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Webinar Transcript: "Overcoming Estate and Elder Care Planning Hurdles"

January 29, 2026

Webinar Transcript (1/29/2026): Overcoming Estate and Elder Care Planning Hurdles

Host: Jonathan I. Shenkman, President & Chief Investment Officer of ParkBridge Wealth Management (Contact: jonathan@parkbridgewealth.com)

Presenter: Elizabeth Forspan, Esq. Partner, Forspan Klear LLP (Contact: EForspan@ForspanKlear.com)

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Jonathan Shenkman: Good morning, and welcome to the Park Bridge Wealth Management Winter Webinar Series. This program is entitled, Overcoming Estate and Elder Care Planning Hurdles. As always, my name is Jonathan Shankman, I'm the President and Chief Investment Officer of Park Bridge Wealth Management.

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Jonathan Shenkman: In that role, I serve in a fiduciary capacity to help my clients achieve their financial objectives. The goal of my programs is to bring professionals together to help them better serve their clients. This is done by educating attendees on the latest topics in wealth planning, and by encouraging collaboration between a client's attorney, CPA, and financial advisor where appropriate. My practice focuses on working with high-net-worth families, businesses, and not-for-profits. I manage individual investment portfolios, trust accounts, corporate retirement plans, and endowment

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Jonathan Shenkman: comments.

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Jonathan Shenkman: to help my clients achieve their financial goals. In addition to the 20 or so events I run every year, I also do a fair amount of writing on the topics of investing and financial planning, and you can read my work in a variety of periodicals, including Barron, CNBC, Forbes, Kiplinger, The Wall Street Journal, and Trust and Estates magazine, to name just a few. You can see all my work on my website at parkbridgewealth.com forward slash articles.

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Jonathan Shenkman: Or, by following me on social media.

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Jonathan Shenkman: at Jonathan on Money. Additionally, you can check out my weekly podcast, which is also called Jonathan on Money, and you can listen to that on Apple, Spotify, or wherever you get your podcasts. Additionally, I published my first book, D is for Diversification, ABCs of Personal Finance, which can now be purchased on Amazon or at JonathanOnMoney.com.

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Jonathan Shenkman: Before I introduce our speaker.

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Jonathan Shenkman: Please pay close attention if you are an attorney or a CPA in Connecticut, New Jersey, or New York, and are taking this program for credit. I'll be giving a code during this program that you'll need to write down. There will only be one code. It will be given at some point in the middle of the program, so I have a pen and a piece of paper ready.

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Jonathan Shenkman: After the program, you'll receive an evaluation form where you'll need to insert the code in order to receive credit. Please stick around until the end of the program for further instructions on receiving credit.

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Jonathan Shenkman: Today, we're privileged to hear from Elizabeth Forsband, managing attorney at Forsband Clear, based on Long Island, New York. Elizabeth practices in the areas of elder law, trust and estates, and taxation. She regularly assists clients in achieving their Medicaid planning goals in a tax-efficient manner through practical and considerate planning techniques. Elizabeth speaks throughout the United States on various aspects of elder care planning, tax law, and estate planning. She has also been featured in New York Magazine, Market Watch.

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Jonathan Shenkman: has been quoted in the New York Times prior to co-founding Force Bank Clear. Elizabeth was a managing attorney of a leading elder law and trust and estates law firm. She also served as a tax manager with Ernst & Young. Today, Elizabeth will be speaking on overcoming estate and elder care planning hurdles.

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Jonathan Shenkman: And with that introduction, I'll now turn the program over to Elizabeth.

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Elizabeth Forspan: Jonathan, thank you so much.

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Elizabeth Forspan: It's an honor, as always, to be here today. Today, we're going to be doing a little bit longer than we normally do, which is great. We're all going to get our CLE, or CPE, or whatever that credit is that Jonathan has been giving out, which is phenomenal.

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Elizabeth Forspan: And, so we have almost an hour, and then I turn into a pumpkin, so I'll stop. It's great to be here with you all. I see on the, attendees

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Elizabeth Forspan: A lot of my friends… oh, that was just to pump up the numbers, I'm sure they logged in. A lot of my clients, so hi to everybody. I'm not gonna call you all out by name, but it's, it's great to see that you're all here. All right, folks, so…

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Elizabeth Forspan: I'm… I'm… I am so inspired by Jonathan.

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Elizabeth Forspan: Who is an author of a children's book, And…

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Elizabeth Forspan: I've been thinking maybe I should write a children's book about estate planning, but it's kind of, like, a little morbid and freaky, but that's actually what we're going to talk about today. Not writing a children's book, but…

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Elizabeth Forspan: overcoming those hurdles, right? That's, that's a big thing. We have people who come in, or people who don't come in, and why don't they come in? Why don't people come into a trust and estates attorney's office? Why do they push it off? Well.

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Elizabeth Forspan: I'm not going to give it away, because then I would have nothing to talk about for the next hour, but we're going to talk about that, and we're going to talk about how we as professionals, can help our clients

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Elizabeth Forspan: overcome those hurdles, and I will give you a little bit of a Medicaid update. There are some actual major changes taking place in New York that most people don't know about yet, so it's kind of hot off the presses, so if we get to it, and we will, I'll go over them. All right, so let's… let's jump into it.

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Elizabeth Forspan: First, I have to make sure I am able to get my slides to work. There we go, here we go. Okay, so I always, like to start with this slide, so we know what we're talking about here.

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Elizabeth Forspan: Right, so when we do estate planning, there are 5 documents that everybody should have. That's a power of attorney, healthcare proxy, living will, a will, and for most people, a trust. Not everybody needs a trust, but more and more, I am recommending trusts.

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Elizabeth Forspan: to my clients, not just irrevocable trust, but also revocable trusts, and I will explain why. So, just very briefly, just as a recap, power of attorney.

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Elizabeth Forspan: what I like to call the single most important planning document, and I do mean that for almost all of us. The power of attorney is where we appoint someone to make financial and legal decisions for us, right? Why do we need this? God forbid if we become incapacitated.

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Elizabeth Forspan: And we cannot make decisions, legal, financial decisions, for ourselves. We want to make sure that there is someone who can step into our shoes and make any decision that we would have made. ANY decision. What do I mean by that?

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Elizabeth Forspan: I mean, not just going to the bank, not just writing checks, although… and paying bills, that's very important, but I also mean…

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Elizabeth Forspan: I also mean making sure that your agent under the power of attorney has the ability to change your beneficiary designations. I know that's scary.

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Elizabeth Forspan: Open up new accounts for you.

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Elizabeth Forspan: Purchase different products for you.

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Elizabeth Forspan: Invest your assets. Make gifts and transfers of your assets. That sounds crazy. Why would we want to empower somebody else to do that? Well, let's say, God forbid, you're incapacitated, and we need to do some Medicaid planning, or try to get our loved one onto Medicaid. Well, how do we do that if we don't

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Elizabeth Forspan: quote-unquote, get rid of the assets, right? We have to be able to take the assets and divest ourselves of those assets. Well, if we're incapacitated and we have nobody

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Elizabeth Forspan: appointed to make those decisions, and with that power, with that authority, then we might not be able to apply for Medicaid unless our loved ones petition the court to be appointed as our legal guardian, which nobody wants. I've done,

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Elizabeth Forspan: many, many, many guardianships in court, and they are very unpleasant, to say the least. So, not only do we want our… do we want all of our clients and ourselves and our family members to have

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Elizabeth Forspan: a power of attorney. We want them to have a great power of attorney, with the ability to create trust, amend trust, revoke trust, exercise powers of appointment, purchase life estates, enter into real estate transactions, make gifts.

