Resources

Four things almost every independent locum ends up buying, and a set of official sources worth bookmarking. The point of this page is the criteria — what separates a good product from a bad one in each category — so that you can judge any provider, including ones we have never heard of.

1. Malpractice cover and tail

Most agencies provide cover, but a clinician working through several agencies, taking direct facility contracts, or wanting one continuous retroactive date usually ends up carrying their own policy.

What to compare:

• Occurrence or claims-made. Occurrence needs no tail, ever, and costs more up front for exactly that reason. This is the first question, not a detail.
• Tail pricing before you buy the policy. Ask what a mature extended reporting endorsement would cost as a multiple of the annual premium, and whether it is waived on death, disability or qualifying retirement.
• Limits, and whether the aggregate is yours or shared with other clinicians on a group policy.
• Defence costs inside or outside the limits. Outside is materially better.
• Consent to settle, and whether a hammer clause takes it back. Settlements are reportable to the National Practitioner Data Bank and follow you through every future credentialing application.
• Carrier financial strength and state admitted status. Your state insurance department can confirm licensing.

Background: Locum Malpractice & Tail Coverage Basics. Premiums you pay yourself are deductible on Schedule C, which reduces both income tax and self-employment tax.

2. LLC, PLLC and S-corporation formation

Read the S-corp analysis before you buy anything here. At most locum incomes the honest annual benefit is a few thousand dollars, it depends heavily on the salary you can defend, and in Tennessee, New York City and the District of Columbia the election commonly costs more than it saves.

What to check before choosing a formation service:

• Whether your state requires a professional entity (PLLC or PC) for licensed clinicians. Many do, and a plain LLC formed by a generic service may be invalid for medical practice.
• Whether the medical board must approve the entity name — several states require this.
• Registered agent cost after year one. The first year is often free and the renewal is not.
• Whether the service files Form 2553 for the S-election, and by when. The deadline is strict.
• Foreign qualification in every state you actually work in, each with its own fee and annual report.
• Ongoing compliance — payroll service and a separate Form 1120-S return, which are the real recurring costs.

A CPA who has seen your numbers is worth more here than any formation service. Formation is the cheap part; the salary decision and the multi-state filings are where the money and the risk are.

3. Bookkeeping and 1099 accounting software

Business expenses are the only thing that reduces income tax and self-employment tax, which makes record-keeping worth roughly 38–47 cents on the dollar. Software is not the important part — a separate business bank account is — but it removes the excuse.

What actually matters for a locum:

• Schedule C categories out of the box, and a clean export your preparer can use.
• Mileage tracking that produces a contemporaneous log, since § 274(d) gives no benefit of the doubt on travel and vehicle records.
• Receipt capture tied to the transaction, not a folder of photographs.
• Quarterly estimated tax projection, so the number is not a surprise four times a year.
• Multi-state income tagging if you work assignments in several states.
• Whether you will actually open it. The best system is the one you use in the first week.

Background: Deductible Business Expenses on Assignment and Estimated Quarterly Taxes.

4. Own-occupation disability insurance

The most important policy a clinician buys, and more important once you are independent because there is no group cover underneath it.

What to compare — the definition matters more than the price:

• True own-occupation, specialty-specific: pays if you cannot perform the material duties of your specialty even if you earn money doing something else. An "any-occupation" definition is close to worthless for a proceduralist.
• Non-cancellable and guaranteed renewable — the insurer cannot raise your premium or change terms.
• Residual or partial disability benefits, for reduced capacity rather than none.
• Future purchase / benefit increase options without new medical underwriting.
• Elimination period — 90 days is the usual trade-off between premium and exposure.
• How the policy treats a 1099 income history, which underwriters handle differently from a salary.

Background: The Locum Tenens Benefits Gap.

Official sources — free, and no commercial relationship

Everything below is a primary source. Where this site's guides cite a rule, this is where it comes from.

Tax

• Schedule C and Schedule SE — the two forms a locum's whole tax position runs through.
• Form 1040-ES — estimated tax, with the worksheet and the vouchers.
• IRS Direct Pay and EFTPS — free ways to pay instalments; EFTPS lets you schedule all four in advance.
• Publication 463 — travel expenses, tax home, temporary assignments, mileage.
• Publication 560 — retirement plans for small business, including the rate table that turns 25% into 20%.
• S Corporation Compensation and Medical Insurance Issues — the IRS position on reasonable compensation.
• Revenue Procedure 2025-32 — the 2026 brackets, standard deduction and § 199A thresholds; Notice 2025-67 — the 2026 retirement limits.
• SSA 2026 COLA fact sheet — the $184,500 Social Security wage base.
• GSA per diem rates — the federal M&IE rate you may substitute for meal receipts.

Licensing and credentialing

• Federation of State Medical Boards — directory of state medical boards.
• Interstate Medical Licensure Compact — expedited licensure across member states for qualifying physicians.
• Nurse Licensure Compact and the NCSBN; state controlled-substance registration requirements vary and are separate from the DEA.
• DEA Diversion Control Division — registration and state-by-state requirements.
• National Practitioner Data Bank — self-query, and the guidebook on what is reportable.

Health cover

• HealthCare.gov — marketplace plans and special enrolment periods (losing employer cover is a qualifying event).
• US Department of Labor — COBRA — the bridge option when you leave an employed post mid-year.