97-33986. Qualified Long-Term Care Insurance Contracts  

  • [Federal Register Volume 63, Number 1 (Friday, January 2, 1998)]
    [Proposed Rules]
    [Pages 35-39]
    From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
    [FR Doc No: 97-33986]
    
    
    
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    DEPARTMENT OF THE TREASURY
    
    Internal Revenue Service
    
    26 CFR Part 1
    
    [REG-109333-97]
    RIN 1545-AV56
    
    
    Qualified Long-Term Care Insurance Contracts
    
    AGENCY: Internal Revenue Service (IRS), Treasury.
    
    ACTION: Notice of proposed rulemaking and notice of public hearing.
    
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    SUMMARY: This document contains proposed regulations relating to 
    consumer protection with respect to qualified long-term care insurance 
    contracts and relating to events that will be considered material 
    changes with respect to long-term care insurance contracts issued prior 
    to January 1, 1997. Changes to the applicable law were made by the 
    Health Insurance Portability and Accountability Act of 1996. The 
    regulations affect issuers of long-term care insurance contracts and 
    individuals entitled to receive payments under these contracts. The 
    regulations are necessary to provide these taxpayers with guidance 
    needed to comply with these changes.
    
    DATES: Written comments must be received by April 2, 1998. Outlines of 
    topics to be discussed at the public hearing scheduled for May 13, 
    1998, must be received by April 2, 1998.
    
    ADDRESSES: Send submissions to: CC:DOM:CORP:R (REG-109333-97), room 
    5226, Internal Revenue Service, POB 7604, Ben Franklin Station, 
    Washington, DC 20044. Submissions may be hand delivered between the 
    hours of 8 a.m. and 5 p.m. to CC:DOM:CORP:R (REG-109333-97), Courier's 
    Desk, Internal Revenue Service, 1111 Constitution Avenue NW, 
    Washington, DC. Alternatively, taxpayers may also submit comments 
    electronically via the Internet by selecting the ``Tax Regs'' option on 
    the IRS Home Page, or by submitting comments directly to the IRS 
    Internet site at http://www.irs.ustreas.gov/prod/tax__regs/
    comments.html. The public hearing will be held in room 2615, Internal 
    Revenue Building, 1111 Constitution Avenue NW, Washington, DC.
    
    FOR FURTHER INFORMATION CONTACT: Concerning the regulations, Katherine 
    A. Hossofsky, (202) 622-3477; concerning submissions and the hearing, 
    LaNita VanDyke, (202) 622-7190 (not toll-free numbers).
    
    SUPPLEMENTARY INFORMATION:
    
    Background
    
        This document contains proposed amendments to the Income Tax 
    Regulations (26 CFR part 1) to provide rules under section 7702B of the 
    Internal Revenue Code of 1986 (the ``Code''). Section 7702B was added 
    by sections 321 and 325 of the Health Insurance Portability and 
    Accountability Act of 1996 (Pub. L. 104-191, 110 Stat. 1936, 2054 and 
    110 Stat. at 2063) (``HIPAA''). Notice 97-31, 1997-21 I.R.B. 5 (May 6, 
    1997), provides interim guidance on certain provisions of section 7702B 
    and other provisions of the Code added or amended by HIPAA.
    
