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Is a cash balance plan right for your practice?

For profitable physicians, dentists and other practice owners, a cash balance plan can shelter far more income than a 401(k) alone. It's also a long-term commitment.

Gulecha CPA3 min read

A cash balance plan is a type of defined benefit pension plan that looks and feels like a 401(k). Each participant has a hypothetical account that grows with annual pay credits and a guaranteed interest credit. For an owner in their 40s, 50s or 60s, the allowed contribution can be several times larger than a 401(k).

How much can you put away?

In 2026, an employee can defer up to $24,500 into a 401(k), plus catch-up contributions from age 50, and total 401(k) additions including profit sharing are capped at $72,000. A cash balance plan sits on top of that. Its limit is based on the benefit the plan can provide at retirement, so allowed contributions rise steeply with age.

For many owners in their 50s, a 401(k) and profit sharing paired with a cash balance plan can support combined deductible contributions well into six figures each year. Your actuary calculates the exact range annually.

A quick example. A practice owner in the 37% federal bracket who also pays Oregon income tax could save roughly 45 cents in combined federal and state income tax for each dollar contributed. A $150,000 contribution would save about $65,000 in tax this year, with taxes deferred until the money is withdrawn.

Who it fits best

  • Owners aged roughly 45 and older, since contribution limits climb with age.
  • Practices with steady, predictable profits that can commit to contributions for at least several years.
  • Owners already maximizing their 401(k) who still have significant taxable income.
  • Practices with a small staff or a staff that is younger than the owners, which keeps the cost of required employee contributions down.

The cost of covering staff

Like any qualified plan, a cash balance plan has to pass nondiscrimination testing. That usually means meaningful contributions for eligible employees, often in the range of 5% to 7.5% of their pay when combined with the profit sharing plan. Good plan design keeps the owners' share of the total contribution high while meeting those rules.

It's a commitment, not a one-year deduction

  • Required funding. Contributions are generally required each year within a range set by the actuary. Plans can be amended if circumstances change, but they aren't meant to be switched on and off.
  • Permanence. The IRS expects a qualified plan to be permanent. Terminating within the first few years without a business reason can raise questions.
  • Administration. Expect annual actuarial and administration fees, and a Form 5500 filing each year.
  • Investment risk. The plan promises a fixed interest credit. If investments underperform it, the practice may need to contribute more.

When to set it up

A new plan can generally be adopted as late as the practice's tax return due date, including extensions, and still count for the prior year. Since contribution amounts depend on the year's profit, the best time to start the conversation is in the fall, when you have a reliable projection.

How your entity type plays in

For S corporation owners, contributions are based on W-2 salary, not distributions. Setting a reasonable salary that also supports the retirement contributions you want is part of the same plan. For partnerships and sole proprietors, contributions are based on net earnings from self-employment.

The bottom line

For the right practice, a cash balance plan is one of the largest deductions available. We work with your plan administrator and actuary to size it to your profits, staff and goals, and then build the funding into your annual tax plan.

This article is general information, not tax, legal or investment advice for your situation. Rules and thresholds change, so please talk with a qualified advisor before acting.

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