Effective April 1, 2026, updates are being made to the Long-Term Care Personal Worksheet for all states except California and Florida. The only change to the worksheet is an update to the Rate Increase History Grid. These updates apply to both paper and electronic applications.
LTC Personal Worksheet Updates
ICC23-470484_2026 (replaces ICC23-470484)
AL, AK, AR, CO, GA, ID, IL, IA, KS, KY, LA, ME, MD, MA, MI, MN, MS, MO, NE, NV, NH, NM, NC, OH, OK, OR, PA, PR*, RI, TN, TX, UT, VT, VA, WA, WV, WI, WISE*, WY
ICC23-470484_SPPR_2026 (replaces ICC23-470484_SPPR)
PR Spanish*
470484_2026 (replaces 470484)
AZ, CT, DE, DC, HI, IN, MT, NJ, NY, ND, SD
470484_SC_2026 (replaces 470484_SC)
SC
The LTC Personal Worksheet cannot be ordered as a standalone form and is included within the LTC application packet. Application packet covers will be updated to show “_2026” instead of “_2025” (except CA and FL).
Forms recently replaced will no longer be accepted after April 30, 2026.
What Producers Should Do
- Begin using the 2026 application packets starting April 1, 2026.
- Ensure all old application versions are retired by April 30, 2026.
- Verify that both paper and electronic submissions use the updated materials.
If you have any questions about the transition or application materials, please reach out to your LTC support team.
Important Update: Long-Term Care Personal Worksheet Form Changes Effective April 1, 2026
#GoldenCareAgent