    Explanation of Statutory Provisions
    
        Section 7702B establishes the tax treatment for qualified long-term 
    care insurance contracts. Sections 7702B(a) (1) and (3) provide that a 
    qualified long-term care insurance contract is treated as an accident 
    and health insurance contract and that any employer plan providing 
    coverage under a qualified long-term care insurance contract is treated 
    as an accident or health plan with respect to that coverage.
        Section 7702B(a)(2) provides that amounts (other than policyholder 
    dividends and premium dividends) received under a qualified long-term 
    care insurance contract are generally excludable from gross income as 
    amounts received for personal injuries and sickness.
        Section 213(d)(1)(D) was amended by section 322 of HIPAA to provide 
    that eligible long-term care premiums as defined in section 213(d)(10) 
    are deductible medical expenses.
        Under section 7702B(b)(1)(F), a qualified long-term care insurance 
    contract must meet the consumer protection provisions of section 
    7702B(g). In addition, section 4980C imposes an excise tax on issuers 
    of qualified long-term care insurance contracts that do not provide 
    further consumer protections.
        Section 7702B of the Code applies to contracts issued after 
    December 31, 1996. Section 321(f)(2) of HIPAA treats a contract issued 
    before January 1, 1997, as a qualified long-term care insurance 
    contract under section 7702B(b) of the Code, and services provided or 
    reimbursed under such a contract as qualified long-term care services 
    under section 7702B(c) of the Code, provided the contract met the long-
    term care requirements of the State in which the contract was sitused 
    at the time the contract was issued. Section 321(f)(2) of HIPAA also 
    provides that in the case of an individual covered on December 31, 
    1996, by a State long-term care plan under section 7702B(f) of the 
    Code, the terms of the plan on that date are treated as a contract 
    meeting the long-term care insurance requirements of that State.
        Section 321(f)(4) of HIPAA provides that for purposes of applying 
    sections 101(f), 7702, and 7702A of the Code, neither the issuance of a 
    rider that is treated as a qualified long-term care insurance contract 
    nor the addition of any provision required to conform any other long-
    term care rider to the requirements applicable to a qualified long-term 
    care insurance contract is treated as a modification or material change 
    of the contract.
    
    Explanation of Provisions
    
        The proposed regulations provide guidance concerning:
    
     the consumer protection requirements that apply to qualified 
    long-term care insurance contracts under sections 7702B(g), 
    7702B(b)(1)(F), and 4980C of the Code; and
     the grandfather provisions of section 321(f)(2) of HIPAA under 
    which pre-1997 contracts are treated as qualified long-term care 
    insurance contracts if certain conditions are met.
    
        The standards in the proposed regulations are based on safe harbors 
    that were originally set forth in Notice 97-31. They reflect comments 
    made by consumer representatives, issuers of long-term care insurance, 
    independent sales agents, State regulators of long-term care insurance, 
    and others. The proposed regulations are intended to provide clear and 
    workable rules to assist those who want to ensure that a contract 
    issued before 1997 retains its status as a qualified long-term care 
    insurance contract.
    
    Notice 97-31
    
        Notice 97-31 was issued to provide interim standards for taxpayers 
    to use in interpreting the new long-term care provisions and to 
    facilitate operation of the insurance market by avoiding the need to 
    amend contracts. For example, Notice 97-31 includes interim guidance on 
    the determination of whether an individual is a ``chronically ill 
    individual,'' including safe harbor definitions of the terms 
    ``substantial assistance,'' ``hands-on assistance,'' ``standby 
    assistance,'' ``severe cognitive impairment,'' and ``substantial 
    supervision.'' The standards contained in Notice 97-31 include interim 
    guidance on both the consumer protection provisions and the scope of 
    the statutory grandfather provisions that apply to long-term care 
    insurance contracts issued before 1997.
    
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    Consumer Protection Requirements
    
        Under sections 7702B(b)(1)(F), 7702B(g), and 4980C, qualified long-
    term care insurance contracts and issuers of those contracts are 
    required to satisfy certain provisions of the model act and model 
    regulation promulgated by the National Association of Insurance 
    Commissioners (NAIC) for long-term care insurance as of January 1993. 
    The requirements relate to guaranteed renewability, unintentional 
    lapse, disclosure, prohibitions against post-claims underwriting, 
    inflation protection, and prohibitions against pre-existing conditions 
    exclusions and probationary periods. Section 4980C imposes an excise 
    tax on an issuer of a qualified long-term care insurance contract if, 
    after 1996, the issuer fails to satisfy certain requirements, including 
    requirements relating to application forms, reporting, marketing, 
    appropriateness of recommended purchase, standard format outline of 
    coverage, delivery of a shopper's guide, right to return, outline of 
    coverage, and incontestability. Most of these requirements are based on 
    the NAIC model act and regulation.
        The proposed regulations reflect the standards that were set forth 
    in Notice 97-31. For example, the consumer protection requirements will 
    be considered satisfied if a contract complies with State law in a 
    State that has adopted the related NAIC model or a more stringent 
    version of the model.
    