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Elizabeth Forspan: change our beneficiaries, TOD, etc. That's the type of power of attorney that we want. Healthcare practice, we all know what that is.

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Elizabeth Forspan: We want people… we want someone in place to make healthcare decisions for us if we become incapacitated. The healthcare proxy would only come into effect upon the incapacity.

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Elizabeth Forspan: Living will, some people want it, some people don't want it. That's where some people say that if, God forbid, you're in a persistent vegetative state, that you would not want to be kept alive, or maybe you do want to be kept alive forever in a vegetative state. Most people don't. I won't share with you my own, my own wishes, but I think you will

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Elizabeth Forspan: pretty much picked that up. And then, of course, the will, right? Everybody needs a will.

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Elizabeth Forspan: The will is very important. It is not only where we say what we want to happen to our stuff when we die, it is also where we say that if, God forbid, we die and we have minor children, who we would want to be the custodial guardians of those children, who we would want to manage the money. You know, many of us have significant life insurance policies, or maybe leaving significant assets to children, you can't leave assets

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Elizabeth Forspan: to a minor, so you need to appoint a trustee to manage money for the minor. Now.

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Elizabeth Forspan: The will is also incredibly, incredibly important if we have a beneficiary, a child, a grandchild, who has a disability, right? If we have a

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Elizabeth Forspan: a grandchild or a child with a disability, and we're leaving something to them in our will. We want to make sure that whatever we leave to them is in what? A supplemental needs trust. When you do a supplemental needs trust in your will, that is a third-party supplemental needs trust. It is not the type of supplemental needs trust that Medicaid will be able to attach, or that the Social Security Administration will be able to attach, but it's very important.

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Elizabeth Forspan: Because if we leave assets to an individual who is disabled, who's on government benefits, if we leave it to them directly, that could create a huge problem for them, because if they are in receipt of a means-tested government program, like, for example.

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Elizabeth Forspan: Medicaid or SSI, then by receiving an inheritance, it could make them ineligible for that. So we want to make sure that we have a supplemental needs trust in all of our wills.

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Elizabeth Forspan: Why all of our wills? Meaning, even if you do not have a family member who has a disability, who is not on government benefits, why would you want to have a supplemental needs trust in your will?

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Elizabeth Forspan: Because we don't know

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Elizabeth Forspan: who might have a disability or need government benefits when we die, right? It could be, God forbid, our spouse, who we're leaving everything to, let's say, might

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Elizabeth Forspan: have dementia, God forbid, or might be disabled in some way, that they're receiving SSI or Medicaid, and we want to make sure that if we leave anything to our spouse, that our will says that if someone who is a beneficiary here under

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Elizabeth Forspan: a beneficiary of our estate is disabled, has a chronic and persistent disability, that their… that whatever asset we leave to them, their inheritance is protected in this bubble of the Supplemental Needs Trust. So…

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Elizabeth Forspan: Every will.

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Elizabeth Forspan: Every single will that your clients, every one of your clients.

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Elizabeth Forspan: should have a supplemental needs trust in their will. It's super important. And folks.

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Elizabeth Forspan: Every single trust that we do.

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Elizabeth Forspan: Every single one of your clients who has a trust should have a supplemental needs trust in the trust.

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Elizabeth Forspan: I know it sounds crazy, but it's true, and we've used it, and we've seen it so many times. We hope that it won't happen to us, and it won't happen to our clients, but it's true, and we need to make sure that we have that. Now, there are various types of trusts. Do all of our clients need trusts?

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Elizabeth Forspan: In the olden days, like last year, I used to say, you know, not everybody needs a trust, but now I have to tell you, I am doing so much trust administration, excuse me, estate administration, right? What does that mean? Someone dies, and we are administering their estate, whether it's an administration proceeding or in a probate proceeding.

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Elizabeth Forspan: Right? A probate proceeding is when someone dies with a will. An administration proceeding is where someone dies without a will.

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Elizabeth Forspan: I'm doing a lot of this now.

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Elizabeth Forspan: And what I am seeing is that the probates are not only taking a long time.

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Elizabeth Forspan: But what we have to understand is that if we create a testamentary trust, if we create a trust

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Elizabeth Forspan: In… Our will, right?

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Elizabeth Forspan: I leave everything to my 5 children, let's say, I don't have 5 children, I leave everything to my 5 children, but it stays in continuing trust for them.

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Elizabeth Forspan: Why do we leave everything in continuing trust for our children? So that their inheritance will be protected for predators, it'll be protected in case of divorce, in case of a predeceased child, so we create a continuing trust for our children, which I recommend. I absolutely recommend. Why not?

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Elizabeth Forspan: Well, if you do that in your will.

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Elizabeth Forspan: Then you… your will will have to be probated.

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Elizabeth Forspan: And in the state of New York, okay, which is where most of us are, and in many other states.

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Elizabeth Forspan: Not only will the will have to be probated, but what we're going to have to do is get what's called letters of trusteeship for all the trusts that are created in our will.

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Elizabeth Forspan: Great!

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Elizabeth Forspan: Letters of trusteeship, just like letters testamentary, say, okay, the trustee who you name in your will is now empowered to be the trustee of your testamentary trust, the trust that's in your will.

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Elizabeth Forspan: What's the problem, particularly here in New York? I've experienced this in my own family.

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Elizabeth Forspan: Every 6 months, letters of trusteeship go stale.

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Elizabeth Forspan: And you need to go to the court, well, not necessarily physically, but you need to go to the court, and you need to get updated letters of trusteeship.

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Elizabeth Forspan: So if you die, And in your will, you create a trust for your children.

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Elizabeth Forspan: Right? Ongoing, continuing trusts that will exist until your children die.

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Elizabeth Forspan: Every 6 months

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Elizabeth Forspan: their trustee, who might be them, right? We can have them be their own trustee in certain circumstances.

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Elizabeth Forspan: Every 6 months!

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Elizabeth Forspan: For the rest of time, they will have to go back and get updated letters of trusteeship, like I have to do for my grandmother. My grandmother died in 2009,

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Elizabeth Forspan: You should rest in peace.

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Elizabeth Forspan: But she did!

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Elizabeth Forspan: Or what her attorneys did, where they created a testamentary trust, a trust within her will.

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Elizabeth Forspan: My father and my aunt, trustees, the trusts, And guess what, folks?

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Elizabeth Forspan: I have to go to the court every 6 months and get my dad and my aunt updated letters of trusteeship. So, we don't want to do that.

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Elizabeth Forspan: So, why are we talking about this? Because nowadays, we can avoid it. How do we avoid it? We create a intervivos trust, a lifetime trust.

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Elizabeth Forspan: Instead of doing a will, although we always need to have a will as a backup, and I'll talk about that, we do a trust! A revocable trust!

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Elizabeth Forspan: And the revocable trust, whatever's in the revocable trust, will never need to be probated. This is very important, folks, right?

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Elizabeth Forspan: I've been asked to speak a lot now on trust administration, estate administration, and probate, because people don't… people are doing the planning, but they're not thinking about what happens at the end of the day. What happens when the person actually dies?

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Elizabeth Forspan: If you have a trust.

