1099-LTC 2016

Field Name	Size	Type	Description	Notes
See Form Filer Common Fields			Filer fields common to all form types.
See Recipient Common Fields			Recipient fields common to all form types.
Box 1 Amount	16	Amount	Box 1: Gross long-term care benefits paid
Box 2 Amount	16	Amount	Box 2: Accelerated death benefits paid
Box 3 Checkbox 1	1	Amount	Box 3 checkbox 1: Type of Payment Indicator: Per Diem
Box 3 Checkbox 2	1	Amount	Box 3 checkbox 2: Type of Payment Indicator: Reimbursed Amount
Box INS SSN	9	Amount	Social Security Number of Insured
Box INS Name	40	Amount	Name of Insured
Box INS Address	40	Amount	Address of Insured
Box INS City	40	Amount	City of Insured
Box INS State	2	Character	State of Insured
Box INS Zip	9	Amount	ZIP Code of Insured
Box 4 Checkbox	1	Amount	Box 4: Qualified Contract Indicator (Optional)
Box 5 Checkbox 1	1	Amount	Box 5 Checkbox 1: Status of Illness Indicator: Chronically Ill
Box 5 Checkbox 2	1	Amount	Box 5 Checkbox 2: Status of Illness Indicator: Terminally Ill
Box 5 Date	8	Amount	Box 5 Checkbox Date: Date Certified