Employer-Provided Long-Term Care Benefits Tax Credit Worksheet

2011

EMPLOYER-PROVIDED LONG-TERM CARE BENEFITS TAX CREDIT

WORKSHEET INSTRUCTIONS

This credit is available to employers that incur costs to provide eligible long-term care insurance to employees. For purposes

of this credit, “employer” means any entity that employs one or more individuals performing services for it within this state.

For a complete deﬁ nition, see 26 MRSA § 1043. Eligible long-term care insurance includes coverage under a qualiﬁ ed

long-term care insurance contract or under a long-term care insurance policy certiﬁ ed by the Superintendent of Insurance in

accordance with Title 24-A. A qualiﬁ ed long-term care insurance contract is deﬁ ned by IRC § 7702B(b) as any contract that

provides coverage for qualiﬁ ed long-term care services. Qualiﬁ ed long-term care services means necessary diagnostic,

preventive, therapeutic, curing, treating, mitigating and rehabilitative services and maintenance or personal care services,

which are required by a chronically ill individual and that are provided in accordance with a plan of care prescribed by a

licensed health care practitioner. The term “chronically ill individual” is deﬁ ned by IRC § 7702B(c)(2). Qualiﬁ ed long-term

care insurance contracts must also meet other technical requirements as speciﬁ ed in § 7702B(b).

The allowable Maine credit is equal to the lowest of:

1) $5,000;

2) 20% of the actual costs incurred in providing long-term care insurance coverage to employees; or

3) $100 for each employee covered by a qualiﬁ ed long-term care insurance contract provided by the employer.

The credit is limited to the regular income tax otherwise due (the credit does not apply to the alternative minimum tax), but

any excess may be carried forward for 15 years.

In the case of pass-through entities (partnerships, LLCs, S corporations, trusts, etc.), the partners, members, shareholders,

beneﬁ ciaries or other owners are allowed credits in proportion to their respective interests in these entities.

SPECIFIC LINE INSTRUCTIONS

Please enter the taxpayer name and social security number (“SSN”) or employer identiﬁ cation number (“EIN”).

Line 1.

Enter the total number of employees with eligible long-term care insurance coverage provided by the employer

during the tax year.

Line 3.

Enter costs incurred by the employer in providing eligible long-term care insurance coverage to employees for

the taxable year.

Line 6.

Enter any credit carryforward amounts claimed but not used in the past 15 years. This amount should come

from your 2010 worksheet, line 10.

Lines 8-10. The credit is limited to the tax liability, excluding minimum tax, of the taxpayer. Any unused credit may be

carried forward for up to 15 years.

Rev. 12/11

Employer-Provided Long-Term Care Benefits Tax Credit Worksheet - 2011 Page 2