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Elizabeth Forspan: Whatever's in the trust does not have to be probated. And so, when the person dies, nothing has to go through the court?

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Elizabeth Forspan: Forever and ever and ever with the continuing trust that you do for your children in your InterVivos trust, the lifetime trust that you do.

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Elizabeth Forspan: Never have to go to the court to request permission or letters of trusteeship.

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Elizabeth Forspan: So folks, more and more often, even for those of our clients who are not doing advanced or sophisticated planning, or Medicaid planning, or estate tax planning, who are not doing slats and irrevocable trust.

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Elizabeth Forspan: Even for those folks, more and more, we are doing revocable trusts.

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Elizabeth Forspan: I love them now. I used to not, but now I do. All right, folks.

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Elizabeth Forspan: Moving on.

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Elizabeth Forspan: Estate planning stumbling blocks. This is what we're here today to discuss.

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Elizabeth Forspan: I gotta tell you, I don't know what the numbers are.

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Elizabeth Forspan: But a huge percentage of us do not engage in an estate plan. I know this because more and more often, people are coming to me.

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Elizabeth Forspan: And asking me.

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Elizabeth Forspan: To help with the administration.

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Elizabeth Forspan: Of somebody, a loved one's estate.

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Elizabeth Forspan: And I say administration because the person dies without a will.

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Elizabeth Forspan: Right?

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Elizabeth Forspan: They die without a will, they die without having ever done any estate planning. And why is that?

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Elizabeth Forspan: It's so easy.

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Elizabeth Forspan: It's inexpensive. It's obvious.

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Elizabeth Forspan: Why are people not engaging in estate planning?

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Elizabeth Forspan: Well… We know the answer.

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Elizabeth Forspan: Right? We could put it into ChatGPT, or AI, and find out why.

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Elizabeth Forspan: First of all, people are scared of talking about death.

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Elizabeth Forspan: Nobody wants to talk about death.

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Elizabeth Forspan: nobody wants to die. I mean, there are some people who want to die, but they're, you know, they have other issues.

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Elizabeth Forspan: Most people do not want to talk about death. They don't want to think about it.

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Elizabeth Forspan: So, they avoid Planning.

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Elizabeth Forspan: Because obviously, when you do planning, you gotta think about what happens when you die.

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Elizabeth Forspan: A big issue that I see

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Elizabeth Forspan: Is that people don't want to discuss their family dynamics.

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Elizabeth Forspan: Every family has issues, okay? Every single family. We all know this, whether we admit it or not, we all think that it's our family who puts the fun back into dysfunctional. We think it's our family that's dysfunctional. Well, guess what? Everybody's family is dysfunctional.

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Elizabeth Forspan: People don't want to talk about the dynamics, the family dynamics.

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Elizabeth Forspan: They don't want to talk about the fact that they might have a child who is disabled. They don't want to talk about the fact that they might have a child who has a substance abuse problem. So…

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Elizabeth Forspan: Obviously, if you do your estate planning.

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Elizabeth Forspan: you need to talk about this, although some people, even when they're sitting in the chair, when they're sitting at the conference room table with us, they don't… they… they… you could tell that they're avoiding talking about something. And what our job, as those of us who are estate planning attorneys, our job is to push. Even if it means that we might lose that client, our job is to push. If we see something.

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Elizabeth Forspan: If we get the sense that there's something there, we have to push to find out what it is.

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Elizabeth Forspan: Another big reason?

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Elizabeth Forspan: Unequal inheritances.

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Elizabeth Forspan: There are going to be circumstances. There are going to be certain circumstances where people will need to leave unequal inheritances to the children.

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Elizabeth Forspan: But they don't want to talk about it, and they don't want to make that decision.

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Elizabeth Forspan: So they avoid doing the planning altogether.

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Elizabeth Forspan: Cost.

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Elizabeth Forspan: Right?

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Elizabeth Forspan: People think… Going to a lawyer!

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Elizabeth Forspan: Doing the will, doing the trusts!

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Elizabeth Forspan: doing a deed, transferring your house into the trust, etc, etc, is gonna cost a lot of money. And it will. It'll cost something. There's no… I'm not… I'm not… I'm not downplaying it. It costs money, right? You gotta pay the lawyer, we gotta pay the county clerk to file the deed, there's going to be a cost. So…

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Elizabeth Forspan: A lot of people say, you know what, I'm just not doing it.

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Elizabeth Forspan: Lack of knowledge.

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Elizabeth Forspan: Okay?

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Elizabeth Forspan: Lack of knowledge.

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Elizabeth Forspan: People, you would be so surprised, they do not know what happens to our estates and to our assets when we die. The biggest thing is, my spouse gets everything, so what do I have to do anything for, right? My spouse will decide, my spouse gets everything, my wife, you know, okay.

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Elizabeth Forspan: Obviously, that's not true. And then the other issue that I see is just plain old procrastination, and we are all guilty of this.

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Elizabeth Forspan: Now, on the elder care planning side, There are some additional

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Elizabeth Forspan: stumbling blocks, right? There are additional hurdles that we have to overcome.

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Elizabeth Forspan: First of all, The fear of incapacity.

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Elizabeth Forspan: Fear of dementia, the idea of it, Alzheimer's, or other forms of dementia.

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Elizabeth Forspan: By definition, when you engage in elder care planning, and it's easy for, you know, Jonathan and I, we're in our 40s, oh, Jonathan, I don't even know if he's turned 40 yet, you know, it's easy for us to talk about this stuff, right?

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Elizabeth Forspan: It's like, that's so far away, right? We could talk about it.

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Elizabeth Forspan: For most of our clients, It's not that far away, right?

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Elizabeth Forspan: the idea!

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Elizabeth Forspan: That we might need help.

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Elizabeth Forspan: with their activities of daily living, that is not that far away, and it's scary, okay? It is a scary, scary prospect.

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Elizabeth Forspan: to think… That we might need help. We might need some elder care.

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Elizabeth Forspan: Help at some point.

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Elizabeth Forspan: I mean, I spoke to a woman yesterday.

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Elizabeth Forspan: And she said to me, she's like, oh, I'm never going into a nursing home. I said, okay, Linda, I know you're never going into a nursing home, but what if you do? She said, my children know, Elizabeth, I'm never going in. I said, okay, Linda, okay, what happens?

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Elizabeth Forspan: If, God forbid, you have a stroke.

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Elizabeth Forspan: And you're hospitalized for the stroke, and you lose your ability to walk, or you lose your ability to, you know, on half the side of your body, or let's say you fall, and you're hospitalized.

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Elizabeth Forspan: And you're in the hospital, and you forget how to walk, and then you have to go to rehab, and then you have dementia. I said, what happens then? Are your kids gonna come into the nursing home and take you home even though you can't go home?

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Elizabeth Forspan: She said, these are real things, but she didn't want to talk about it, right? She didn't want to face that reality that this is something that happens to so many of us.

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Elizabeth Forspan: So, people have a real fear.

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Elizabeth Forspan: of talking about incapacity. A real fear, a real fear of talking about aging.

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Elizabeth Forspan: Again, family dynamics, but now a little bit differently.

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Elizabeth Forspan: which one of my children is going to take care of me? You know, I think about this all the time, because I only have boys, right? And, you know, I made the mistake of not having girls, so are my kids, are my boys going to be able to take care of me, right? It's a real thing. You have to have a girl to take care of you. I hope I, with God's help, I get good daughters-in-law. My kids are very, very little, but of course, you know, I'm an elder law attorney, so I think about these things.

