Sec. 3. Long-term care insurance benefits
1,247 words·~6 min read·
/bill/117/hr/4289/ih/section-3A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
Title II of the Social Security Act ( 42 U.S.C. 401 et seq. ) is amended by adding at the end the following: Every individual who— has attained retirement age (as defined in section 216(l)(1)); has filed an application for long-term care insurance benefits; is insured for long-term care insurance benefits (as determined under subsection (c)) at the time such individual’s application is filed; and has a continual serious functional disability (as defined in subsection (d)) and, at the time such individual’s application is filed, has had such disability for a substantial period of time (as determined under subsection (e)), shall be entitled to a long-term care insurance benefit for each month beginning with the 1st month in which the individual meets the criteria specified in paragraphs
(1)through (4), and ending with the earlier of the month in which the individual dies or the 1st month in which the individual no longer has a continual serious functional disability (as so defined). Such individual’s long-term care insurance benefit for each month shall be an amount equal to the product of— an estimate, to be determined by the Secretary of Health and Human Services in consultation with the Department of Labor, of the median cost of 6 hours per day of paid personal assistance in the United States, indexed to wages in the long-term care sector, multiplied by the ratio (not greater than 1) of the number of quarters of coverage the individual has during the applicable base period (as defined in subsection (c)(2)) to 40. For purposes of subsection (a), an individual shall be insured for long-term care insurance benefits in any month if the individual has 6 quarters of coverage during the applicable base period. For purposes of this subsection, the term applicable base period means the period that begins with the 1st quarter of 2022. For purposes of subsection (a), an individual shall be considered to have a continual serious functional disability if the person is a chronically ill individual (as determined under section 7702B(c)(2) of the Internal Revenue Code of 1986) and is expected to remain a chronically ill individual (as so determined) for at least 1 year or until the individual’s death. For purposes of subsection (a), a substantial period of time means— in the case of an individual who, at the time described in paragraph (3), has average indexed monthly earnings for long-term care equal to or less than the dollar amount representing the 40th percentile in the table established under subsection
(f)for such calendar year, 12 months; and in the case of an individual who, at such time, has average indexed monthly earnings for long-term care greater than such dollar amount, 12 months plus 1 additional month for each 1.25 percentile interval above the 40th percentile for which the individual’s average indexed monthly earnings for long-term care would attain (as specified in such table). The Commissioner of Social Security shall establish a table, for each calendar year beginning with calendar year 2022, setting forth— the dollar amount representing the 40th percentile among the average indexed monthly earnings for long-term care (as determined under subparagraph (B)) of each individual who has attained age 62 and whose primary insurance amount is first computed during such calendar year (or, for calendar year 2032, during any previous calendar year); and the dollar amounts representing percentiles over 40 (increasing linearly from 40 in intervals of 1.25) among the average indexed monthly earnings for long-term care (as so determined) of each such individual. For purposes of this subsection, the average indexed monthly earnings for long-term care of an individual shall be determined under section 215(b) as if such section were amended— in paragraph (2)(A), by striking reduced— and all that follows through the end and inserting reduced by the number of benefit computation years for which no wages were paid in and no self-employment income credited. ; and in paragraph (2)(B)(ii), by striking 1950 and inserting 2021 . The time described in this paragraph is— in the case of an individual who has 40 quarters of coverage during the applicable base period (as defined in subsection (c)(2)) prior to becoming entitled to old-age insurance benefits, the time at which the individual’s primary insurance amount was first computed with respect to the individual’s application for such benefits; and in the case of any other individual, the time at which the individual files an application for long-term care insurance benefits under this section. The Commissioner of Social Security shall provide to each individual entitled to a long-term care insurance benefit under this section, as soon as practicable following the first day of the first month of such entitlement, information describing the steps the individual may take to obtain long-term care, including an explanation of the services (including care planning, care management, and administrative services for hired care providers, by referral or in-house, for a fee) provided by, and the appropriate contact information for, the Aging and Disability Resource Centers described in section 202(b)(8) of the Older Americans Act of 1965 and the area agencies on aging (as defined in section 102(6) of such Act). Any person may submit applicable information with respect to an individual’s application for long-term care insurance benefits, an annual statement described under subsection (i)(2), or any other information required to be submitted by the individual under this title, including, as applicable, the individual’s representative, or any family member or other appropriate person. A long-term care insurance benefit payment shall not be regarded as income and shall not be regarded as a resource for any month, for purposes of determining the eligibility of the recipient (or the recipient’s spouse or family) for benefits or assistance under any Federal program or under any State or local program financed in whole or in part with Federal funds. An individual entitled to a long-term care insurance benefit for a month during a calendar year shall, in any case in which such individual hires an employee who is not a family member to provide paid personal care to the individual during such month, comply with all applicable State and Federal laws relating to— the payment of a minimum wage; and the withholding of payroll taxes and other employment-related taxes. An individual entitled to a long-term care insurance benefit for a month during a calendar year shall submit a statement to the Commissioner of Social Security at least once during such calendar year, as directed by the Commissioner— affirming that the individual— continues to have a continual serious functional disability (as defined in subsection (d)); and is in compliance with the laws described in paragraph (1); and specifying the country of residence of the individual. No long-term care insurance benefit shall be payable to an individual for any month— with respect to which the individual fails to satisfy any of the requirements described in the preceding paragraphs of this subsection; or beginning after the fifth consecutive year with respect to which the individual has reported, in the annual statement required under paragraph (2), a country of residence other than the United States (including any territory of the United States). . Section 1143(a)(2) of the Social Security Act ( 42 U.S.C. 1320b–13 ) is amended— in subparagraph (D), by striking and at the end; in subparagraph (E), by striking the period at the end and inserting ; and ; and by adding at the end the following: an estimate of the potential long-term care insurance benefits payable to the individual. .
Connectionstraces to 1
Traces to 1 document
U.S. Code
1 reference not yet in our index
- 42 USC 1320b–13
Citation graph
cites case law
Cites 2Cited by 0 across 0 sources