Financial Health Assessment
Ingrid and Hugo: Obstetrics and Gynecology Household Scores 22 Out of 100
By Ryan Inman
Published · Updated
Obstetrics and gynecologyEstablished · Four years post trainingCouple, two children
Financial Health Assessment score
22 out of 100
Needs a workup
- Needs a workup 0 to 39
- Corrections 40 to 69
- Stable 70 to 84
- Healthy 85 to 100
The score grades the household on 20 measures across seven frameworks. Ingrid and Hugo lands at 22, in the Needs a workup band, score 0 to 39.
Ingrid is an obstetrician gynecologist about four years out of training, earning $330,000 a year. Hugo is a high school teacher earning $80,000, two years from finishing a PhD program he is paying for in cash. The household earns $410,000, has two school aged children, and lives in a high cost of living area. The assessment scores the household 22 out of 100, in the Needs a workup band.
The monthly shape is two large fixed claims: a $5,000 mortgage payment on a $799,000 loan just refinanced at 2.8 percent, and a nanny at about $4,000 a month, ahead of stated outgo of about $14,700 across the listed lines. Saving is stated at about $3,000 a month after funding the 529 accounts, described as highly variable, and neither the intake nor the hosts could say where it lands: no taxable account and no IRAs are stated.
The finished work here is the paper most households skip. The estate set is complete: will, power of attorney, healthcare directive and living trust, one of two full boxes in the protection stack, beside her term life. Against that: there is no umbrella policy at all, Ingrid's disability cover runs through her employer only, Hugo's life cover is a small policy through his job, and health cover and malpractice are not stated. The traced path runs from 22 to a target of 28, on two purchases, and the prescription section shows them.
$5,000
Mortgage payment per month · on $799,000 at 2.8 percent
$4,000
Nanny cost per month · the second housing payment
$3,000
Stated saving per month · destination not stated
$410,000
Household income · OBGYN plus teacher
About $14,700
Stated monthly outgo · across the listed lines
$276,000
In the two retirement accounts stated
The short version
- The score: 22 out of 100, in the Needs a workup band. The Protection Stack earns 8 of 22 and the Decision Filter the full 4 of 4, while the Tax Ladder and the Transition framework both earn 0.
- The estate set is finished: will, power of attorney, healthcare directive and living trust are all in place. The estate documents box earns the full 4, one of two full boxes in this household's protection stack, beside her term life.
- The saving cannot be pointed to: about $3,000 a month, highly variable, with no taxable account and no IRAs stated. The hosts asked where it goes and the file does not answer.
- Cover leans on employers. Ingrid's disability is employer coverage only, Hugo's life cover is a small policy through his job, and there is no umbrella policy in place at all.
- The traced path to 28 is two purchases: an umbrella policy (+4) and individual own occupation disability cover for Ingrid (+2).
The documents are done. The cover is borrowed from employers.
What They Did Right
A household that finished the documents most families postpone. This is the machinery already running.
- The estate set, finished Will, power of attorney, healthcare directive and living trust, all in place. The estate box grades at the full 4.
- Her loans, paid off Her student debt is gone in full since residency.
- $2,000,000 of individual term on Ingrid Bought on her own name rather than left to the job, plus $300,000 more through work.
- The PhD, paid in cash About $20,000 a year for his doctorate, cash flowed with two years to go and no new loans taken for it.
- No credit card debt A mortgage, a student loan and two leases stand in the file, and the card line states no carried debt.
The Score: 22 out of 100
The Financial Health Assessment grades a household across the same seven frameworks and lands the total in a band. Ingrid and Hugo scores 22, in the Needs a workup band. This household is scored on the attending rubric, on the established fork of the Transition framework.
20
Measures graded
7
Frameworks
22
Ingrid and Hugo's score
The 3 Bucket Framework earns 3 of 20. Milestones earn 0, because the milestone net cannot be determined from what the intake states. The emergency fund earns 0: the fund sits in a high yield savings account and its balance is not stated. Named lanes earn 0: the stated saving is variable and its destination is not stated, so no lane system can be graded. Goals funded earns 3, with dollars aimed at retirement, college, travel and the home while no goal carries a costed target, so goals are not fully funded.
The Physician Wealth Equation earns 5 of 14. The Debt Anchor earns 5: total stated debt of $854,000 against $410,000 of income is about 2.08 times, partial credit on the established bar. Stretch saving earns 0: about 9 percent if the stated $3,000 a month counts in full, below the 12 percent partial line, on a flow whose destination the record cannot verify.