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Elizabeth Forspan: Which of my children will take care of me?

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Elizabeth Forspan: Will my children have my best interests at heart?

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Elizabeth Forspan: Who am I going to be able to trust?

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Elizabeth Forspan: Folks, People don't want to think about this. They want to put their heads in the sand.

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Elizabeth Forspan: I pretend like everything is great.

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Elizabeth Forspan: Right? That's it.

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Elizabeth Forspan: Cost. Another stumbling block. Cost.

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Elizabeth Forspan: Okay.

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Elizabeth Forspan: People don't get long-term care insurance. This is an unbelievable thing.

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Elizabeth Forspan: I can't understand this.

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Elizabeth Forspan: have had long-term care insurance since I am 34 years old.

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Elizabeth Forspan: You might say I'm crazy, And I am.

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Elizabeth Forspan: But not for this.

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Elizabeth Forspan: Long-term care insurance is so important

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Elizabeth Forspan: And so beneficial. And I know you might think that that's weird to hear from an elder law attorney whose job it is to help people who don't have long-term care insurance, or who don't have enough long-term care insurance, but the reality is, is I see this at the end of the day. I see this when mom and dad are going into the facility, or when mom and dad need help at home.

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Elizabeth Forspan: The long-term care insurance is key.

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Elizabeth Forspan: So many people who can qualify for it do not get it. Now, nowadays.

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Elizabeth Forspan: people are not getting those old policies, the use-it-or-lose-it policies, which are amazing, you know, those Genworth, or there's John Hancock, or nationwide policies, where it was, like, $600 a day, or $700 a day, no maximum. When I see that, it warms my heart. Most clients don't have that.

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Elizabeth Forspan: And many clients who I talk to, who are in their 50s, or early 60s, who are in good health, they say, no, I'm not getting it, it's too expensive. That's a mistake. Because nowadays, you can get a life insurance policy. This is what I have, this is what I got for my dad. You can get a life insurance policy with a long-term care rider that's built in.

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Elizabeth Forspan: And you could use the long-term care component. If you don't lose it, there might be a life insurance component left over for your children and for your family. Why not just look into it? Okay?

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Elizabeth Forspan: You'll be surprised. It's not as expensive as you think, and trust me.

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Elizabeth Forspan: the cost of not getting it is far greater than the cost of getting it in so many circumstances. I know I sound like an insurance salesperson.

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Elizabeth Forspan: I have sent many people to Jonathan, who has helped… he's helped so many of my clients with not just their, their planning, their, their, their, asset planning, and their financial planning, but also with this, because this is a huge component! This is a huge component of

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Elizabeth Forspan: asset protection planning and financial planning, right? Because if you don't do the insurance, or if you don't do the Medicaid planning, which we're going to talk about in a second.

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Elizabeth Forspan: you're going to draw down so significantly on your savings to pay for care, right? We'll talk about that in an upcoming slide. Medicaid planning.

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Elizabeth Forspan: Oh my gosh!

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Elizabeth Forspan: People say, I'm not gonna go to a lawyer, I'm not gonna do my Medicaid planning, because it's gonna cost me $4,000 or $5,000 to do a trust.

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Elizabeth Forspan: We'll see in an upcoming slide the cost of not doing the Medicaid planning, right? Medicaid planning is for those

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Elizabeth Forspan: who already have long-term care insurance, or excuse me, who don't have long-term care insurance, or who have long-term care insurance, but it's insufficient. Which, unfortunately, folks, we see a lot, people come in and they say, we don't need to do the planning, we have a long-term care insurance policy.

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Elizabeth Forspan: Yesterday, my friend Linda said the same thing to me. She said, Liz, I don't have to do it. I have long-term care insurance. I said, okay, your long-term care insurance pays $600 a day if you're in a nursing home? And she said, no. I said, what does it pay, Linda? $200 a day? She said, yeah, it's like $225, I don't even have the long-term… the, inflation rider.

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Elizabeth Forspan: So, Linda, a nursing home costs $600 a day, what are you talking about over here? Right? She was 80 years old, and she can't get the… she can't get additional insurance at this point, and she thought that she was okay, because she had the long-term care insurance. Well, guess what? She's not okay, because she has long-term care insurance that's going to cost a third of what the cost of care is.

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Elizabeth Forspan: Okay.

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Elizabeth Forspan: Lack of knowledge, just like with estate planning.

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Elizabeth Forspan: So many people are unaware of programs that are available. They're unaware of Medicaid. They're unaware of the long-term care insurance. They're unaware of the

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Elizabeth Forspan: Veterans! Veterans benefits! So many of our clients are veterans, and they get veterans… they could qualify for veterans benefits, and they just don't do it. And then…

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Elizabeth Forspan: Procrastination, right? What do I always tell people? When is the best time to do… best time to do Medicaid planning or elder care planning, right?

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Elizabeth Forspan: Well, unless there's, like, some, you know, health consideration, the ideal time to do it is in the mid to late 60s.

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Elizabeth Forspan: Right? Why do we say mid to late 60s? Because we have the 5-year look-back, which we'll talk about. Well…

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Elizabeth Forspan: Statistically, if you're in your mid to late 60s, you'll have the 5 years, you'll be okay, you'll be healthy for 5 years, so you can do the planning, and then let the 5 years go, and your assets will be protected. Well, folks, how many people that are in their mid to late 60s actually come in to do the planning?

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Elizabeth Forspan: Not that many. Most of the time, it's people in their late 70s, early 80s, late 80s, early 90s, mid 90s, late 90s, you'd be very surprised.

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Elizabeth Forspan: I had a woman come in just recently, God bless her, and she's great, 99 years old, the husband's 98, it's amazing, they came in, nobody had a walker, nobody had a cane, they drove here themselves.

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Elizabeth Forspan: very unusual, but she said, okay, I'm ready for my Medicaid planning.

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Elizabeth Forspan: And it was great, and we took care of her, we helped her, and it was… it was wonderful. Procrastination, folks. A lot of procrastination. Jonathan, you want to give a coat?

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Jonathan Shenkman: Yes, thank you, perfect timing. I just want to interject here briefly before we continue. For accountants and attorneys who are taking this program for credit, please write this down. The code is G41, again, G as in gold.

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Jonathan Shenkman: The number 4 and the number 1, one final time, G41. Back to you.

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Elizabeth Forspan: Did you do G41 because I'm 41?

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Jonathan Shenkman: Yeah, that's exactly… I try to coordinate with the credit people.

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Elizabeth Forspan: Yes, yes, very good, very good. Okay, thank you, Jonathan.

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Elizabeth Forspan: We'll move on. Maybe by the time people listen to this, I'll be 42. Although we have a few months to go, a few months to go. Okay, procrastination we talked about. Now…

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Elizabeth Forspan: Brass tacks, let's talk about brass tacks, people. How do we overcome these obstacles?

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Elizabeth Forspan: Well… We could do it bluntly, could talk about it bluntly with our clients, or we could do it

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Elizabeth Forspan: nicely.

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Elizabeth Forspan: And gently…

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Elizabeth Forspan: For me, it depends on the mood that I'm in. I'm just joking. Normally, I think one of the things that I'm known for is that I can do this in a kind and sweet and gentle way with our clients, and I advise all of you who are dealing with this with your clients to do the same.

