Long-Term Care and Accelerated Death Benefits.

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Page 1 of 2 Instructions for Form 1099-LTC (2011)

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2012

Department of the Treasury
Internal Revenue Service

Instructions for Form
1099-LTC

Section references are to the Internal Revenue Code unless
otherwise noted.

What’s New

D

Truncating policyholder/insured identification numbers on
paper payee statements. Notice 2011-38 allows filers of this
form to truncate policyholder’s and insured’s identification
numbers (social security number (SSN), individual taxpayer
identification number (ITIN), or adoption taxpayer identification
number (ATIN)) on paper payee statements for tax years 2011
and 2012. See part M in the 2012 General Instructions for
Certain Information Returns.

Reminder
D

In addition to these specific instructions, you should also use
the 2012 General Instructions for Certain Information Returns.
Those general instructions include information about the
following topics.
• Backup withholding.
• Electronic reporting requirements.
• Penalties.
• Who must file (nominee/middleman).
• When and where to file.
• Taxpayer identification numbers.
• Statements to recipients.
• Corrected and void returns.
• Other general topics.
You can get the general instructions from IRS.gov or by
calling 1-800-TAX-FORM (1-800-829-3676).

a. If the insured is terminally ill, the provider must meet the
requirements of sections 8 and 9 of the Viatical Settlements
Model Act of the National Association of Insurance
Commissioners (NAIC), relating to disclosure and general rules.
The provider must also meet the requirements of the Model
Regulations of the NAIC for evaluating the reasonableness of
amounts paid in viatical settlement transactions with terminally
ill individuals.
b. If the insured is chronically ill, the provider must meet
requirements similar to those of sections 8 and 9 of the Viatical
Settlements Model Act of the NAIC and must also meet any
standards of the NAIC for evaluating the reasonableness of
amounts paid in viatical settlement transactions with chronically
ill individuals.
However, if a state enacts a licensing requirement but
does not permit viatical settlement providers to engage
CAUTION
in business until the licenses are granted, the provider
will not be considered as licensed under section
101(g)(2)(B)(i)(I). See Rev. Rul. 2002-82, which is on page 978
of Internal Revenue Bulletin 2002-51 at www.irs.gov/pub/
irs-irbs/irb02-51.pdf.

!

Qualified Long-Term Care Insurance Contract
A contract issued after 1996 is a qualified long-term care
insurance contract if it meets the requirements of section
7702B, including the requirement that the insured must be a
chronically ill individual (see Chronically ill Individual below). A
contract issued before 1997 generally is treated as a qualified
long-term care insurance contract if it met state law
requirements for long-term care insurance contracts and it has
not been materially changed.

Accelerated Death Benefits

Specific Instructions
File Form 1099-LTC, Long-Term Care and Accelerated Death
Benefits, if you pay any long-term care benefits.

Long-Term Care Benefits
Long-term care benefits means:
1. Any payments made under a product that is advertised,
marketed, or offered as long-term care insurance (whether
qualified or not) and
2. Accelerated death benefits (excludable in whole or in part
from gross income under section 101(g)) paid under a life
insurance contract or paid by a viatical settlement provider.

Who Must File
File Form 1099-LTC if you paid any long-term care benefits,
including accelerated death benefits. Payers include insurance
companies, governmental units, and viatical settlement
providers.

Viatical Settlement Providers
A viatical settlement provider is any person who:
1. Is regularly engaged in the trade or business of
purchasing or taking assignments of life insurance contracts on
the lives of terminally or chronically ill individuals and
2. Is licensed in the state where the insured lives. If
licensing is not required in the state, the provider must meet
other requirements (including those below) depending on
whether the insured is terminally or chronically ill.

An accelerated death benefit is any amount paid under a life
insurance contract for an insured individual who is terminally or
chronically ill. It also includes any amount paid by a viatical
settlement provider for the sale or assignment of a death benefit
under a life insurance contract for a chronically or terminally ill
individual.