The Protection Stack earns 8 of 22. Health earns 0, because household cover is not stated. Disability earns 0: employer coverage only for Ingrid, nothing individual for either earner, and Hugo's cover is not stated. Life earns the full 4, on $2,000,000 of individual term in force on Ingrid. Umbrella earns 0: no policy is in place, stated plainly. Malpractice earns 0, type and tail not stated. Estate documents earn the full 4: the complete set is in place.
The Transition framework, on the established fork, earns 0 of 10. Education debt finished earns 0: his $55,000 student loan is outstanding with no forgiveness plan stated, even though hers is paid off. No lingering consumer or vehicle debt earns 0: two leased vehicles are present, which the established reading counts against the box.
The Tax Ladder earns 0 of 8: no Roth fact and no bracket fact is stated, and no deliberate move is stated. The Decision Filter earns the full 4 of 4 on five stated goals.
The Lifestyle Guardrails earn 2 of 22. The Savings Floor earns 0, on a rate of about 9 percent at best. The leak earns 0: the unaccounted share of spending is not stated, and the episode's own hosts could not trace where the stated saving goes. Wealth first automation earns 2: payroll deferrals into the 401k and the 403b run first, and the record grades the automation partial.
| Framework | What it covers | Points |
|---|---|---|
| 02 3 Bucket Framework | Milestones 0, emergency fund 0 (balance not stated), named lanes 0, goals funded 3 | 3 of 20 |
| 03 Physician Wealth Equation | Debt anchor 5 at about 2.08 times income, stretch saving 0 at about 9 percent | 5 of 14 |
| 04 Protection Stack | Health 0 (not stated), disability 0, life 4, umbrella 0, malpractice 0, estate documents 4 | 8 of 22 |
| 05 Transition | Education debt 0, his loan outstanding. No lingering debt 0, two leased vehicles | 0 of 10 |
| 06 Tax Ladder | Roth against pre tax 0, bracket plus moves 0 | 0 of 8 |
| 07 Decision Filter | Goals written 4, five goals stated | 4 of 4 |
| 08 Lifestyle Guardrails | Savings floor 0, the leak 0, wealth first automation 2 | 2 of 22 |
| Total | Needs a workup band | 22 out of 100 |
Read the shape, not just the total. This is a paperwork complete, cover borrowed household: the estate set is finished at full marks while the disability and umbrella boxes sit at zero on employer only cover and a plainly stated gap. Underneath, the largest unknown is not a purchase at all: $3,000 a month of stated saving that nobody, including the hosts, can point to. The traced path buys the two missing covers. The untraced work is giving the saving a stated home.
The Prescription
The traced fixes first, then the open items the record carries without a gain.
- Buy an umbrella policy. Sized to the household's income and assets, on the hosts' advice. The umbrella box moves from 0 to the full pattern. (+4 points when in force.)
- Add individual own occupation disability cover for Ingrid. Her income carries the file, and today it is protected only through her employer. An individual policy of her own moves the disability box from 0 to its partial pattern. (+2 points when in force.)
- Give the $3,000 a stated home. Name the accounts it lands in each month, retirement first, so the saving can be graded as a rate. No points are claimed for this step in the record's basis. The traced path runs through steps 1 and 2 only.
- Price Hugo's own life cover. His policy runs through his job, and the hosts' math gives even a non earning spouse a cover figure of $500,000 to $1,000,000. No points are claimed for this step. The life box already grades Ingrid's individual term at full marks.
The traced path runs 22 to 28: plus 4 for the umbrella, and plus 2 for Ingrid's individual disability cover. Both steps are purchases the hosts named on the episode. The file's deeper item, the untraceable saving, carries no traced gain and is listed as such. It is still the first thing a follow up assessment would ask about. The target is 28, stated with its arithmetic.
What This Case Teaches
Documents and cover are different jobs. This household finished the documents: a complete estate set, in place, at full marks. The cover that pays during a working life is mostly missing or borrowed: no umbrella, disability through an employer, a spouse's life policy through a school district. A will decides where assets go after a death. It does nothing for the mortgage during a disability, and grading the two halves separately is what keeps a finished file from looking finished.
A finished will does not pay a mortgage during a disability.
The second lesson is about evidence. A savings rate is a claim about money that moved, and a claim needs a destination: an account, a balance, a flow that can be pointed to. The hosts, two planners reading the same intake, could not find where this household's saving goes, and the Guardrails grade that absence exactly the way they grade a low rate. Stating where the money lands is free, and it is the difference between a rumor and a rate.
