Long Term Care Agreement Sample Contracts

Exhibit 26(d)(9) LONG TERM CARE AGREEMENT This agreement is a part of the policy to which it is attached and is subject to all its terms and conditions. This agreement is effective as of the policy date of this policy unless a different effective date...
Long Term Care Agreement • August 28th, 2012 • Minnesota Life Individual Variable Universal Life Account

This agreement is a part of the policy to which it is attached and is subject to all its terms and conditions. This agreement is effective as of the policy date of this policy unless a different effective date is shown on the policy data pages.

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Contract
Long Term Care Agreement • November 16th, 2021

Long Term Care Agreement for Foster Parents or Relative Caregivers RE: CHILD’S NAME This agreement is entered into between DCYF and (foster parent/relative caregiver name) as a Long Term Care Agreement. It has been determined in a share planning meeting that it is in(child’s name) best interest to remain in the home of (foster parent/relative caregiver name) and be raised by them as a member of their family until he/she reaches the age of 18.It has also been determined that other permanent plans, such as return home, adoption, third party custody andguardianship are not appropriate options for this child. I/We, (foster parent/relative caregiver name), agree to be the caregiver(s) for (child’s name) until he/she reaches the age of 18. I/We will not ask for him/her to be removed from our home, except under serious, unusual circumstances that cannot be alleviated by services provided by DCYF. I/We understand that this is a foster care placement and that the child will continue to be a dep

Long-Term Care Agreement Supplemental Application
Long-Term Care Agreement • November 1st, 2013

THIS AGREEMENT IS INTENDED TO BE A TAX QUALIFIED LONG-TERM CARE INSURANCE BENEFIT UNDER SECTION 7702B(b) OF THE INTERNAL REVENUE CODE. BENEFITS PAID UNDER THIS ACCELERATED BENEFIT AGREEMENT FOR LONG-TERM CARE COVERAGE MAY BE TAXABLE. IF SO, YOU OR YOUR BENEFICIARY MAY INCUR A TAX OBLIGATION. AS WITH ALL TAX MATTERS, YOU SHOULD CONSULT YOUR PERSONAL TAX ADVISOR TO ASSESS THE IMPACT OF THIS BENEFIT.

Long Term Care Agreement
Long Term Care Agreement • March 25th, 2010

This agreement is a part of the policy to which it is attached and is subject to all its terms and conditions. This agreement is effective as of the policy date of this policy unless a different effective date is shown on the policy data pages.

Long Term Care Agreement for Foster Parents or Relative Caregivers
Long Term Care Agreement • November 16th, 2021

It has been determined in a share planning meeting that it is in   (child’s name) best interest to remain in the home of   (foster parent/relative caregiver name) and be raised by them as a member of their family until he/she reaches the age of 18. It has also been determined that other permanent plans, such as return home, adoption, third party custody and guardianship are not appropriate options for this child.

Contract
Long Term Care Agreement • February 12th, 2019
Contract
Long Term Care Agreement • February 11th, 2019

DEPARTMENT OF CHILDREN, YOUTH, AND FAMILIES (DCYF)Long Term Care Agreement for Foster Parents or Relative Caregivers RE: CHILD’S NAME This agreement is entered into between Children’s Administration and (foster parent/relative caregiver name) as a Long Term Care Agreement. It has been determined in a share planning meeting that it is in (child’s name) best interest to remain in the home of (foster parent/relative caregiver name) and be raised by them as a member of their family until he/she reaches the age of 18. It has also been determined that other permanent plans, such as return home, adoption, third party custody and guardianship are not appropriate options for this child. I/We, (foster parent/relative caregiver name), agree to be the caregiver(s) for (child’s name) until he/she reaches the age of 18. I/We will not ask for him/her to be removed from our home, except under serious, unusual circumstances that cannot be alleviated by services provided by Children’s Administration. I/

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