---
title: "Mutual of Omaha - Important Update: Long-Term Care Personal Worksheet Form Changes Effective April 1, 2026"
description: Mutual of Omaha's Long-Term Care Personal Worksheet Form Changes Effective April 1, 2026
image: https://www.ltcipartners.com/hubfs/Brokerage/Brokerage%20Logos%20for%20Blogs/MOO%20Logo-1%20(1).png
---

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Mar 30, 2026 • [LTCI Partners](https://www.ltcipartners.com/carriernews/author/ltci-partners)

## Mutual of Omaha - Important Update: Long-Term Care Personal Worksheet Form Changes Effective April 1, 2026

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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.

To read the full express report, [click here](https://blogs.mutualofomaha.com/express/index.php/2026/03/08/important-update-long-term-care-personal-worksheet-pws-form-changes-effective-april-1-2026/?utm_medium=email&utm_content=2&utm_source=hs_email). 

## Written by [LTCI Partners](https://www.ltcipartners.com/carriernews/author/ltci-partners)

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