Behind the score
The Household
Ingrid is 36, about four years out of training, and Hugo is 39. They own their home in a high cost of living area and have two small school aged children. A nanny is with the children all day, at about $1,000 a week.
The stated monthly lines add to about $14,700: mortgage $5,000, nanny $4,000, his doctoral program $1,600, home maintenance about $1,000, his student loan payment $860, two leased cars at $768 combined, food about $500, utilities $400, clothing and extras for the kids about $300, and auto insurance $266. Saving is stated at about $3,000 a month after funding the 529 accounts, and the amount is stated as highly variable. The 529 balances and contribution amounts are not stated.
Nine thousand dollars a month goes to the house and the nanny before anything else moves.
Balances are stated in two accounts: her 401k at $250,000 in a target date fund, and his 403b at $26,000 in an S&P 500 index fund. Banking runs through Bank of America, two separate checking accounts and a joint savings account, with a high yield savings account at American Express holding the emergency fund. Its balance is not stated. No taxable account is stated, and no IRAs are stated, which is why the hosts' central question, where the $3,000 a month actually goes, has no answer in the file.
Debt sits in two stated lines plus the leases. The mortgage is $799,000, just refinanced at 2.8 percent, $5,000 a month. Her student loans are paid off in full since residency. His student loans are $55,000 at 3.1 percent, $860 a month, from undergraduate and master's degrees, alongside the PhD he is cash flowing at about $20,000 a year with two years to go. Total stated debt is $854,000, about 2.08 times income. There is no credit card debt.
Protection is a finished estate set standing next to borrowed cover. Ingrid holds $2,000,000 of individual term life plus $300,000 through her job. Hugo holds a small life policy through his job, amount not stated. Ingrid's disability cover comes through her employer. Its type, amount and own occupation status are not stated, and Hugo's disability cover is not stated. There is no umbrella insurance, stated plainly. Household health cover is not stated, and malpractice type and tail are not stated. The estate documents are complete: will, power of attorney, healthcare directive and living trust. No guardian is separately stated for the two minor children.
| Household fact | Where it stands |
|---|---|
| Careers | Obstetrician gynecologist, about four years out of training. High school teacher and PhD student |
| Household income | $410,000: $330,000 plus $80,000 |
| Family | Couple, two school aged children |
| Mortgage | $799,000 at 2.8 percent, just refinanced, $5,000 a month |
| Student loans | Hers paid off in full since residency. His $55,000 at 3.1 percent, $860 a month, with a PhD program at about $20,000 a year paid in cash |
| Other debt | Two leased cars at $768 a month combined. No credit card debt. Total stated debt $854,000 |
| Childcare | Nanny about $4,000 a month |
| Emergency fund | Held in a high yield savings account. Balance not stated |
| Saving | About $3,000 a month after funding the 529 accounts, stated as highly variable. Where it lands is not stated |
| Balances | 401k $250,000 in a target date fund. 403b $26,000 in an S&P 500 index fund. No taxable account or IRAs stated |
| Disability | Ingrid: employer coverage only, type and amount not stated. Hugo: not stated |
| Life insurance | Ingrid $2,000,000 individual term plus $300,000 through her job. Hugo a small policy through his job, amount not stated |
| Umbrella | None in place, stated plainly |
| Estate documents | Complete set in place: will, power of attorney, healthcare directive and living trust |
| Goals | Five stated goals |
The Two Frameworks Behind the Score
The score grades 20 measures across seven frameworks. Two of them carry this case: the Protection Stack, which scores 8 of 22 on one full life box and a complete estate set, and the Lifestyle Guardrails, which score 2 of 22 because the saving cannot be traced.
Framework one
The Protection Stack
The Protection Stack grades the coverage that keeps one bad month from ending the plan. Two boxes in this stack are finished work. The two that pay during a working life are the empty ones.
- Life, in force on Ingrid Built
- Individual term of $2,000,000, plus $300,000 through her job. Hugo holds a small policy through his job, amount not stated. The box earns the full 4.
- Estate documents, complete Built
- Will, power of attorney, healthcare directive and living trust, all in place. The box earns the full 4.
- Disability and umbrella, at zero Missing
- Her disability cover runs through her employer only, nothing individual stands on either earner, and there is no umbrella policy in place at all. Each box earns 0.
Framework two
The Lifestyle Guardrails
The Guardrails grade whether today's lifestyle leaves room for the plan: the savings floor, the leak, and whether wealth is paid first.
- The savings floor Missing
- About 9 percent at best, if the stated $3,000 a month counts in full, below the 12 percent partial line, on a flow whose destination is not stated. The box earns 0 of 12.