    Pre-1997 Long-Term Care Insurance Contracts
    
        Section 321(f)(2) of HIPAA provides that a contract issued before 
    January 1, 1997, is treated as a qualified long-term care insurance 
    contract if the contract met the ``long-term care insurance 
    requirements of the State'' in which the contract was sitused at the 
    time it was issued. Under the proposed regulations, the date on which a 
    long-term care insurance contract other than a group long-term care 
    insurance contract is issued is generally the date assigned to the 
    contract by the insurance company. In no event is the issue date 
    earlier than the date on which the policyholder submitted a signed 
    application for coverage to the insurance company. In addition, if the 
    period between the date of application and the date on which the long-
    term care insurance contract actually becomes effective is 
    substantially longer than under the insurance company's usual business 
    practice, then the issue date is the date the contract becomes 
    effective. For purposes of applying the grandfather rule of section 
    321(f)(2) to a group long-term care insurance contract, the issue date 
    of the contract is the date the group contract was issued. As a result, 
    coverage for an individual who joins a grandfathered group long-term 
    care insurance contract on or after January 1, 1997, is accorded the 
    same treatment under section 321(f)(2) as is accorded coverage for 
    those who joined the group before that date.
        For purposes of applying section 321(f)(2) of HIPAA to long-term 
    care insurance contracts issued before January 1, 1997, a material 
    change in the contract generally is considered the issuance of a new 
    contract. Notice 97-31 provides that a material change includes any 
    change in the terms of the contract altering the amount or timing of 
    any item payable by the policyholder (or certificate holder), the 
    insured, or the insurance company. Notice 97-31 also provides that the 
    exercise of an option or right granted to a policyholder under a 
    qualified long-term care insurance contract as in effect on December 
    31, 1996, does not constitute a material change.\1\
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        \1\ The definition of material change in Notice 97-31 is 
    narrower than the definition of material change for purposes of 
    other sections of the Code. For example, the exercise of an option 
    in a life insurance contract results in the loss of grandfathering 
    under section 7702 if the option only guarantees terms that are 
    likely to be available when the option is exercised.
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        After Notice 97-31 was issued, commentators recommended that 
    certain common practices should not cause long-term care insurance 
    contracts issued before January 1, 1997, to lose their grandfathered 
    status. In response to these comments, the proposed regulations provide 
    additional exceptions to the general rule that a material change in a 
    long-term care insurance contract issued before January 1, 1997, will 
    be considered the issuance of a new contract.
         The proposed regulations provide that the exercise of any 
    right provided to a policyholder (i.e., a right that can be exercised 
    without the issuer's consent and without other conditions, such as 
    underwriting) or the addition of any right that is required by State 
    law to be provided to the policyholder will not be treated as a 
    material change to a long-term care insurance contract.
         In addition, the proposed regulations provide that the 
    following practices will not be treated as material changes for 
    purposes of section 7702B: (1) Any change in the mode of premium 
    payment, such as a change from paying premiums monthly to quarterly; 
    (2) any classwide increase or decrease in premiums for contracts that 
    have been issued on a guaranteed renewable basis; (3) a reduction in 
    premiums due to the purchase of a long-term care insurance policy by a 
    member of the policyholder's family; (4) any reduction in coverage 
    (with correspondingly lower premiums) made at the request of a 
    policyholder; (5) the addition, without an increase in premiums, of 
    alternative forms of benefits that may be selected by the policyholder; 
    (6) the purchase of a rider to increase benefits under a pre-1997 
    contract if the rider would constitute a qualified long-term care 
    insurance contract if it were a separate contract; \2\ (7) the deletion 
    of a rider or provision of a contract (called an HHS rider) that 
    prohibited coordination of benefits with Medicare; and (8) the 
    effectuation of a continuation or conversion of coverage right under a 
    group contract following an individual's ineligibility for continued 
    coverage under the group contract.
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        \2\ Thus for example, the only coverage provided under the rider 
    must be coverage for qualified long-term care services and the 
    purchase must satisfy the consumer protection requirements of 
    section 7702B(g) of the Code. (This would not include protections 
    that apply only the first time a contract is purchased, i.e., 
    subsections (g)(2)(A)(i)(III), (V), (VII) (other than section 6B of 
    the NAIC model regulation), and (X), (g)(3), and (g)(4) of section 
    7702B. Similarly, subsections (c)(1)(A)(i) and (c)(2) of section 
    4980C would apply only the first time a contract is purchased.)
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        The proposed regulations include examples illustrating certain of 
    these standards. The exceptions to the general rule that a material 
    change results in the issuance of a new contract apply solely for 
    purposes of determining whether a pre-1997 insurance contract is 
    treated as a qualified long-term care insurance contract under section 
    7702B.\3\
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        \3\ The exceptions depart from the definition of material change 
    that would apply for purposes of other sections of the Code, 
    including sections 7702, 7702A, 101(f), and 264. These exceptions 
    are consistent with the purpose of section 7702B, which has the 
    effect of expanding the tax benefits for certain long-term care 
    insurance contracts. By contrast, sections 7702, 7702A, 101(f), and 
    264, for example, limit the tax benefits associated with certain 
    insurance products and, unlike pre-1997 long-term care insurance 
    contracts, apply to contracts with a substantial investment 
    orientation.
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        Comments are requested on these standards, including (1) whether 
    the material change rules in the proposed regulations should be limited 
    to pre-1997 long-term care insurance contracts that cannot have cash 
    surrender value; (2) whether there are any conditions under which the 
    expansion of coverage under a group long-term care insurance contract 
    in connection with a corporate merger, acquisition or similar 
    transaction should not constitute a material change; and (3) whether 
    the extension of a group long-term care contract to a collective 
    bargaining unit is a material change in all cases. For
    
