Issuer disclosures certified long-term care insurance

Issuer Disclosures for the payment of certified long-term care insurance using qualified long-term care distributions

Section 401(a)(39)(E) of the Internal Revenue Code (IRC) permits distributions from a defined contribution plan for the payment of certified long-term care insurance premiums if certain disclosure requirements are met, including that the issuer of the certified long-term care insurance must file an “Issuer Disclosure” with the IRS.

IRC Section 401(a)(39)(E)(iii) provides that a long-term care premium statement will be accepted by a defined contribution plan only if you (the issuer) file an Issuer Disclosure with the IRS describing the specific coverage life insurance product that is the subject of the long-term care premium statement.

Use the procedures on this webpage to make an Issuer Disclosure only if you plan on filing a long-term care premium statement with a defined contribution plan with respect to a policyholder’s request for qualified long-term care distributions.

Procedures for submitting an Issuer Disclosure with the IRS

Submit an Issuer Disclosure to the IRS, Employee Plans Division, using the procedures described on this webpage.

Caution: The procedures for submitting an Issuer Disclosure may be subject to change. Always check this webpage for the most current instructions before filing any Issuer Disclosure.

What information to include in an Issuer Disclosure

An Issuer Disclosure must include the following information:

• Contact information of the issuer, including the name, address, and taxpayer identification number. When providing the issuer’s contact information, include a person to contact at the issuer with that contact person’s information, including the telephone number of the contact person.
• A general description of the type of long-term care coverage provided.
• Statements that:
  • The coverage offered is certified long term care insurance (as defined in IRC Section 401(a)(39)(C)); and
  • The coverage offered has been filed with and approved by a State regulatory authority, including the identity of the State regulatory authority that approved the coverage.
• A penalties of perjury declaration that includes the following language and is signed by the issuer: “Under penalties of perjury, I declare that I have examined this disclosure to the IRS, and, to the best of my knowledge and belief, the facts presented in this disclosure are true, correct, and complete.”

Caution: If any of the required information is missing, the IRS will treat the disclosure as incomplete.

Where to submit an Issuer Disclosure to the IRS

Send the Issuer Disclosure to the Employee Plans Division:
Fax: 855-224 1311. 

On the cover sheet, include the following language: “Issuer Disclosure to satisfy the reporting requirement in IRC Section 401(a)(39)(E)(iii).”

What happens after you file

Once the IRS receives an Issuer Disclosure, it will be reviewed for its completeness. You will receive a response from the IRS:

If the Issuer Disclosure is incomplete

• The IRS will contact the person listed on the Issuer Disclosure.
• You will have 21 calendar days from the date of the contact to provide the missing information.
• Once received, the IRS will resume its review.

If the Issuer Disclosure is complete

• The IRS will send an acknowledgment letter to you at the address provided on the Issuer Disclosure.
• This letter will indicate that the Issuer Disclosure satisfied the requirements in IRC Section 401(a)(39)(E)(iii).
• The acknowledgement letter will include a unique alphanumeric identifier associated with that Issuer Disclosure.

Keep the acknowledgment letter for your records.

After receiving the acknowledgment letter, you are then permitted to file a long-term care premium statement with a plan administrator of a defined contribution plan upon the request of a participant in the defined contribution plan.

Additional Information:

For more detailed information relating to qualified long-term care distributions, including the filing and content requirements of an Issuer Disclosure, the content requirements of a long-term care premium statement, and the reporting requirements for Form 1099-LPS, Long-Term Care Premiums Paid Statement, see Q&As A-1 through A-11 of Notice 2026-33 PDF, 2026-24 IRB (June 8, 2026).