- The leak Missing
- The unaccounted share of spending is not stated, and the stated saving itself could not be traced to any account in the intake. The box earns 0 of 6.
- Wealth first automation Partial
- Payroll deferrals into the 401k and the 403b run first. The record grades the automation partial, and the box earns 2 of 4.
Where the $3,000 Goes
The first look is the hosts' unanswered question. The intake states saving of about $3,000 a month after funding the 529 accounts. It also states no taxable account, no IRAs, and two retirement balances of $250,000 and $26,000. On the episode, the hosts walked the same figures and stopped at the same place: where is the $3,000 actually going?
The distinction they drew is the one the Guardrails grade. Money set aside for a vacation, for the 529 accounts, or for the next home project is saving for spending. It does not raise net worth. Paying yourself first, in the hosts' frame, means 25 percent of take home pay moving to things that improve the balance sheet: debt payoff, retirement accounts, investments.
Saving you cannot point to is a rumor, not a rate.
The file does not say, and the score grades what is stated: the Savings Floor earns 0 at about 9 percent, the leak earns 0 with the unaccounted share unstated, and the milestone net cannot be determined.
The fix costs nothing and buys information before it buys points: name the accounts the $3,000 lands in, month by month, and the next assessment can grade a rate instead of a rumor. Until then this household's open number is the one it cannot point to.
Cover That Belongs to the Employer
The second look is the cover that ends with a job change. Ingrid's disability protection runs through her employer. Hugo's life policy runs through his. The episode's disability discussion made the point that matters: group cover ends with the job.
The disability box grades individual own occupation cover, and there is none in this file for either earner, so the box earns 0. The record traces the fix on Ingrid's line at +2: an individual own occupation policy of her own, bought while she is insurable, at four years out of training.
Employer cover ends on the last day of the job. The risks do not.
Beside it sits the plainest gap in the file: no umbrella insurance, stated in one sentence in the intake. The hosts told this household to get umbrella coverage and raise the auto limits to attending levels. The record traces an umbrella policy sized to the household at the full pattern, +4, the largest single step on this file's path.
None of this contradicts the file's real strength. The estate documents are finished, which is the paperwork half of protection. The insurance half is the half that pays during a working life, and today most of it is borrowed from two employers.
Milestones: Scored on What Is Stated
Inside the 3 Bucket Framework, the milestone checklist tracks the markers a household has already hit. This checklist earns 0 for Ingrid and Hugo, because the intake never states a milestone list the net can be computed from. The box pays only for stated milestones.
The rest of the bucket picture: the emergency fund earns 0 with its balance not stated, named lanes earn 0 with the saving's destination unstated, and goals funded earns 3 of 6 on aims that reach every goal area without costed targets. The framework earns 3 of 20.
Questions this case answers
What score did Ingrid and Hugo receive on the Financial Health Assessment?
Ingrid and Hugo scored 22 out of 100, in the Needs a workup band. The Protection Stack earns 8 of 22 and the Decision Filter the full 4 of 4, while the Tax Ladder and the Transition framework earn 0.
What did this household finish that most have not?
The estate documents. The will, power of attorney, healthcare directive and living trust are all in place, and the estate box earns the full 4. The hosts praised the set on the episode. It is one of two full boxes in this household's protection stack, beside her term life.
Why do the Lifestyle Guardrails earn only 2 of 22?
The savings floor earns 0: about 9 percent at best, on a stated flow whose destination cannot be verified. The leak earns 0: the unaccounted share is not stated, and the hosts could not trace where the $3,000 a month goes. Wealth first automation earns 2 on payroll deferrals into the two retirement plans.
What is missing for Ingrid and Hugo?
There is no umbrella policy in place. Household health cover and malpractice type and tail are not stated, the emergency fund balance is not stated, Hugo's disability cover and the amount of his life cover are not stated, and no guardian is separately stated for two minor children.
Sources and Basis
This assessment is built from the household's own intake for the Financial Health Assessment and the episode assessment of it. Every figure on this page comes from that record, and the score is traced box by box under the locked attending rubric.
The attending rubric weights the seven frameworks at 20, 14, 22, 10, 8, 4, and 22, for a total of 100. The bands are Needs a workup from 0 to 39, Corrections from 40 to 69, Stable from 70 to 84, and Healthy from 85 to 100. Attendings are scored on the Transition fork by years since training: for established attendings, whether education debt is finished, and whether consumer or vehicle debt remains.
Written by Ryan Inman, MBA, MAFM. Last updated October 2026.