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    example, should the extension of a group long-term care contract to a 
    bargaining unit after 1997 be treated as a material change if the 
    bargaining agreement for the unit has not been renewed since before the 
    group contract was first adopted?
        Comments also are requested on what the effective date of the final 
    regulations should be. It is intended that the regulations will not be 
    effective until after the end of a specified period following adoption 
    of the final regulations. Taxpayers may rely on these proposed 
    regulations for guidance pending the issuance of final regulations. If, 
    and to the extent, future guidance is more restrictive than the 
    guidance in these proposed regulations, the future guidance will be 
    applied without retroactive effect. In addition, until further notice, 
    taxpayers may continue to rely on Notice 97-31.
    
    Special Analyses
    
        It has been determined that this notice of proposed rulemaking is 
    not a significant regulatory action as defined in EO 12866. Therefore, 
    a regulatory assessment is not required. It has also been determined 
    that section 553(b) of the Administrative Procedure Act (5 U.S.C. 
    chapter 5) does not apply to these regulations, and because the 
    regulations do not impose a collection of information on small 
    entities, the Regulatory Flexibility Act (5 U.S.C. chapter 6) does not 
    apply. Pursuant to section 7805(f) of the Internal Revenue Code, this 
    notice of proposed rulemaking will be submitted to the Chief Counsel 
    for Advocacy of the Small Business Administration for comment on its 
    impact on small business.
    
    Comments and Public Hearing
    
        Before these proposed regulations are adopted as final regulations, 
    consideration will be given to any comments that are submitted timely 
    to the IRS (a signed original and eight (8) copies). All comments will 
    be available for public inspection and copying.
        A public hearing has been scheduled for May 13, 1998, at 10 a.m., 
    in room 2615, Internal Revenue Building, 1111 Constitution Avenue NW, 
    Washington, DC. Because of access restrictions, visitors will not be 
    admitted beyond the Internal Revenue Building lobby more than 15 
    minutes before the hearing starts.
        The rules of 26 CFR 601.601(a)(3) apply to the hearing.
        Persons that wish to present oral comments at the hearing must 
    submit written comments by April 2, 1998 and submit an outline of the 
    topics to be discussed and the time to be devoted to each topic by 
    April 2, 1998.
        A period of 10 minutes will be allotted to each person for making 
    comments.
        An agenda showing the scheduling of the speakers will be prepared 
    after the deadline for receiving outlines has passed. Copies of the 
    agenda will be available free of charge at the hearing.
    
    Drafting Information
    
        The principal author of these regulations is Katherine A. 
    Hossofsky, Office of Assistant Chief Counsel (Financial Institutions & 
    Products). However, other personnel from the IRS and Treasury 
    Department participated in their development.
    
    List of Subjects in 26 CFR Part 1
    
        Income taxes, Reporting and recordkeeping requirements.
    