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Elizabeth Forspan: Folks, Everybody's gonna die, right? We're all gonna die, hopefully we live a long time.

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Elizabeth Forspan: But we're all gonna die.

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Elizabeth Forspan: And we need our clients… our clients know that, we just have to help them remember that.

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Elizabeth Forspan: And we have to help them remember.

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Elizabeth Forspan: That dying without a plan

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Elizabeth Forspan: will mean that you're not deciding what happens when you die. Somebody else, or something else, right?

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Elizabeth Forspan: Maybe your kids, Maybe the state, somebody else, maybe the court?

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Elizabeth Forspan: Somebody else is going to decide what happens when you die, if you don't make these Plans now.

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Elizabeth Forspan: And that's not what anybody wants. There's nobody who wants the court to decide what happens to them if they become incapacitated, and there's nobody that wants the court to decide what will happen to their estate when they die, rather than deciding it themselves. If we really put them to it, if we really put the question to them.

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Elizabeth Forspan: Now, When it comes to people who have minor children.

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Elizabeth Forspan: You can't roll the dice, right?

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Elizabeth Forspan: You gotta have a will.

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Elizabeth Forspan: This is the most important thing for young people.

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Elizabeth Forspan: you know… And when I say young people, I mean people who have young children.

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Elizabeth Forspan: It's… it's astounding to me That people do not do their wills when they are expecting their first child.

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Elizabeth Forspan: That's when I did my will. When I was 27, 28 years old, I was expecting my first baby.

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Elizabeth Forspan: and…

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Elizabeth Forspan: That's when my husband and I did our wills, and I don't even think that… maybe, yeah, maybe I was already in the area of trust and estates at that point. I think I was. That's when we did our wills.

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Elizabeth Forspan: That's when we really bulked up our life insurance,

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Elizabeth Forspan: You gotta… you gotta do it, and your clients have to do it.

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Elizabeth Forspan: Because… If you don't… decides.

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Elizabeth Forspan: Who will be the guardian for your minor children if, God forbid, something happens to you and your spouse, or in the case of someone who doesn't have a spouse, if something happens to you.

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Elizabeth Forspan: You are saying, I want a judge.

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Elizabeth Forspan: who I've never met.

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Elizabeth Forspan: Who may not even be a judge right now, maybe just a regular, you know, idiot like… like me, right?

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Elizabeth Forspan: That person to decide who's going to raise my children if something happens to me.

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Elizabeth Forspan: It's crazy!

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Elizabeth Forspan: If we would all understand that, then… We would all have wills.

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Elizabeth Forspan: So I think that this is, like, something that we need to discuss, not only with our clients.

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Elizabeth Forspan: But with our own children, who may have children, right? I tell this to all my… most of my clients are elderly. I mean, I…

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Elizabeth Forspan: Quite a bit of younger, you know, clients in their 30s and 40s, but most of my clients have grandchildren.

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Elizabeth Forspan: And I say to them.

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Elizabeth Forspan: Have your kids done their planning, right? Have your kids decided who's going to be the guardian for their kids, right? It's so important, and it's astounding, astounding how many people have not done this. So…

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Elizabeth Forspan: That's just something I want to just

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Elizabeth Forspan: You know, put out there to everybody.

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Elizabeth Forspan: Folks!

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Elizabeth Forspan: We have to explain to our clients that estate planning is a lot more than just death, right? It's a lot more than who gets our stuff when we die.

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Elizabeth Forspan: Right? If we don't engage in our estate planning, might there be a large estate tax when we die?

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Elizabeth Forspan: people think.

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Elizabeth Forspan: there's not going to be an estate tax. You know, there's so much misinformation out there, right? People think, oh, I need to have $30 million in order for there to be an estate tax. Well, that's not true, because if you live in New York.

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Elizabeth Forspan: Right? If you live in New York.

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Elizabeth Forspan: The estate tax exemption currently, right, 2026, is $7.35 million. Once you hit 5% of that, your entire estate is taxed.

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Elizabeth Forspan: Right? And so…

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Elizabeth Forspan: What that means is that if you have some young clients, or some clients who have a life insurance policy and a house.

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Elizabeth Forspan: they might be… their estate might be subject to an estate tax, a New York estate tax.

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Elizabeth Forspan: So, estate planning is just so much more than just the will and what happens when we die. We have to explain that to our clients, we have to discuss incapacity, advanced directives, gifting, etc.

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Elizabeth Forspan: The fear of incapacity, dementia, talking about it, okay? It's real, we talked about this. It's very, very real, and we need to understand that about our clients.

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Elizabeth Forspan: we need to understand that we do this every day, right? We talk about dying and death every single day, but our clients don't.

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Elizabeth Forspan: And so we need to be very, very sensitive with them about this, okay?

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Elizabeth Forspan: We need to say, I understand how you feel. I understand how you feel.

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Elizabeth Forspan: You know, by the way, guys.

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Elizabeth Forspan: I never really understood how my clients felt until I sat down and did a new healthcare proxy.

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Elizabeth Forspan: I don't remember when this was, but when I had to sign my healthcare proxy, I… it was like, oh my god.

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Elizabeth Forspan: Might I become incapacitated at some point? Might there be somebody else who's going to be making health decisions and medical decisions for me? This is freaky!

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Elizabeth Forspan: So actually, maybe the best way To understand our clients, is to maybe…

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Elizabeth Forspan: revisit or renew our own planning. It's an interesting… it's an interesting idea that I just… I just thought about, but, you know, we need to sit down very gently with our clients and explain, look.

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Elizabeth Forspan: a lot of people… a lot of people land up with dementia. I mean, it's the reality, we see it in our own lives, we see it with our parents, our grandparents, with our friends, I mean, they're young people that

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Elizabeth Forspan: Have dementia. It's a terrible, terrible thing.

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Elizabeth Forspan: We don't want to talk about it, but we have to.

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Elizabeth Forspan: Because we… I always… I always talk about my mom, she should rest in peace, she always used to say, she had great sayings, I mean, really great sayings.

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Elizabeth Forspan: One of them was that we hoped for the best.

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Elizabeth Forspan: But we plan for the worst.

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Elizabeth Forspan: Just because we're doing this planning doesn't mean that we're not hopeful people.

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Elizabeth Forspan: optimistic people, and we should be. We should all live with hope and optimism. You know, it's actually a really good thing for us, emotionally and physically.

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Elizabeth Forspan: But we need to talk about the consequences of not doing the planning.

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Elizabeth Forspan: Because if we become incapacitated, we have to have our clients understand

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Elizabeth Forspan: That if we did not do an advance or advance directive, if we did not do a healthcare practice and a power of attorney, then what's going to happen is that somebody is going to have to petition for a court-appointed guardian to be appointed for you.

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Elizabeth Forspan: And the court will decide.

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Elizabeth Forspan: Your family members may fight. I have been engaged as an attorney in many contested Article 81 guardianships in the Supreme Court.

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Elizabeth Forspan: where… kids… Or other family members?

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Elizabeth Forspan: Or other stakeholders in the person's lives?

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Elizabeth Forspan: Are fighting to become The Guardian?

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Elizabeth Forspan: And it is incredibly expensive.

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Elizabeth Forspan: It tears families apart, and guess what? Guess whose money's gonna be used? Your money.

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Elizabeth Forspan: At the end of the day.

