Instructions For Form 1099-Ltc - 2006 Page 5
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26participant). You must report long-term care benefits to the
amounts paid out on a per diem (or other periodic) basis or on a
policyholder even if the payments were made to the insured or
reimbursed basis. It includes amounts paid to the insured, to
to a third party (for example, a nursing home, caretaker, or
the policyholder, and to third parties. You are not required to
physician). The policyholder also may be the insured.
determine whether any benefits are taxable or nontaxable.
Enter the name, address, and taxpayer identification number
Box 2. Accelerated Death Benefits Paid
(TIN) of the policyholder on Form 1099-LTC. If the policyholder
Enter the gross accelerated death benefits paid under a life
is not an individual, no reporting is required.
insurance contract this year to or on behalf of an insured who
Insured
has been certified as terminally or chronically ill. Include the
amount paid by a viatical settlement provider for the sale or
The insured is the chronically or terminally ill individual on
assignment of the insured’s death benefit under a life insurance
whose behalf long-term care benefits are paid.
contract.
Enter the name, address, and TIN of the insured on Form
Box 3. Check if Per Diem or Reimbursed
1099-LTC.
Amount
Statement to Policyholder and Insured
Check a box to indicate whether the payments were made on a
If you are required to file Form 1099-LTC, you must furnish a
per diem (or other periodic) basis or on a reimbursed basis. For
statement (or acceptable substitute) to both the policyholder
accelerated death benefits, do not check a box if you made
and to the insured as shown.
payments on behalf of a terminally ill person. Per diem basis
means payments made on any periodic basis without regard to
IF the statement is for the ...
THEN use...
actual expenses. Reimbursed basis means payments made for
Policyholder
Copy B
actual expenses incurred.
Insured
Copy C
Box 4. Qualified Contract (Optional)
Check the box to indicate whether long-term care insurance
Policyholder and the policyholder Copy B (Copy C is optional)
benefits are paid from a qualified long-term care insurance
is the insured
contract. See Qualified Long-Term Care Insurance Contract on
page LTC-1.
For more information about the requirement to furnish a
statement to the policyholder and to the insured, see part M in
Box 5. Check if Chronically ill or Terminally ill
the General Instructions for Forms 1099, 1098, 5498, and
(Optional)
W-2G.
Check the box to indicate whether the insured was chronically
Account Number
or terminally ill. Also, enter the latest date certified. If the
insured was neither chronically nor terminally ill, leave this box
The account number is required if you have multiple accounts
blank. See Chronically ill Individual and Terminally ill Individual
for a recipient for whom you are filing more than one Form
on page LTC-1.
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 2006 General Instructions for Forms 1099, 1098,
5498, and W-2G.
Box 1. Gross Long-Term Care Benefits Paid
Enter the gross long-term care benefits paid this year (other
than accelerated death benefits). These benefits are all
LTC-2
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