Chronically ill Individual
A chronically ill individual is someone who has been certified (at
least annually) by a licensed health care practitioner as:
1. Being unable to perform, without substantial assistance
from another individual, at least two daily living activities
(eating, toileting, transferring, bathing, dressing, and
continence) for at least 90 days due to a loss of functional
capacity or
2. Requiring substantial supervision to protect the individual
from threats to health and safety due to severe cognitive
impairment.

Terminally ill Individual
A terminally ill individual is someone who has been certified by
a physician as having an illness or physical condition that can
reasonably be expected to result in death in 24 months or less
after the date of certification.

Reporting
Report payments only if the policyholder is an individual.
Reportable payments are those made to the policyholder, to the
insured, or to a third party.

Cat. No. 27981Y

Page 2 of 2 Instructions for Form 1099-LTC (2011)

11:06 - 19-MAY-2011

The type and rule above prints on all proofs including departmental reproduction proofs. MUST be removed before printing.

You may report benefits paid from each contract on a
separate Form 1099-LTC. At your option, you may aggregate
benefits paid under multiple contracts on one Form 1099-LTC if
the same information is reportable on the form for each contract
(other than the amount of benefits paid).

1099-LTC. Additionally, the IRS encourages you to designate
an account number for all Forms 1099-LTC that you file. See
part L in the 2012 General Instructions for Certain Information
Returns.

Policyholder

Enter the gross long-term care benefits paid this year (other
than accelerated death benefits). These benefits are all
amounts paid out on a per diem or other periodic basis or on a
reimbursed basis. It includes amounts paid to the insured, to
the policyholder, and to third parties. You are not required to
determine whether any benefits are taxable or nontaxable.

Box 1. Gross Long-Term Care Benefits Paid

The policyholder is the individual who owns the contract,
including the owner of a contract sold or assigned to a viatical
settlement provider. In the case of a group contract, the term
policyholder includes the certificate holder (or similar
participant). You must report long-term care benefits to the
policyholder even if the payments were made to the insured or
to a third party (for example, a nursing home, caretaker, or
physician). The policyholder also may be the insured.
Enter the name, address, and taxpayer identification number
(TIN) of the policyholder on Form 1099-LTC. If the policyholder
is not an individual, no reporting is required.

Box 2. Accelerated Death Benefits Paid
Enter the gross accelerated death benefits paid under a life
insurance contract this year to or on behalf of an insured who
has been certified as terminally or chronically ill. Include the
amount paid by a viatical settlement provider for the sale or
assignment of the insured’s death benefit under a life insurance
contract.

Insured
The insured is the chronically or terminally ill individual on
whose behalf long-term care benefits are paid.
Enter the name, address, and TIN of the insured on Form
1099-LTC.

Box 3. Check if Per Diem or Reimbursed
Amount
Check a box to indicate whether the payments were made on a
per diem or other periodic basis or on a reimbursed basis. For
accelerated death benefits, do not check a box if you made
payments on behalf of a terminally ill person. Per diem basis
means payments made on any periodic basis without regard to
actual expenses. Reimbursed basis means payments made for
actual expenses incurred.

Statement to Policyholder and Insured
If you are required to file Form 1099-LTC, you must furnish a
statement or acceptable substitute to both the policyholder and
to the insured as shown.
IF the statement is for the ...

THEN use...

Box 4. Qualified Contract (Optional)

Policyholder

Copy B

Insured

Copy C

Check the box to indicate whether long-term care insurance
benefits are paid from a qualified long-term care insurance
contract. See Qualified Long-Term Care Insurance Contract on
page 1.

Policyholder and the policyholder Copy B (Copy C is optional)
is the insured

Box 5. Check if Chronically ill or Terminally ill
(Optional)

For more information about the requirement to furnish a
statement to the policyholder and to the insured, see part M in
the 2012 General Instructions for Certain Information Returns.

Check the box to indicate whether the insured was chronically
or terminally ill. Also, enter the latest date certified. If the
insured was neither chronically nor terminally ill, leave this box
blank. See Chronically ill Individual and Terminally ill Individual
on page 1.

Account Number
The account number is required if you have multiple accounts
for a recipient for whom you are filing more than one Form

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Instructions for Form 1099-LTC (2011)