Recording Evaluation Information

Recording Evaluation Information – Padma’s Case

Padma Das picture.

Before you move on to evaluate the next case you should record your evaluation results for Padma’s annuity on Padma’s Annuity Data Worksheet (DHS-5532) (PDF) and on her MA-LTC Case Checklist (DHS-5590).

To Do: Take out your copy of Padma’s DHS-5532. Click on each of the following links to learn the information that should be recorded:

FYI icon. Beneficiary Designation.

Based on the activity, we know that DHS has been named the preferred remainder beneficiary of Padma’s annuity. Complete the “Designate DHS PRB” line of the “MA-LTC Information” section.

FYI icon. Funding Source.

Update the “Funded By” section found in the “MA-LTC Information” section of the DHS-5532 with the information provided on the DHS-5143 (annuity was funded by a court-ordered settlement) and in the annuity contract (Padma purchased the contract with $50,000.00 of the court-ordered settlement).

FYI icon. Other Information.

Notice there are three lines left in the “MA-LTC Information” section that have not been completed.
Annuity Transaction - You have determined that an annuity transaction occurred on the date Padma’s annuity was annuitized (CM -8 months/ 30/ YY).

Death Benefit - You determined that Padma’s annuity allows for someone other than the surviving spouse to be designated as a beneficiary.

Transfer Evaluation - You will complete this line when we discuss the second MA-LTC annuity requirement.

To Do: Now, take out your copy of Padma’s MA-LTC Case Checklist (DHS-5590). Update the Annuity line found on page 2 of the checklist to indicate the annuity verification has been provided and that DHS has been designated as the preferred remainder beneficiary.

Page 4

Designating DHS as the PRB - Designation Activity

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