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WA Cares Fund:
Long-Term Services and Supports (LTSS) Trust Act

(scroll down to advance to the state's website or to visit the LTC +Life Insurance enrollment site)

 

In 2019 the state enacted a long-term care (LTC)  insurance benefit for all eligible Washingtonians, funded by worker contributions into a Trust Fund, now known as the WA Cares Fund.   Under this law, individuals will have access to a lifetime benefit of $36,500 that will be adjusted annually for inflation.*

Beginning in January 2022, non-exempted workers will pay .58% of wages earned. Beginning in January 2025, workers who have vested in the Fund and need long-term care will be able to access their earned LTSS benefits. Please see the sample chart below.

 

Annual Salary Estimated Monthly
Payroll Contribution

Calculate your estimated contribution using the following:
Annual Salary x .58% = Annual LTSS Trust Contribution

$50,000

$24.17

$100,000

$48.33

$150,000

$72.50

$200,000

$96.67

$300,000

$145.00

$400,000

$193.33

 

Owners of private long-term care insurance may "opt-out" of the Trust Act permanently by applying for an exemption.  Exemption rules and definitions are pending finalization from the Washington State Employment Security Department’s (ESD).  On Wednesday 4/21/2021, Governor Inslee signed into law SHB 1323, formalizing the “purchase by” deadline of November 1, 2021 for Long-Term Care Insurance intended to qualify for exemption from the WA Cares Fund.

The decision to own long-term care coverage and opt-out from the WA Cares Fund is an individual and personal decision. You also have the choice to participate in the Fund and own private LTC coverage. Once an employee is exempt, they are permanently ineligible for benefits from the WA Cares Fund.

Below you will find an interpreted benefits summary of the WA Cares Fund and comparison to the LTC + Life Insurance plan. Refer to the Washington State Department of Social and Health Services and http://wacaresfund.wa.gov for additional information.

 

Plan Design Specifications
WA Cares Fund (LTSS Trust)*
LTC + Life Insurance Plan
     
Monthly Benefit Amount (in today's dollars) $3,000 / Month $1,000 - $6,000 / Month
Total Benefit Amount (in today’s dollars) $36,500 $50,000 - $300,000

Death Benefit/Life Insurance

 None YES
Benefit Increase Option  Subject to review by Trust Commission, not to exceed the Washington Consumer Price Index NO
Waiting Period (Vesting) At least 10 years at any point in your life without a break of 5 or more years within those 10 years, or 3 of the last 6 years and at least 500 hours per year during those years.* None
Payment Type Payroll Contribution Voluntary Payroll Deduction
Program Cost .58% of wages Rates based on age, nicotine/non-nicotine status, and benefit amount elected
Qualifying Benefit Triggers 3 of 10 Activities of Daily Living and other defined issues* 2 of 6 Activities of Daily Living or Severe Cognitive Impairment such as Alzheimer's Disease or Dementia
Covered Benefits Professional or personal care in your home, a licensed residential facility or a nursing facility and other long-term care services.  Visit the DSHS website for additional benefits. Designed to provide coverage for one or more necessary or medically necessary diagnostic, preventive, therapeutic, rehabilitative, maintenance or personal care services that are provided in a long-term care facility, in the community or in your home.  The plan provides coverage in the form of a fixed dollar indemnity benefit, by accelerating 4% of the death benefits available under your certificate for long-term care expenses.  Visit "How it Works" on the LTC + Life Insurance enrollment website.
Is Severe Cognitive Impairment an Independent Trigger? NO YES
Portable across state lines? NO YES (within US only)
Reimbursement vs Cash Benefit Payments Reimbursement Cash
Contract oversight by Washington OIC NO YES
Significant pre-existing conditions approved YES YES (up to age 70)

 

 

Go to the LTC + Life Insurance Website

 

 

 

* WA Cares Fund (LTSS Trust Act) Disclaimer:  Site references include http://wacaresfund.wa.gov and https://www.dshs.wa.gov/altsa/stakeholders/long-term-services-and-supports-ltss.  Material provisions of the Program are subject to future rule making and regulatory recommendations by the Washington State Legislature and members of the Trust Commission. This content is an interpreted summary based on the best available information at the time of publication. It is not to be used as financial, legal, or tax advice.  Refer to the Washington State Department of Social and Health Services and other official state resources for final LTSS Trust Act details.