    Proposed Amendments to the Regulations
    
        Accordingly, 26 CFR part 1 is proposed to be amended as follows:
    
    PART 1--INCOME TAXES
    
        Paragraph 1. The authority citation for part 1 continues to read in 
    part as follows:
    
        Authority: 26 U.S.C. 7805 * * *
    
        Par. 2. Sections 1.7702B-1 through 1.7702B-2 are added to read as 
    follows:
    
    
    Sec. 1.7702B-1  Consumer protection provisions.
    
        (a) In general. Under sections 7702B(b)(1)(F), 7702B(g), and 4980C, 
    qualified long-term care insurance contracts and issuers of those 
    contracts are required to satisfy certain provisions of the Long-Term 
    Care Insurance Model Act (Model Act) and Long-Term Care Insurance Model 
    Regulation (Model Regulation) promulgated by the National Association 
    of Insurance Commissioners (NAIC), as adopted as of January 1993. The 
    requirements for qualified long-term care insurance contracts under 
    sections 7702B(b)(1)(F) and 7702B(g) relate to guaranteed renewal or 
    noncancellability, prohibitions on limitations and exclusions, 
    extension of benefits, continuation or conversion of coverage, 
    discontinuance and replacement of policies, unintentional lapse, 
    disclosure, prohibitions against post-claims underwriting, minimum 
    standards, inflation protection, prohibitions against pre-existing 
    conditions exclusions and probationary periods, and prior 
    hospitalization. The requirements for qualified long-term care 
    insurance contracts under section 4980C relate to application forms and 
    replacement coverage, reporting requirements, filing requirements for 
    marketing, standards for marketing, appropriateness of recommended 
    purchase, standard format outline of coverage, delivery of a shopper's 
    guide, right to return, outline of coverage, certificates under group 
    plans, policy summary, monthly reports on accelerated death benefits, 
    and incontestability period.
        (b) Coordination with State requirements--(1) Contracts issued in a 
    State that imposes more stringent requirements. If a State imposes a 
    requirement that is more stringent than the analogous requirement 
    imposed by section 7702B(g) or 4980C, then, under section 4980C(f), 
    compliance with the more stringent requirement of State law is 
    considered compliance with the parallel requirement of section 7702B(g) 
    or 4980C. The principles of paragraph (b)(3) of this section apply to 
    any case in which a State imposes a requirement that is more stringent 
    than the analogous requirement imposed by section 7702B(g) or 4980C (as 
    described in this paragraph (b)(1)), but in which there has been a 
    failure to comply with that State requirement.
        (2) Contracts issued in a State that has adopted the model 
    provisions. If a State imposes a requirement that is the same as the 
    parallel requirement imposed by section 7702B(g) or 4980C, compliance 
    with that requirement of State law is considered compliance with the 
    parallel requirement of section 7702B(g) or 4980C, and failure to 
    comply with that requirement of State law is considered failure to 
    comply with the parallel requirement of section 7702B(g) or 4980C.
        (3) Contracts issued in a State that has not adopted the model 
    provisions or more stringent requirements. If a State has not adopted 
    the Model Act, the Model Regulation, or a requirement that is the same 
    as or more stringent than the analogous requirement imposed by section 
    7702B(g) or 4980C, then the language, caption, format, and content 
    requirements imposed by sections 7702B(g) and 4980C with respect to 
    contracts, applications, outlines of coverage, policy summaries, and 
    notices will be considered satisfied for a contract subject to the law 
    of that State if the language, caption, format, and content are 
    substantially similar to those required under the parallel provision of 
    the Model Act or Model Regulation. Only nonsubstantive deviations are 
    permitted in order for language, caption, format, and content to be 
    considered substantially similar to the requirements of the Model Act 
    or Model Regulation.
    
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    Sec. 1.7702B-2  Special rules for pre-1997 long-term care insurance 
    contracts.
    
