Nurse Practitioner Benefits Package (What Is FAIR?)

What should be included benefit-wise in an offer letter for a nurse practitioner? An offer letter is normally step one of your employment with your prospective future employer. In the offer letter, it’s normally going to outline a couple of things. One is going to explain what your position is. If you’re specialized, what kind of services are you going to be providing, what location and what setting, is it a hospital, clinic, hybrid? Kind of just depends on your specialty. Normally, there will also be something in there roughly about your schedule. Sometimes it will just say 40 hours, or it may break it up if you’re helping in the OR, or a hospital setting will say 70% this, 30% in the clinic.

And it may discuss if you have any call duties, so like nights or weekends, that’s typically included in an offer letter as well. Now, let’s talk about the benefits. What benefits are going to be included in that offer letter? Let’s start with some of the nurse’s health benefits. Normally, you don’t get a detailed outline or even a benefits package at this level when you’re just first receiving your offer letter. Once you receive the offer letter, it will normally just state that you will get some sort of health insurance, vision, dental, life insurance disability, maybe long term, short term, and then some type of retirement. And it’s not going to say a detailed explanation of how much each policy is going to pay out, like all that stuff. That’s going to be in a benefits summary or a benefits package. Sometimes that’s included later in a nurse employment agreement, but when we’re just at the level of your offer letter, it just states this is what they provide.

So, that’s going to be the number one, probably it’s just going to outline them briefly, just say the name of what it is. Then the next set of benefits you’re sort of like your ancillary benefits. Those are normally included also in your offer letter. That’s going to include any type of continuing education allowance, licensing, fees, dues, especially a DEA license right now. Those are normally always included in there. If you have any type of board expenses that they’re going to be paying for, that also would be in there, and then also for sure, it will be your compensation. Probably the number one thing you want to look at is what is your compensation and how is it calculated? And then PTO time will also be in there as well.

How much you’re offered if you have any additional PTO days for continuing education, that’s something you always want to look out for as well. And then any type of signing bonus or relocation bonus, all of those will be in the offer letter. The purpose of the offer letter is to start the process of negotiating and to start the process of you becoming a nurse employee. Now, if you sign an offer letter, you’re not agreeing to become employed by the practice. You’re agreeing to enter into negotiations for your employment. And normally, offer letters are pretty good, too. They’re going to be forthcoming with your benefits because they want to entice you to become an employee. So, they’re going to show a nurse all the good stuff right up front.

Your benefits should always be included. You’re going to look for all those health benefits like we just talked about retirement but go further and look and make sure there’s continuing education, there’s reimbursement for those expenses like dues, licensing fees, DEA license, any type of boards that you may be taking, all that kind of stuff you’ll want to look for as well. And then lastly, always look for PTO, how much you’re getting, and look, are you able to calculate it? Sometimes it gets a little confusing. I know it’s popular right now to do a four-day work week, but when your PTO time is calculated in hours, sometimes that can get a little confusing. So, you may want to reach out and ask them to clarify what that is, and how many weeks is that with your four-day work week if that makes sense.

Red Flags in a Nurse Practitioner Salary and Benefits Package

What are some red flags in nurse practitioner contracts? This is kind of a long list, but I’m going to boil it down to the most common ones that I see in an employment contract. A nurse should always want to read their contract carefully. I think we can start with a red flag. If you ever read anything that you don’t understand and cannot get clarity on, that’s a red flag. You should seek out an attorney like us who are familiar with employment contract issues. And we can explain that to you. And then if we still don’t understand it, then that’s a red flag. You want to get those words clear in your employment agreement, so you know what you’re signing and what your expectations are.

I’d say that’s kind of the first red flag. It’s very general, just understanding the clauses that you’re signing. I’d say the second red flag I always look for in an agreement, and if I don’t see this, it’s a big red flag to me. There needs to be a clause in a nurse’s employment agreement. That is a without cause termination, meaning, either party but especially yourself can terminate this agreement without any sort of reason or no reason at all. So, without cause termination, you give your notice to the practice or the group company, whatever, and normally there is a specific number of days that you have to give notice. Normally, that’s anywhere between 60 to 90 days, you’ll give your notice of termination, and then you are let out of the contract.

Now, you want to be careful, read it carefully. There could be some sort of bonuses or non-competes that would apply, but you are allowed out of the contract. It’s a huge red flag if there’s no way to terminate the agreement. You could be stuck in this contract for however many years unless the other party breaches or you’re let out of the agreement. So, this is a huge red flag. Always look for a without cause termination. And then you want to look for how many days’ notice you must give before you can get out of that contract. Another big red flag I see a lot is overly restrictive non-compete clauses. It kind of depends on the laws of your state. But you want to read your employment agreement carefully because non-competes can be kind of sneaky. Sometimes they go by different names, or you don’t understand what a restrictive covenant is, which is just a promise not to do something.

You’re promising not to compete with your employer. But you want to be careful that you fully understand what that non-compete is restricting. For how long, normally, that’s straightforward, but when we get to red flags, it’s normally the area that you’re restricted for. It could be too many miles. If you are in New York City and they’re restricting you 20 miles, well, that takes out a huge area. That would be a huge red flag. And then also, a nurse should want to consider how many locations their non-compete applies to. It’s a red flag if you are restricted from all the locations of the practice even if you don’t provide services there. Another red flag is if you are restricted from locations where you provide any services for.