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Elizabeth Forspan: 99% of the time, the court is going to say that all the fees for all of this is going to come out of the pocket of the AIP, the alleged incapacitated person.

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Elizabeth Forspan: When you do… we have to… we have to tell our clients that when we make a plan for incapacity.

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Elizabeth Forspan: That is a… To them. That is a gift to their children.

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Elizabeth Forspan: We're taking the decision away from the children.

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Elizabeth Forspan: We're making the decision now.

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Elizabeth Forspan: We're parents… most of us are parents.

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Elizabeth Forspan: And we know, we want to do everything to protect our children. We'll do this, give them their… give them this gift.

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Elizabeth Forspan: Okay.

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Elizabeth Forspan: Family dynamics, People don't want to talk about this.

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Elizabeth Forspan: drug abuse.

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Elizabeth Forspan: Substance abuse, alcoholism, disability.

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Elizabeth Forspan: Almost every family that comes in, almost every couple has this in their lives, okay? Whether they say it at first or not, when we tease it out of them.

305

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Elizabeth Forspan: Mental health issues with the kids.

306

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Elizabeth Forspan: Alcoholism, unfortunately, it's there.

307

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Elizabeth Forspan: It's there.

308

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Elizabeth Forspan: Child may have a disability that's not obvious, right? Maybe it's a… Bipolar disorder.

309

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Elizabeth Forspan: Maybe it's an intellectual disability, and people don't want to talk about it. They're very nervous to talk about

310

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Elizabeth Forspan: Anything…

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Elizabeth Forspan: with anyone outside the family, and frankly, they don't even discuss it between spouses. It's just like, let's put our head in the sand, and let's make believe it doesn't exist.

312

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Elizabeth Forspan: It is a very, very difficult discussion to have with your clients. It's a difficult discussion for your clients to have, and we need to approach that with sensitivity.

313

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Elizabeth Forspan: But we need to address it head on.

314

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Elizabeth Forspan: And what we explained to the clients, and I… this really…

315

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Elizabeth Forspan: I find that this really helps

316

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Elizabeth Forspan: is that every family has issues. You are not alone. We all have issues.

317

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Elizabeth Forspan: And sometimes, I talked to them about the issues in my old family, and believe me, there are many.

318

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Elizabeth Forspan: Every family has issues.

319

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Elizabeth Forspan: You know, and this is why, folks.

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Elizabeth Forspan: AI is never going to be able to replace us. I mean, I hope I don't eat my words, but

321

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Elizabeth Forspan: AI will never, as advanced as AI is, and believe me, it is, oh my god, you can have conversations with Alexa and with Siri, it's incredible.

322

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Elizabeth Forspan: But they are never going to be able to… AI is never going to be able to do this planning with people with this type of sensitivity and tease out the issues.

323

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Elizabeth Forspan: I know a lot of estate planners and financial planners are worried about… are worried about AI, but frankly, I'm not. It's because of this.

324

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Elizabeth Forspan: We need to address, as I mentioned, with sensitivity.

325

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Elizabeth Forspan: And there are ways that, that we can, that we can, help our clients and say, look, I know you might have one kid who has these issues.

326

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Elizabeth Forspan: But we're gonna do a continuing trust for all of your children, right? When you die, every one of them is going to have a trust

327

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Elizabeth Forspan: for the inheritance. And that, you'd be surprised, that makes them feel a lot better that they're not singling out one of their children. Okay.

328

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Elizabeth Forspan: a big issue is unequal inheritances. You know, sometimes there is a real desire to leave an unequal inheritance, to our children, right? You may have one child who is a hedge fund manager and has more money than you could ever dream of.

329

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Elizabeth Forspan: And then another one of your children is a schoolteacher, right? And so you know inside.

330

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Elizabeth Forspan: That the school teacher is gonna need a lot more, or could benefit from, we shouldn't say need, could benefit from a lot more when you die.

331

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Elizabeth Forspan: And so you know it.

332

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Elizabeth Forspan: But you're scared.

333

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Elizabeth Forspan: Because when they go and they read the will, and folks, there's no real reading of the will, but when they read the will, they're gonna see that you left nothing to the hedge funds

334

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Elizabeth Forspan: Child, managing child.

335

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Elizabeth Forspan: And everything for the school teacher child.

336

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Elizabeth Forspan: And they're gonna… the kids are gonna think, like, well, did mom and dad, did they not love me? Right? Or did they not love me as much?

337

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Elizabeth Forspan: Because that's… that's oftentimes what… what's… what's gonna happen. And so…

338

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Elizabeth Forspan: I think that we need to discuss this with our clients.

339

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Elizabeth Forspan: And help them figure out how to do this.

340

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Elizabeth Forspan: If they want to do it, if they… listen, some clients, many clients, in fact, most, will say, I don't care. It's going to go equally to each one of the children.

341

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Elizabeth Forspan: But… We can help our clients figure out a way to do it.

342

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Elizabeth Forspan: where it's not so obvious. It's not in the reading of the will, right? Maybe they have a beneficiary designation to one child, and not to the other, and it's not obvious, it's not in their face.

343

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Elizabeth Forspan: maybe they put that child as a joint account holder with them on some of their accounts. Of course, we have to be very careful if it's a brokerage account not to lose the basis step-up, but like on the bank account, for example, when we're not worried about a basis step-up, maybe that's where we do it.

344

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Elizabeth Forspan: There are ways to do this, and we have to approach it with sensitivity with our clients. We need to get down to the bottom of what do you mean by unequal, right? What does unequal actually mean? Sometimes unequal… unequal is still equitable, so we need to… we need to do that.

345

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Elizabeth Forspan: So, you know, that's… that's an important discussion. Okay, cost, and then I'm gonna get into some more… a little bit more technical stuff that I think is very important for today.

346

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Elizabeth Forspan: When the clients are worried about cost.

347

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Elizabeth Forspan: We have to explain to them, and it's oftentimes not us, the estate planners, but it's the accountant, or the financial advisor, or somebody else in their lives, who has to explain

348

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Elizabeth Forspan: The cost of not engaging in the planning!

349

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Elizabeth Forspan: Will be far more costly than engaging in the planning.

350

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Elizabeth Forspan: If you fail to engage in your estate tax planning.

351

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Elizabeth Forspan: You may be leaving your kids or your, or your beneficiaries with a very large estate tax problem.

352

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Elizabeth Forspan: If you fail to engage in elder care planning, You may be?

353

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Elizabeth Forspan: Saddled with a huge, huge cost for long-term care, right?

354

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Elizabeth Forspan: A nursing home could cost $20,000 a month, and that's not a crazy number!

355

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Elizabeth Forspan: Whereas… You might spend $5,000 or $6,000 on a lawyer to do a trust and a deed.

356

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Elizabeth Forspan: To do your whole estate plan!

357

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Elizabeth Forspan: That's a quarter of what one month in a nursing home will cost.

358

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Elizabeth Forspan: Home care's gonna be $10,000, over $10,000, private pay?

359

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Elizabeth Forspan: If you need 24-7 care, $10,000 a month?

360

00:43:17.920 --> 00:43:20.000

Elizabeth Forspan: It's $120,000 a year!

361

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Elizabeth Forspan: If you would have just gone and done your plan, For $5,000 or $6,000!

362

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Elizabeth Forspan: Maybe you could have avoided all of that, right?

363

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Elizabeth Forspan: It's a tiny cost when you look at it in comparison to the cost of not doing the planning.

