Contents -

Form 1099-LTC

NOTE

ANY INSTRUCTIONS CONTAINED HEREIN ARE ADVISORY ONLY.

REFER TO IRS INSTRUCTIONS FOR OFFICIAL INFORMATION.



Form 1099-LTC - Long-Term Care and Accelerated Death Benefits

File Form 1099-LTC if you pay any long-term care benefits.
Long-T-term care benefits means: 
  1. Payments 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.

Account number (Required)
Enter any number assigned by the payer to the payee that can be used by the IRS to distinguish between information returns.  This number must be unique for each information return.  The account number is critical in the correction process, especially when more than one information return is filed for a payee.  MAG-FILER will automatically assign an account number if the field is blank.

TIN # (Required)
Enter the payee's valid 9-digit Taxpayer Identification Number (SSN or EIN, as appropriate).  Leave this field blank if the TIN# is unknown.   Any form filed containing an invalid identification number in this entry may be returned for correction.

SSN  (else EIN) (Required)
Check this box if the payee TIN # is a Social Security Number (SSN) of an individual.  Leave this box blank if the payee TIN # is an Employer Identification Number (EIN) of a business or an organization.

NOTE: Imbedded blanks, extraneous words, titles, and special characters ( i.e., Mr., Mrs., Dr., period [.], apostrophe [ ' ] should be removed from Payee Name Lines.  An ampersand (&) and a dash (- ) are the only acceptable special characters.  A comma ( , ) between last name and first name that is placed by MAG-FILER is also acceptable.

Name (Required)
Enter the name of the recipient belonging to the Taxpayer Identification Number (TIN).  If the TIN, is an SSN, enter as last name suffix, first, middle initial, e.g., Doe Jr., John A.).  If the TIN is an EIN, the name is entered as is.  Use the Second Name Field if additional space is required.

Second Name Field
If the payee name requires more space than is available in the name field, ENTER ONLY THE REMAINING PORTION OF THE NAME IN THIS ENTRY.  If there are multiple payees, this field may be used for those payees' names.  DO NOT USE THIS FIELD FOR ADDRESS INFORMATION. 

Address (Required)
Enter the payee's mailing address.  The address MUST be present.  This entry must not contain any data other than the payee's mailing address.

City (Required)
Enter the payee's city.   Do not enter state and zip code information in this entry.

State (Required)
Enter the abbreviation for the payee's state or foreign country.  You must use valid U.S. Postal Service state abbreviations for U.S. addresses.

Zip (Required)
Enter the payee's valid 9-digit zip code assigned by the U.S. Postal Service.

Gross Long-Term Care Benefits Paid 
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.

Accelerated Death Benefits Paid
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. 

Per Diem / Reimbursed Amount Check boxes
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. 

Insured
Enter the insured's first and last name.  The insured is the chronically or terminally ill individual on whose behalf long-term care benefits are paid.

Insured SS#
Enter the insured's social security number.

Address
Enter the insured's street address (including apartment number).

City
Enter the insured's city.

State
Enter the insured's two-character state abbreviation.

Zip
Enter the insured's zip code.

Qualified Contract (Optional)
Check this box to indicate whether long-term care insurance benefits are paid from a qualified long-term care insurance contract.

Chronically Ill
Check this box if the insured has been certified as chronically ill.
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
Check this box if the insured 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.

Date Certified
Enter the date (in format MMDDYYYY) when the insured was certified as chronically or terminally ill.  If chronically or terminally ill is checked, than the date certified is required.

Select Print
Check this box to select specific payees for printing

Corrected Return
Check this box if this entry is a corrected return.  This is only used IF YOU HAVE ALREADY SUBMITTED MAGNETIC MEDIA FILING and wish to print or file corrected returns.  NOTE: The same account number reported on the original must also be on the corrected record.