so it can range anywhere from a few hundred dollars a visit, or for an hour, all the way through 24-7 care, which is like $25,000 a week for 24-7 nursing care. We have recognized that the percentage of the population who have invested in long-term care policies can really benefit from this. What's important for long-term care policy holders to recognize is that the sooner we can come aboard and be participating in the care, even in times where it's not so critical — so if you know you're going to have surgery, bring us in beforehand so you hit that 90-day mark. Usually it's like a 60 or 90-day threshold, right? So let's start that care beforehand so that way when you're out of the hospital, when we start that 24-7 care afterwards, in some of our cases, we've been able to get 24-7 nursing care covered by long-term care policies. So people don't need to go to skilled nursing. They can actually recover at home with their family, and it's covered by their long-term care policies. So it's just a matter of making sure that we can start the services ahead of time before they hit the 24-hour mark after surgery. And then that way we can really maximize the benefits for people. Stephan Shipe That's something I've never considered. That's a really good point because everyone worries about those exclusion periods. Generally, when it comes to long-term care, that's how they're priced. You do want a 30-day exclusion, a 90-day exclusion, a 120-day exclusion. Starting that earlier, I could definitely see as a huge benefit. Have you seen the types of coverage for long-term care change? Jasmine Bhatti I will just say I am not a long-term care policy expert by any means. I just see what comes in with our clients, and typically the clients that we've had are older, so they have these older long-term care policies. So I think that's where most of our clients are. They probably have what we would say is the Cadillac of long-term care policies, but they do exist. And especially for those people and their families, we want them to know that this is a really significant opportunity for them to use what they've invested in for all of these years. And in some cases, Stephan Shipe Yeah. Jasmine Bhatti we can actually provide 24-7 nursing care alongside caregiving and it will all be covered. Just opening the conversation I think is important, and once we can dive into the policy, then we can really understand what someone qualifies for, just because they're so variable. Stephan Shipe That makes sense. I think you're getting the selection of only those who've had the Cadillac policy and haven't had the chance to buy the Hyundai policies that seem to be sold today. So if someone has their plan, I know you mentioned being proactive around surgeries or anything like that. How soon should someone be having these conversations, whether it's with family members or for themselves? Do they need to be thinking about this five to 10 years out for something like your services, or is that something that is a lot more attainable at a quicker pace? Jasmine Bhatti Oh my gosh. You know, we're just in Phoenix, Arizona right now. The goal is to grow bigger, but there are private duty nursing companies around the country that you can tap into for this. And ultimately, people want to age at home. For the most part, they don't actually want to go into facilities. They really want to stay in their home with their memories and the things that matter to them. And one of the conversations we're really not talking about is how much these facilities cost, right? I think there are a few in my neighborhood in Phoenix and Scottsdale where they're $400,000 to a million dollars down, plus $8,000 to $10,000 a month. That doesn't include if you happen to need more nursing care, or if your loved one has any cognitive decline and they need a dementia unit — that's even more. So that's a massive investment for someone's parents. And we're trying to figure out our own retirement planning, now having to think about how we're going to care for our parents — that's important. Oftentimes our older loved ones don't want to feel like they're a burden, but they also want to stay incredibly independent. Having conversations earlier with your parents about, hey, I'm worried about you, I just want someone else to bring a second set of eyes and ears in, especially if there's a new diagnosis or something, and slowly weaving nurses into the conversation earlier, can really help with some of those really difficult family conversations that happen across the board. And the most beautiful thing is if the nurse can begin to build a relationship with your loved one, then that becomes incredibly powerful leverage when things start to change and they need more support. It makes parents much more receptive to welcoming nurses and caregivers and other people for extended periods of time in their house to help them, because they've built relationships and they understand the value. Stephan Shipe It really makes me think about some of the other options that are available too, just in this whole space, right? Because you're at the vanguard of this on the nursing side of the medical area. But what are the other trends that you're seeing out there now for those who are looking for customized or personalized solutions for healthcare, whether it's concierge medicine or maybe things I don't know about yet? Give us the inside scoop on what those are. Jasmine Bhatti There's a handful of them. And I think what it comes down to is people are wanting a healthcare experience that they feel comfortable and satisfied with. One where they feel heard and listened