        (a) Scope. The definitions and special provisions of this section 
    apply solely for purposes of determining whether an insurance contract 
    (other than a qualified long-term care insurance contract described in 
    section 7702B(b) and any regulations issued thereunder) is treated as a 
    qualified long-term care insurance contract for purposes of the 
    Internal Revenue Code.
        (b) Pre-1997 long-term care insurance contracts.--(1) In general. A 
    pre-1997 long-term care insurance contract is treated as a qualified 
    long-term care insurance contract, regardless of whether the contract 
    satisfies section 7702B(b) and any regulations issued thereunder.
        (2) Pre-1997 long-term care insurance contract defined. A pre-1997 
    long-term care insurance contract is any insurance contract with an 
    issue date before January 1, 1997, that met the long-term care 
    insurance requirements of the State in which the contract was sitused 
    on the issue date. For this purpose, the long-term care insurance 
    requirements of the State are the State laws (including statutory and 
    administrative law) that are intended to regulate insurance coverage 
    that constitutes ``long-term care insurance'' (as defined in section 4 
    of the National Association of Insurance Commissioners (NAIC) Long-Term 
    Care Insurance Model Act, as in effect on August 21, 1996), regardless 
    of the terminology used by the State in describing the insurance 
    coverage.
        (3) Issue date of a contract. (i) In general. The issue date of a 
    contract is the issue date assigned to the contract by the insurance 
    company, but in no event is the issue date earlier than the date the 
    policyholder submitted a signed application for coverage to the 
    insurance company. However, if the period between the date the signed 
    application is submitted to the insurance company and the date coverage 
    under the contract actually becomes effective is substantially longer 
    than under the insurance company's usual business practice, then the 
    issue date is the date coverage under the contract becomes effective 
    (if this is later than the issue date assigned to the contract by the 
    insurance company). A policyholder's right to return a contract within 
    a ``free-look'' period following delivery for a full refund of any 
    premiums paid is not taken into account in determining the contract's 
    issue date.
        (ii) Special rule for group contracts. The issue date of a group 
    contract (including any certificate issued thereunder) is the date on 
    which coverage under the group contract becomes effective.
        (iii) Exchange of contract or material change in a contract treated 
    as a new issuance. For purposes of this paragraph (b)(3)--
        (A) A contract issued in exchange for an existing contract after 
    December 31, 1996, is considered a contract issued after that date;
        (B) Any material change (as defined in paragraph (b)(4) of this 
    section) in a contract is treated as the issuance of a new contract 
    with an issue date no earlier than the date the material change goes 
    into effect; and
        (C) If a material change occurs with regard to one or more, but 
    fewer than all, of the certificates evidencing coverage under a group 
    contract, then the insurance coverage under the changed certificates is 
    treated as coverage under a newly issued group contract (and the 
    insurance coverage provided by any unchanged certificate continues to 
    be treated as coverage under the original group contract).
        (4) Material change. (i) In general. For purposes of paragraph 
    (b)(3) of this section, except as provided in paragraph (b)(4)(ii) of 
    this section, a material change means--
        (A) A change in the terms of a contract that alters the amount or 
    timing of an item payable by the policyholder (or certificate holder), 
    the insured, or the insurance company;
        (B) A substitution of the insured under an individual contract; or
        (C) A change (other than an immaterial change) in the eligibility 
    for membership in the group covered under a group contract.
        (ii) Exceptions. For purposes of this paragraph (b)(4), the 
    following changes are not treated as a material change:
        (A) A policyholder's exercise of any right provided under the terms 
    of the contract as in effect on December 31, 1996, or a right required 
    by applicable State law to be provided to the policyholder;
        (B) A change in the mode of premium payment (for example, a change 
    from monthly to quarterly premiums);
        (C) In the case of a policy that is guaranteed renewable or 
    noncancellable, a classwide increase or decrease in premiums;
        (D) A reduction in premiums due to the purchase of a long-term care 
    insurance contract by a family member of the policyholder;
        (E) A reduction in coverage (with a corresponding reduction in 
    premiums) made at the request of a policyholder;
        (F) The addition, without an increase in premiums, of alternative 
    forms of benefits that may be selected by the policyholder;
        (G) The addition of a rider (including any similarly identifiable 
    amendment) to a pre-1997 long-term care insurance contract in any case 
    in which the rider, if issued as a separate contract of insurance, 
    would itself be a qualified long-term care insurance contract under 
    section 7702B and any regulations issued thereunder (including the 
    consumer protection provisions in section 7702B(g) to the extent 
    applicable to the addition of a rider);
        (H) The deletion of a rider or provision of a contract (often 
    referred to as an HHS rider) that prohibited coordination of benefits 
    with Medicare; and
        (I) The effectuation of a continuation or conversion of coverage 
    right provided under a group contract following an individual's 
    ineligibility for continued coverage under the group contract.
        (5) Examples. The following examples illustrate the principles of 
    this paragraph (b):
    