364

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Elizabeth Forspan: So, engaging in the planning, lifetime, intervivors planning.

365

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Elizabeth Forspan: Is going to save your heirs, or your children, a lot later on.

366

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Elizabeth Forspan: Clients need to understand that.

367

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Elizabeth Forspan: Lack of knowledge, right? I thought my wife gets everything. Guys, knowledge is power. CPA, financial advisor, they need to say, look, that's not how it goes, right? If you become incapacitated, your spouse is not going to be able to

368

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Elizabeth Forspan: manage your IRA. Your IRA is not a joint account.

369

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Elizabeth Forspan: You need a power of attorney. You need your spouse to be your power of attorney, or someone else to be your power of attorney. And you need to have a successor power of attorney, a successor agent, if something happens to your spouse, right?

370

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Elizabeth Forspan: Because an IRA is an individual retirement account, there was nobody else on it.

371

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Elizabeth Forspan: So there's no joint account holder who could transact.

372

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Elizabeth Forspan: You need to have the power of attorney.

373

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Elizabeth Forspan: If you die without a will, will your spouse get everything? Well, if you're in the state of New York, no. Your spouse will get the first $50,000, and then 50%, then your children will get the other 50%. Well, what if that 50% that's going to your spouse is not enough to provide for them?

374

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Elizabeth Forspan: problem. So, people need to understand that your spouse doesn't just get everything, that's not how the rules work, you need to plan for that.

375

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Elizabeth Forspan: And you need to ex… we need to explain to our clients that there are programs out there.

376

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Elizabeth Forspan: And we need to explain to our clients that one of the biggest misconceptions is that Medicare pays for long-term care. Medicare does not pay for long-term care. People think Medicare will pay for a nursing home, or will pay for home care. It does not. Medicare might pay for up to 100 days in a rehab after you're hospitalized for a minimum of 3 days, or maybe it won't.

377

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Elizabeth Forspan: Maybe it won't. It doesn't pay it every time, right? If they've determined that you've plateaued, or that you're not getting any better. Medicare does not pay for long-term care. Clients don't realize that. We have to explain it. Okay. Communication.

378

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Elizabeth Forspan: Be open.

379

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Elizabeth Forspan: Have a family meeting, maybe. Maybe some family's family meeting is not good. You, as the professional, have to understand that.

380

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Elizabeth Forspan: And help your clients work through that. Maybe leave a letter to your loved ones and say, look.

381

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Elizabeth Forspan: My wonderful son, you manage that hedge fund so beautifully, I'm so proud of you, I love you so much. And I love you as equally to all our other children, for you're a billionaire, so I'm not leaving you anything.

382

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Elizabeth Forspan: But I hope that you know that I loved you, okay? I'm simplifying it, but sometimes a letter to your loved ones that explains everything is a good thing, right? Some attorneys say, don't do it, it's going to lead to litigation, this, that, please, okay? As a professional, as an attorney, we'll take it…

383

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Elizabeth Forspan: Case by case of explaining it to our clients. Okay.

384

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Elizabeth Forspan: I am going to skip this slide, although it's extremely important.

385

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Elizabeth Forspan: I spoke about this, I think, last year, but we just have to understand that as we do our Medicaid planning, our elder care planning, there are a lot of tax considerations, and there are a lot of estate planning considerations. Sometimes they don't all go together beautifully, but we could make them go together beautifully, so we have to be very careful.

386

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Elizabeth Forspan: We know what the,

387

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Elizabeth Forspan: gift tax exemptions currently are. We also have to understand that just because the gift… annual gift tax exemption is $19,000 per donnee.

388

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Elizabeth Forspan: That doesn't mean that that's okay for Medicaid, because if you apply for Medicaid, they're going to look at all transfers you've made within the last 5 years, probably transfers of $2,000 and above.

389

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Elizabeth Forspan: What I want to talk about very briefly is give a little bit of a Medicaid update.

390

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Elizabeth Forspan: Now.

391

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Elizabeth Forspan: This has the new numbers, okay? And we can all see what the numbers are, how much money you can have in order to apply the

392

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Elizabeth Forspan: For… for Medicaid.

393

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Elizabeth Forspan: $32,000 for an individual, $43,000 if both members of the couple are applying for Medicaid. If you have anything in excess of that, you're not going to be eligible for Medicaid, with an exception, with a couple of exceptions. Sometimes your home will not be counted if you're living in it, and the net equity value of your home is under a million dollars.

394

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Elizabeth Forspan: This is New York, folks.

395

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Elizabeth Forspan: and a retirement account. Now, folks, this is a very big change, and a very big thing I want to talk about. It's pretty much hot off the presses. It just… just came out at the end of December, but everybody was busy with the holidays, and the new year, and kind of went over a lot of people's heads.

396

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Elizabeth Forspan: We have some phenomenal news in New York, and I really don't know how this is gonna play out.

397

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Elizabeth Forspan: In New York, You can have a million dollars

398

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Elizabeth Forspan: in a retirement account, in an IRA, and still be eligible for Medicaid.

399

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Elizabeth Forspan: This is crazy.

400

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Elizabeth Forspan: It used to be, until a few weeks ago.

401

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Elizabeth Forspan: That as… actually, let me… let me say this again.

402

00:48:25.080 --> 00:48:27.889

Elizabeth Forspan: Because this is new. I'm processing myself.

403

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Elizabeth Forspan: If you have a retirement account.

404

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Elizabeth Forspan: It's exempt, as long as it's in payout status.

405

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Elizabeth Forspan: Now, payout status, what does that mean?

406

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Elizabeth Forspan: Well, it used to mean that in New York City, in the five boroughs.

407

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Elizabeth Forspan: you were getting your minimum required distributions. If you got your minimum required distributions, the IRA was an exempt asset. Medicaid did not count it towards that $32,000 or $43,000 number. Okay.

408

00:48:58.200 --> 00:49:08.420

Elizabeth Forspan: In Nassau, Suffolk, Westchester, every other county, Medicaid had their own life expectancy tables, and in fact, you had to take out a lot more

409

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Elizabeth Forspan: a lot more than the RMDs in order for the asset to be considered exempt and not countable.

410

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Elizabeth Forspan: Well, folks, At the end of December.

411

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Elizabeth Forspan: New York State issued a GIS, G-I-S, a General Information System, that said

412

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Elizabeth Forspan: As long as it's in periodic payout status.

413

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Elizabeth Forspan: The IRA is exempt and not countable.

414

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Elizabeth Forspan: But it did not have to be in maximum payout status. It does not have to be in maximum payout status.

415

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Elizabeth Forspan: So the way I am reading this now.

416

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Elizabeth Forspan: is, let's say you're under 73, and you need Medicaid.

417

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Elizabeth Forspan: Well, you don't have to do the MRDs.

418

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Elizabeth Forspan: Because you're under 73. The IRS only says you only got to take it when you're 73. Let's say you're 69.

419

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Elizabeth Forspan: What if you put your IRA in payout status where you get $1 a month from your IRA?

420

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Elizabeth Forspan: Does that mean that the entire IRA is not countable?

421

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Elizabeth Forspan: I am sure that Medicaid will come out with more guidance on this, but the way that I read it now, right, in early 26, early 2026,

422

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Elizabeth Forspan: Is that as long as it's in some sort of a payout status, That maximum payout status.