to and can proactively start to manage their health. And that can come in a variety of ways. So number one, right now we're seeing a lot of work towards longevity. So how can younger people, those of us in midlife, really put more dollars into providers and practitioners who can help us understand, for example, our gut and give us personalized medicine, not just here's a packet of information. You want to sit down and actually work with someone. So I have a friend here in Arizona who has created a company called Futurome, and that's what she does. As a pharmacist by background, she dives into your microbiome, your genes, multiomics, and helps provide personalized longevity care. We also see a lot of development in PT, OT, and speech therapy — all of these therapies that insurance doesn't cover what people really want and need. People aren't satisfied with the status quo of having any sort of healthcare provider come into your house or come into the room and then just leave. That doesn't feel like you're being attended to. And so we see that with all the other clinical aspects. And then of course, we're seeing this huge surge of people looking for concierge medicine. Sometimes it's concierge medicine with just a focus on general medicine, but there are a lot of people who are looking at integrative health. So how can you find an integrative physician who also blends holistic modalities in with traditional medicine? And so we're seeing a lot of those things playing out for people. And of course the women's health movement with understanding hormones better — that's a really significant area for women to invest in and understand how to better take care of themselves. Stephan Shipe Why do you find that people are managing this? Once you have all of these different types of concierge services, are they using more of a concierge service that acts as kind of the center of it all? I imagine you go to more of a general practitioner, but then you want to add speech therapy or you want to add some of these longevity practices. It seems like it'd be difficult to find someone who is the master of all of these. Have you seen that as an area that someone has really jumped into yet, to be the connector or the concierge for all the different concierge providers that are out there? Jasmine Bhatti It's really funny you ask that because that's essentially what nurses do. So for us in our practice, when clients hire us, one of the first things we ask them is what are your goals? And when we start to listen to understand what it is that they want and what they want to experience out of their healthcare experience, then we'll start bringing in the different opportunities for them to decide what fits best for them. So nurses are just inherent connectors across all of these different modalities because we can oftentimes recognize what someone needs even if they can't recognize it themselves. So it's a combination of what we're seeing and what we're hearing. And I would find that concierge physicians are great at this as well. So I think the concierge physicians, the concierge nurses, we've developed great networks within our communities so we can really connect people well. And that allows us as a community of concierge providers to actually work in collaboration really well for the best of the person, because healthcare isn't experienced best if it's siloed. That's the problem that we have now. When all of your medical team can work in collaboration, that's when you actually have the best experience and the best outcomes. Stephan Shipe That makes perfect sense to me. I think that's a great way to bring a lot of the topics you've gone over today together. But as we wrap up, is there anything you would add? You've given us a lot of great tips and things to think about today for families who are looking to evaluate some of these services. What would you throw out there as your main advice? Jasmine Bhatti Oh my gosh. I mean, I think the first thing is just giving permission to people to ask for help, because I think so often we just take on this role as a loved one of, I need to be the person doing the care. But sometimes the best thing you can do as a loved one is provide the resources so you can just sit back and be the loved one. And that's really, really important. It's important to ask for help and it's important to advocate for your own needs too. And I think just bringing it all back together — we're at a place where people have the means to be able to create the healthcare experience that they want. For us, for example, we have clients who have homes around the world. Our nurses hop on planes and go with them across their homes and travel with them. And so when you think about older adults that you're afraid to get on a plane with, that doesn't have to be a fear anymore. Let nurses come aboard and help you live that life that you want. And so just knowing that there are resources available for you to just have that dream life — it's possible. You just have to ask for help and then really find the credible resources in your community. Meaning they have good partnerships, they come recommended through credible institutions in your community. That's really important. Yeah, I think those would be the main points I would start with. Stephan Shipe Those are great points. I can't argue with any of those. Sounds wonderful. Well, Jasmine, thank you so much for joining us today. Lots of great things to take out of this episode. Jasmine Bhatti Thank you for having me, Stephan. You too. Stephan Shipe Have a great one. That's our show. Thanks for listening and we'll see you next week.