        Example 1. (i) On December 3, 1996, A, an individual, submits a 
    signed application to an insurance company to purchase a nursing 
    home contract that meets the long-term care insurance requirements 
    of the State in which the contract is sitused. The insurance company 
    decides on December 20, 1996, that it will issue the contract, and 
    assigns December 20, 1996, as the issue date for the contract. Under 
    the terms of the contract, A's insurance coverage becomes effective 
    on January 1, 1997. The company delivers the contract to A on 
    January 3, 1997. A has the right to return the contract within 15 
    days following delivery for a refund of all premiums paid.
        (ii) Under paragraph (b)(3)(i) of this section, the issue date 
    of the contract is December 20, 1996. Thus, the contract is a pre-
    1997 long-term care insurance contract that is treated as a 
    qualified long-term care insurance contract.
        Example 2. (i) The facts are the same as in Example 1, except 
    that the insurance coverage under the contract does not become 
    effective until March 1, 1997. Under the insurance company's usual 
    business practice, the period between the date of the application 
    and the date the contract becomes effective is 30 days or less.
        (ii) Under paragraph (b)(3)(i) of this section, the issue date 
    of the contract is March 1, 1997. Thus, the contract is not a pre-
    1997 long-term care insurance contract, and, accordingly, the 
    contract must meet the requirements of section 7702B(b) and any 
    regulations issued thereunder to be a qualified long-term care 
    insurance contract.
        Example 3. (i) B, an individual, is the policyholder under a 
    long-term care insurance contract purchased in 1995. On June 15, 
    2000, the insurance coverage and premiums under the contract are 
    increased by agreement between B and the insurance company.
    
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        (ii) Under paragraph (b)(4)(i)(A) of this section, a change in 
    the terms of a contract that alters the amount or timing of an item 
    payable by the policyholder or the insurance company is a material 
    change in the contract. Thus, B's coverage is treated as coverage 
    under a contract issued on June 15, 2000, and, accordingly, the 
    contract must meet the requirements of section 7702B(b) and any 
    regulations issued thereunder in order to be a qualified long-term 
    care insurance contract.
        Example 4. (i) C, an individual, is the policyholder under a 
    long-term care insurance contract purchased in 1994. At that time 
    and through December 31, 1996, the contract met the long-term care 
    insurance requirements of the State in which the contract was 
    sitused. In 1996, the policy was amended to add a provision 
    requiring the policyholder to be offered the right to increase 
    dollar limits for inflation every three years (without the 
    policyholder being required to pass a physical or satisfy any other 
    underwriting requirements). During 2002, C elects to increase the 
    amount of insurance coverage (with a resulting premium increase) 
    pursuant to the inflation protection provision.
        (ii) Under paragraph (b)(4)(ii)(A) of this section, an increase 
    in the amount of insurance coverage at the election of the 
    policyholder (without the insurance company's consent and without 
    underwriting or other limitations on the policyholder's rights) 
    pursuant to a pre-1997 inflation protection provision does not 
    constitute a material change in the contract. Thus, C's contract 
    continues to be a pre-1997 long-term care insurance contract that is 
    treated as a qualified long-term care insurance contract.
    Michael P. Dolan,
    Deputy Commissioner of Internal Revenue.
    [FR Doc. 97-33986 Filed 12-31-97; 8:45 am]
    BILLING CODE 4830-01-U
    
    
    

Document Information

Published:
01/02/1998
Department:
Internal Revenue Service
Entry Type:
Proposed Rule
Action:
Notice of proposed rulemaking and notice of public hearing.
Document Number:
97-33986
Dates:
Written comments must be received by April 2, 1998. Outlines of topics to be discussed at the public hearing scheduled for May 13, 1998, must be received by April 2, 1998.
Pages:
35-39 (5 pages)
Docket Numbers:
REG-109333-97
RINs:
1545-AV56: Qualified Long-Term Care Services and Insurance
RIN Links:
https://www.federalregister.gov/regulations/1545-AV56/qualified-long-term-care-services-and-insurance
PDF File:
97-33986.pdf
CFR: (2)
26 CFR 1.7702B-1
26 CFR 1.7702B-2