423

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Elizabeth Forspan: the IRA will be exempt. This is tremendous news, because what that means is that people will have to pull out so little from their IRAs, which means that they're going to have a lot in it to leave over. So they're going to be able to be on Medicaid.

424

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Elizabeth Forspan: They'll be on Medicaid, they'll be eligible for Medicaid, but only be taking out their minimum required distributions, right? Most of our… let me say it like this.

425

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Elizabeth Forspan: Most of our clients who are receiving Medicaid are above the age of 73, right? That's… unless there's some major health issue or early onset dementia, they're going to be over 73. So they will, under the IRS rules.

426

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Elizabeth Forspan: need to take out their minimum required distributions, but they will not have to take out this huge amount they previously had to take out every month in order to be eligible from a Medicaid perspective. So this is huge news.

427

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Elizabeth Forspan: there is nothing on the 30-month look-back yet. Yet, yet, yet. Right? We know that there is a 5-month… excuse me, I wish it were 5 months. There is a 5-year look-back for nursing home care, so…

428

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Elizabeth Forspan: We gotta transfer our assets to a trust, not our retirement assets, transfer our countable assets, our house, potentially our brokerage account, money in the bank, not everything, put it in a trust, wait 5 years, then we're eligible for nursing home Medicaid.

429

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Elizabeth Forspan: But there's no look back for home care in New York, which is incredible, because basically you could transfer your assets to a Medicaid trust.

430

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Elizabeth Forspan: or a trust, on January 30th, and then by February 1st.

431

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Elizabeth Forspan: Or even January 31st, even. And then by… on February 1st, you're financially eligible for Medicaid from a home care perspective.

432

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Elizabeth Forspan: It's an amazing thing. There's supposed to be a 30-year… a 30-month look back for home care that they have now pushed off. It's going on almost 6 years now, the implementation, so we have to always keep a very close eye on that, because that will be coming soon, and what that means is that for our clients, like Linda, who I mentioned earlier, who will never go into a nursing home, right? She says she's never going into a nursing home.

433

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Elizabeth Forspan: None of us want to, but for home care, our clients still need to be engaging in this plan, because we can't… at some point, we're not going to be able to do it at the last minute.

434

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Elizabeth Forspan: Okay? And this is the regional rates in New York.

435

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Elizabeth Forspan: which I'm not going to get into, because it's a complex discussion, but this is how we calculate the penalty period, for the 5-year look back. I want us to always, always, always, always, when we do the Medicaid planning.

436

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Elizabeth Forspan: When our clients do the Medicaid planning, we have to be very cognizant of the tax issues, right? Are we giving away money? Are we giving away assets? If we're giving away assets, are we doing it directly to our children? No. First of all, it's stupid to do that, but second of all, we don't want to give them a carryover basis, we want to make sure

437

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Elizabeth Forspan: that there's a basis step up when we die. How do we achieve that? We put it in a trust that has a state inclusion. A trust where it will be a completed gift from a Medicaid perspective, but an incomplete gift from a

438

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Elizabeth Forspan: a tax perspective, we want to make sure that we're going to get the basis step up, okay? Maybe the trust says that the grantor is entitled to income.

439

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Elizabeth Forspan: I don't like that, in most cases.

440

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Elizabeth Forspan: In most cases, how we're going to get around this is we're going to have the grantor retain what's called a limited power of appointment, the ability to change the beneficiaries of the trust. That will bring it back into the estate

441

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Elizabeth Forspan: For tax purposes, so whatever we put into that trust is not going to have… is not going to be a completed gift, we will be able to get the basis step up when we die. Very important, particularly for our homes.

442

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Elizabeth Forspan: Which have, of course, a very… in most cases, most of our clients' homes have a very low basis.

443

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Elizabeth Forspan: Okay, and folks, that is all I am going to talk about today, although there are a lot more slides here. Some of you have seen many of these slides before, the requirements of Medicaid trusts, and how we have to be careful about it.

444

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Elizabeth Forspan: what we could put into a Medicaid trust, what we shouldn't, how we maintain our $250,000 exemption, even if our house is in a Medicaid trust, right, from the sale of the principal residence. If you transfer your house into a Medicaid trust.

445

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Elizabeth Forspan: And then you decide to sell it.

446

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Elizabeth Forspan: will you still be entitled to the $250,000 or $500,000 exemption from capital gain under Section 121A of the Internal Revenue Code? The answer is, if you do it properly, if you draft that trust properly.

447

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Elizabeth Forspan: and you live in the home, then yes, you will be able to. And all the different types of liquid, non-liquid assets, we would transfer, potentially, a non-qualified annuity. Can it be transferred into an irrevocable trust? Yes. Gotta be careful.

448

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Elizabeth Forspan: And we need to understand the rules on non-qualified annuities, because folks.

449

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Elizabeth Forspan: Even though we might not think that's the best investment, so many of our clients have them when they come in and talk to us. Okay, folks! Well, Jonathan and everybody, it's been a pleasure, it's been an honor, as always. I hope I didn't put too many people to sleep today. And of course, my email address is on this last slide.

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Elizabeth Forspan: And my phone number. Best way to reach me is, of course, email. For those of you who have Brandy, my assistant's email address, please CC her, because that's the best way to get through to me.

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Elizabeth Forspan: I'm kind of old school, she prints out my emails, we go over them at the end of the day, but I'm gonna try to respond to as many questions that come in via email. So thank you, thank you so much.

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Elizabeth Forspan: Jonathan, turning it back over.

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Jonathan Shenkman: Great, thank you so much, Elizabeth. If anyone has any specific questions, new business opportunities, or any other issues they'd like to discuss, please feel free to reach out directly to Elizabeth or myself where appropriate, and I'll be sure to include her contact information in the follow-up email to this program as well. Four more quick items before I let you go. First and most important, later today, you'll receive an email.

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Jonathan Shenkman: from me with an evaluation form for the program. I'll ask you to input the code that I mentioned here today in order to receive your credit.

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Jonathan Shenkman: After that is submitted, in the coming days, you'll receive an email from ACE Seminars with your certificate. Again.

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Jonathan Shenkman: Please keep an eye out for an email from Ace Seminars. If you don't see that email in the next few days, be sure to check your spam folder. Again, the email with your certificate will not be from me, it will be from Ace Seminars. Second, my next webinar is on Thursday, February 12th, on Escape from New York, Tax and Estate Planning Considerations for Moving to Florida or Israel, featuring Lawrence Garboos, who is a partner at Lewis Garboos, based in New York, and Boas Feinberg

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Jonathan Shenkman: who's a partner, Arnold Toddmore Levy, based in Tel Aviv. I'll be sure to send out the invitation to this program in the coming days. In the meantime, if you have a friend or colleague who would like to be, notified of these webinars, they can email me with the word webinar on the subject line. My email is jonathan at parkbridgewealth.com.

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Jonathan Shenkman: You can follow me and all my work on X and Instagram at Jonathan or Money, and by connecting with me on LinkedIn, you could also listen to my weekly podcast called Jonathan on Money, which is available on Apple, Spotify, or wherever you get your podcasts, and you can watch my practical planning videos, which I post several times a week by following me on YouTube at Jonathan on Money as well. And fourth, please take 30 seconds to fill out my survey at the end of this program. It helps me improve my webinars and provide timely and interesting content to the

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Jonathan Shenkman: I thank you in advance for that. And with that, this concludes today's session. Please stay safe and healthy, and have a wonderful day, everybody.