Nursing Offer Letter Concerns

You’ve gone there one time during your employment, and you’re now restricted from that area. So, you want to make sure that they’re reasonable. Otherwise, that’s a huge red flag, and a lot of times, people don’t think about non-competes when they’re signing the agreement. It’s exciting. You’re starting a new job. You’re going to be making money. But you need to think about, if this ends what are my consequences or how is this going to affect me? Am I going to have to move? Do I have to move out of the state? Even so, non-competes that are overly restrictive are a huge red flag. Another red flag probably would be confusing compensation models. When you sign your contract, you should know how you’re going to be paid and when you’re going to be paid. Normally, base compensations are standard, but when you get into bonuses, sometimes they’ll say something like it’s at the sole discretion of the employer and can change at any time.

It’s kind of a red flag because you don’t know what the criteria are. You have no idea what to expect. So again, confusing compensation models, I would say, would be a red flag. Another one would probably have to be with scheduling or call expectations. Sometimes employment agreements are completely silent on that. You have no idea what the expectation is of your schedule or if you are responsible for any on-call duties. So, that would be a red flag. Typically, an agreement is going to be general, but there should be some type of language that’s going to give you an expectation of what your day-to-day is going to look like. And then going even further than that, some agreements state that you are to provide 40 hours of clinical services that don’t include any admin time.

That’s a red flag. You definitely want to address that because you don’t want to spend hours having to finish up your charting and records before you go home every night, then you’re going to be working well over 40 hours. Just like I said, look at the schedule, the on-call duties, and does it allow for any sort of admin? And then I would say, kind of circling back, it is a red flag if you don’t have any sort of ancillary benefits or business expenses reimbursed from your practice. Now, depending on the size of the practice or clinic that you’re going to be working for or hospital, you may not receive as many business expenses reimbursement, but you should receive some. That’s going to be your CME, you should get money for your CME annually. You should get your license and your dues paid for, DEA licenses, those are expensive.

And the renewals are expensive as well. So, those are things you want to be looking out for. If you’re not receiving those, and it’s completely silent, that’s a red flag. You should bring that up with your prospective future employer. So, to kind of go back through my list, I would start with any unclear terms, that’s a red flag. Non-compete clauses that are overly restrictive, a red flag. In compensation models, you don’t know how you’re getting paid, you can’t figure it out, that’s a red flag. And then not receiving any sort of CME, licensing, dues, that can be a red flag as well, and then not knowing your schedule or on-call duties. You have no idea what to expect whenever you start there, that’s a red flag as well.

NP Time Off and Benefits

How much PTO should nurse practitioners receive? The short answer is it really kind of varies. And it really depends on how long you, as a nurse have been there. Have you accumulated seniority? Have you been practicing for a long period of time? Where are you in the country? It really depends on a plethora of factors, but some things to really consider that I see honestly day to day with PTO is if you have a four-day work week, sometimes your PTO is less than it would normally be. And that’s just the employer thinking that because you have an extra day off every week, therefore you’re entitled to less PTO.

I would disagree with this, so it’s something that you would maybe want to advocate and double-check. Also, another thing you want to consider is what is in your PTO amount of time, sometimes you’re given just several days and that includes vacations, holidays, CEs or continuing education, and sick time. When you get that initial number of PTO, it looks great. You’re like, wow, going on vacation, but you want to be careful because you need to see what’s included in your PTO time. You should always receive PTO for continuing your education. And that should be an additional three to five days. You also want to account for all of your national holidays, you should have that time off, or you should be compensated for working on those holidays, additional compensation. And then normally, it’s anywhere from like three to five weeks, I would say is average starting out.

And then it just kind of goes up from there. But just to recap, you just want to know how much and what’s included, because it can get a little tricky. Another thing I see with PTO is your schedules in days and sometimes your shifts vary on how many hours; is it 10 hours and eight hours? But PTO is in days, so that gets a little confusing. Are those eight-hour days you’re being compensated for or 10-hour days? You don’t know. And then also, again, if you have a four-day work week, but you have three to four weeks off, is that including the four days or five days? So, it gets a little confusing. However, your schedule is broken down, if it’s broken down to how many hours or how many days per week, it’s customary that your PTO should be broken down in this same amount of time.

That way, you should always know by reading the agreement how many PTO days you’re agreeing to in this employment offer. The other thing I see sometimes is that your PTO has to accumulate. So, on day one, you’re not going to be receiving that full three weeks. It’s kind of prorated for how long you work there. You want to make sure that that’s outlined accurately in your employment contract or agreement, so you know how long you must work there in order to receive those. And then the last thing about PTO, I always check this in the termination section, in most of the time when you give your notice and sometimes you have to give it 90 days in advance, anywhere from 60 to 90 days, you’re not allowed to take any of your vacation days, you forfeit those, and they will not reimburse you for those.

So, keep that in mind. If you’re thinking about terminating your agreement, you want to check and make sure, are you going to be losing all your vacation, sick days, or any type of paid time off? Because you’ll want to take that or be paid out for that before you’d decide to terminate your agreement.

Consultation with Chelle Law

When your contract is reviewed by an experienced attorney, you will find great financial benefits which end up outweighing the cost of the review. If you are in need of assistance with an employment agreement or contract review schedule a Nurse Practitioner Contract Review with Chelle Law today!