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Section 13, Part B.1 - Long Term Care Insurance - Detailed Questions - FOR NEW HOUSEHOLDS ONLYSection 13, Part B.1 collects detailed information about long term care insurance policies reported in Part A.2.For definitions Information Booklet » What is the name of the insurance company for "your (1st, 2nd, 3rd)"
long term care policy? [enter text] __________________
Briefly describe the policy. [enter text] ______________ Are the policy premiums paid -
Are any premiums paid through payroll deductions? Since the first of the reference month, what was your or your household total expense for this insurance policy? [enter value] ______________ * Enter the actual amount the household paid. Do not include any expenses paid for the household by others How much was paid this month? [enter value] ______________ * Enter 'C' for a combined expense What other type of policy is the "long term care insurance" combined with?
Which property (ies) does this policy cover? [enter text] ______________ Do you or any members of your household have any or make payments for any other "long term care insurance" policy? End of Section 13B Long Term Care Insurance Go to Section 13 Part B - Life/Disability Insurance - FOR NEW HOUSEHOLDS ONLY » Go to Section 14 Part A.1 - Hospitalization and Health Insurance » Go to CAPI Home Page »
Last Modified Date: April 12, 2011 |