Long-Term Care Premiums Paid Statement

Forms and Documents

Document	Type	Status	Availability
Form Form 1099-LPS Long-Term Care Premiums Paid Statement	Form and Instruction	New	Available
2026 Supporting Statement 1545-NEW Form 1099-LPS.docx	Supporting Statement A	Uploaded 2026-06-17	Available

IC Document Collections

IC ID	Collection	Type	Status	Form
279861	Long-Term Care Premiums Paid Statement	Form and Instruction	New	Long-Term Care Premiums Paid Statement

ICR Details

OMB Control No:	ICR Reference No: 202604-1545-010
Status: Received in OIRA	Previous ICR Reference No:
Agency/Subagency: TREAS/IRS	Agency Tracking No:
Title: Long-Term Care Premiums Paid Statement
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 07/01/2026

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	7,500	0
Time Burden (Hours)	1,500	0
Cost Burden (Dollars)	0	0

---

Abstract: Internal Revenue Code (IRC) section 401(a)(39)(E) respectively defines a long-term care premium statement and its requirements. IRC section 6050Z defines requirements of reporting, statements to be furnished, contracts or coverage covering more than one insured, and statements to be furnished on request. Issuers of certified long-term care insurance that files a long-term care premium statement use Form 1099-LPS to report long-term care insurance contracts.

---

Authorizing Statute(s): PL: Pub.L. 117 - 328 136 Stat. 4459 Name of Law: SECURE 2.0 Act
   US Code: 26 USC 401 Name of Law: Qualified pension, profit-sharing, and stock bonus plans
   US Code: 26 USC 6050Z Name of Law: Reports relating to long-term care premium statements
  

Citations for New Statutory Requirements: PL: Pub.L. 117 - 328 334 Name of Law: SECURE Act 2.0

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 17836	04/08/2026
30-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 39720	06/30/2026
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Long-Term Care Premiums Paid Statement	Form 1099-LPS	Long-Term Care Premiums Paid Statement

---

ICR Summary of Burden

	Total Request	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	7,500	0	7,500	0	0	0
Annual Time Burden (Hours)	1,500	0	1,500	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new collection due to enactment of Section 334 of the SECURE 2.0 Act.

---

Annual Cost to Federal Government: $16,416

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 07/01/2026

---