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Rev lokakuu 2019

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Department of the Treasury  
Internal Revenue Service  
Instructions for Form  
1099-LTC  
(Rev. October 2019)  
Long-Term Care and Accelerated Death Benefits  
Viatical Settlement Providers  
A viatical settlement provider is any person who:  
Future Developments  
For the latest information about developments related to Form  
1099-LTC and its instructions, such as legislation enacted after  
they were published, go to IRS.gov/Form1099LTC.  
1. Is regularly engaged in the trade or business of  
purchasing or taking assignments of life insurance contracts on  
the lives of terminally or chronically ill individuals, and  
2. Is licensed in the state where the insured lives. If licensing  
is not required in the state, the provider must meet other  
requirements (including those below) depending on whether the  
insured is terminally or chronically ill.  
a. If the insured is terminally ill, the provider must meet the  
requirements of sections 8 and 9 of the Viatical Settlements  
Model Act of the National Association of Insurance  
Commissioners (NAIC), relating to disclosure and general rules.  
The provider must also meet the requirements of the Model  
Regulations of the NAIC for evaluating the reasonableness of  
amounts paid in viatical settlement transactions with terminally ill  
individuals.  
b. If the insured is chronically ill, the provider must meet  
requirements similar to those of sections 8 and 9 of the Viatical  
Settlements Model Act of the NAIC and must also meet any  
standards of the NAIC for evaluating the reasonableness of  
amounts paid in viatical settlement transactions with chronically  
ill individuals.  
Reminders  
In addition to these specific instructions, you should also use the  
current General Instructions for Certain Information Returns.  
Those general instructions include information about the  
following topics.  
Who must file.  
When and where to file.  
Electronic reporting.  
Corrected and void returns.  
Statements to recipients.  
Taxpayer identification numbers (TINs).  
Backup withholding.  
Penalties.  
Other general topics.  
You can get the General Instructions for Certain Information  
Continuous-use form and instructions. Form 1099-LTC and  
these instructions have been converted from an annual revision  
to continuous use. Both the form and instructions will be updated  
as needed. For the most recent version, go to IRS.gov/  
However, if a state enacts a licensing requirement but  
does not permit viatical settlement providers to engage  
!
CAUTION  
in business until the licenses are granted, the provider  
will not be considered as licensed under section 101(g)(2)(B)(i)  
(I). See Rev. Rul. 2002-82, which is on page 978 of Internal  
Revenue Bulletin 2002-51 at IRS.gov/pub/irs-irbs/irb02-51.pdf.  
Online fillable form. Due to the very low volume of paper  
Forms 1099-LTC received and processed by the IRS each year,  
this form is available in an online fillable format. You may fill out  
the form, found online at IRS.gov/Form1099LTC, and send Copy  
B to the recipient. For filing with the IRS, follow the applicable  
procedures for filing electronically, or, for this form only, if you  
are qualified to file on paper, send in the black-and-white Copy A  
with Form 1096 that you print from the IRS website.  
Qualified Long-Term Care Insurance Contract  
A contract issued after 1996 is a qualified long-term care  
insurance contract if it meets the requirements of section 7702B,  
including the requirement that the insured must be a chronically  
ill individual (see Chronically Ill Individual, later). A contract  
issued before 1997 generally is treated as a qualified long-term  
care insurance contract if it met state law requirements for  
long-term care insurance contracts and it has not been  
materially changed.  
Specific Instructions  
File Form 1099-LTC if you paid any long-term care benefits.  
Long-Term Care Benefits  
“Long-term care benefits” means:  
Accelerated Death Benefits  
1. Any payments made 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.  
An accelerated death benefit is any amount paid under a life  
insurance contract for an insured individual who is terminally or  
chronically ill. It also includes any amount paid by a viatical  
settlement provider for the sale or assignment of a death benefit  
under a life insurance contract for a chronically or terminally ill  
individual.  
Chronically Ill Individual  
Who Must File  
Payers of long-term care benefits who must file Form 1099-LTC  
include insurance companies, governmental units, and viatical  
settlement providers.  
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,  
Oct 24, 2019  
Cat. No. 27981Y  
   
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.  
Truncating recipient’s TIN on payee statements. Pursuant  
to Regulations section 301.6109-4, all filers of this form may  
truncate a recipient’s TIN (social security number (SSN),  
individual taxpayer identification number (ITIN), adoption  
taxpayer identification number (ATIN), or employer identification  
number (EIN)) on payee statements. Truncation is not allowed  
on any documents the filer files with the IRS. A payer's TIN may  
not be truncated on any form. See part J in the current General  
Instructions for Certain Information Returns.  
Terminally Ill Individual  
A terminally ill individual is someone who 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  
after the date of certification.  
Account Number  
The account number is required if you have multiple accounts for  
a recipient for whom you are filing more than one Form  
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 current General Instructions for Certain Information  
Returns.  
Reporting  
Report payments only if the policyholder is an individual.  
Reportable payments are those made to the policyholder, to the  
insured, or to a third party.  
You may report benefits paid from each contract on a  
separate Form 1099-LTC. At your option, you may aggregate  
benefits paid under multiple contracts on one Form 1099-LTC if  
the same information is reportable on the form for each contract  
(other than the amount of benefits paid).  
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 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.  
Policyholder  
The policyholder is the individual who owns the contract,  
including the owner of a contract sold or assigned to a viatical  
settlement provider. In the case of a group contract, the term  
“policyholder” includes the certificate holder (or similar  
participant). You must report long-term care benefits to the  
policyholder even if the payments were made to the insured or to  
a third party (for example, a nursing home, caretaker, or  
physician). The policyholder may also be the insured.  
Box 2. Accelerated Death Benefits Paid  
Enter 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.  
Enter the name, address, and TIN of the policyholder on  
Form 1099-LTC. If the policyholder is not an individual, no  
reporting is required.  
Box 3. Check if Per Diem or Reimbursed  
Amount  
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  
The insured is the chronically or terminally ill individual on whose  
behalf long-term care benefits are paid.  
Enter the name, address, and TIN of the insured on Form  
1099-LTC.  
Box 4. Qualified Contract (Optional)  
Statement to Policyholder and Insured  
If you are required to file Form 1099-LTC, you must furnish a  
statement or acceptable substitute to both the policyholder and  
to the insured as shown.  
Check the box to indicate whether long-term care insurance  
benefits are paid from a qualified long-term care insurance  
earlier.  
Box 5. Check if Chronically Ill or Terminally Ill  
(Optional)  
IF the statement is for the ...  
Policyholder  
THEN use...  
Copy B  
Check the box to indicate whether the insured was chronically or  
terminally ill. Also, enter the latest date certified. If the insured  
was neither chronically nor terminally ill, leave this box blank.  
Insured  
Copy C  
Policyholder and the policyholder is  
the insured  
Copy B (Copy C is optional)  
For more information about the requirement to furnish a  
statement to the policyholder and to the insured, see part M in  
the current General Instructions for Certain Information Returns.  
-2-  
Instructions for Form 1099-LTC (Rev. 10-2019)