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Page 2 of 3 Fileid: … s/I1099LTC/2019/A/XML/Cycle03/source 17:42 - 26-Sep-2018
The type and rule above prints on all proofs including departmental reproduction proofs. MUST be removed before printing.
Chronically Ill Individual IF the statement is for the ... THEN use...
A chronically ill individual is someone who has been certified Policyholder Copy B
(at least annually) by a licensed health care practitioner as:
Insured Copy C
1. Being unable to perform, without substantial
assistance from another individual, at least two daily living Policyholder and the policyholder is Copy B (Copy C is optional)
activities (eating, toileting, transferring, bathing, dressing, the insured
and continence) for at least 90 days due to a loss of
functional capacity; or
2. Requiring substantial supervision to protect the For more information about the requirement to furnish a
individual from threats to health and safety due to severe statement to the policyholder and to the insured, see part M
cognitive impairment. in the 2019 General Instructions for Certain Information
Returns.
Terminally Ill Individual Truncating recipient’s TIN on payee statements.
A terminally ill individual is someone who has been certified Pursuant to Regulations section 301.6109-4, all filers of this
by a physician as having an illness or physical condition that form may truncate a recipient’s TIN (social security number
can reasonably be expected to result in death in 24 months (SSN), individual taxpayer identification number (ITIN),
or less after the date of certification. adoption taxpayer identification number (ATIN), or employer
identification number (EIN)) on payee statements. Truncation
Reporting is not allowed on any documents the filer files with the IRS. A
Report payments only if the policyholder is an individual. payer's TIN may not be truncated on any form. See part J in
Reportable payments are those made to the policyholder, to the 2019 General Instructions for Certain Information
the insured, or to a third party. Returns.
You may report benefits paid from each contract on a Account Number
separate Form 1099-LTC. At your option, you may aggregate The account number is required if you have multiple
benefits paid under multiple contracts on one Form accounts for a recipient for whom you are filing more than
1099-LTC if the same information is reportable on the form one Form 1099-LTC. Additionally, the IRS encourages you to
for each contract (other than the amount of benefits paid). designate an account number for all Forms 1099-LTC that
you file. See part L in the 2019 General Instructions for
Policyholder Certain Information Returns.
The policyholder is the individual who owns the contract,
including the owner of a contract sold or assigned to a Box 1. Gross Long-Term Care Benefits Paid
viatical settlement provider. In the case of a group contract, Enter the gross long-term care benefits paid this year (other
the term “policyholder” includes the certificate holder (or than accelerated death benefits). These benefits are all
similar participant). You must report long-term care benefits amounts paid out on a per diem or other periodic basis or on
to the policyholder even if the payments were made to the a reimbursed basis. It includes amounts paid to the insured,
insured or to a third party (for example, a nursing home, to the policyholder, and to third parties. You are not required
caretaker, or physician). The policyholder also may be the to determine whether any benefits are taxable or nontaxable.
insured.
Box 2. Accelerated Death Benefits Paid
Enter the name, address, and TIN of the policyholder on Enter the gross accelerated death benefits paid under a life
Form 1099-LTC. If the policyholder is not an individual, no insurance contract this year to or on behalf of an insured who
reporting is required. has been certified as terminally or chronically ill. Include the
amount paid by a viatical settlement provider for the sale or
Insured assignment of the insured's death benefit under a life
insurance contract.
The insured is the chronically or terminally ill individual on
whose behalf long-term care benefits are paid. Box 3. Check if Per Diem or Reimbursed
Enter the name, address, and TIN of the insured on Form Amount
1099-LTC. Check a box to indicate whether the payments were made on
a per diem or other periodic basis or on a reimbursed basis.
Statement to Policyholder and Insured For accelerated death benefits, do not check a box if you
made payments on behalf of a terminally ill person. “Per diem
If you are required to file Form 1099-LTC, you must furnish a basis” means payments made on any periodic basis without
statement or acceptable substitute to both the policyholder regard to actual expenses. “Reimbursed basis” means
and to the insured as shown. payments made for actual expenses incurred.
Box 4. Qualified Contract (Optional)
Check the box to indicate whether long-term care insurance
benefits are paid from a qualified long-term care insurance
contract. See Qualified Long-Term Care Insurance Contract,
earlier.
-2- Instructions for Form 1099-LTC (2019)
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