Instructions For Form 8853 - Archer Msas And Long-Term Care Insurance Contracts - 2002 Page 6
ADVERTISEMENT
1
2
3
4
5
6
7
8Filing Requirements for Section C
Go through this chart for each insured person for
whom you received long-term care (LTC) payments.
See Definitions beginning on page 5.
Start Here
Did you (or your spouse, if
filing jointly) receive
Were any of those
payments in 2002 made on
payments made
Complete all of
Yes
Yes
Section C
a per diem or other periodic
under a qualified LTC
basis under an LTC
insurance contract?
insurance contract?
No
No
Did you (or your spouse, if
Did you (or your spouse, if
filing jointly) receive any
filing jointly) receive any
accelerated death benefits
accelerated death benefits in
Complete only lines
in 2002 from a life
2002 from a life insurance
No
16a, 16b, and 19 of
insurance policy that were
policy that were made on a
Section C
made on a per diem or
per diem or other periodic
other periodic basis?
basis?
Yes
Were any of the payments
Complete only lines 16a,
paid on behalf of a
16b, 17, 18, 19 (if
No
Yes
No
chronically ill (not terminally
applicable), and 28 of
ill) individual?
Section C
Yes
Do not complete
Complete all of Section C
Section C
contracts at the time the contract was
least 90 days, due to a loss of functional
Terminally Ill Individual
issued and has not been changed
capacity or
A terminally ill individual is any individual
•
materially.
who has been certified by a physician as
Requiring substantial supervision to
having an illness or physical condition
protect the individual from threats to
Per Diem Payments
that may reasonably be expected to result
health and safety due to severe cognitive
in death within 24 months.
Per diem payments are payments of a
impairment.
fixed amount made on a periodic basis
Line 17
without regard to actual expenses
Accelerated Death Benefits
Special rules apply in determining the
incurred. Box 3 of Form 1099-LTC should
Generally, amounts paid as accelerated
taxable payments if other individuals
indicate whether payments were per diem
death benefits under a life insurance
received per diem payments under a
payments.
qualified LTC insurance contract or as
contract or under certain viatical
accelerated death benefits with respect to
Chronically Ill Individual
settlements are fully excludable from your
the insured listed on line 16a. See
gross income if the insured is a terminally
A chronically ill individual is someone who
Multiple Payees on page 7 for details.
ill individual (defined next). Accelerated
has been certified (at least annually) by a
death benefits paid with respect to an
licensed health care practitioner as —
Line 20
•
insured individual who is chronically ill
Being unable to perform at least two
generally are excludable from your gross
activities of daily living (ADLs) (eating,
If you have more than one LTC
income to the same extent as they would
!
toileting, transferring, bathing, dressing,
period, you must separately
be under a qualified LTC insurance
and continence), without substantial
calculate the taxable amount of
CAUTION
contract.
assistance from another individual, for at
the payments received during each LTC
-6-
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial