Long-Term Care Insurance

Long-term care goes beyond medical care and nursing care to include the assistance you could need if you ever have a chronic illness or disability that leaves you unable to care for yourself for an extended period of time.

At KMi, we are dedicated to helping you navigate the complicated and changing environment related to long-term care. We will begin with the basics and then move to breaking down how long-term care insurance (LTC) works, if you will qualify, and what the costs will likely be if you do.

While we represent all of the major insurance carriers, the LTC market in Washington State has shifted significantly and essentially collapsed. There currently aren’t any private carries accepting applications for individuals. There are some carriers accepting applications for employers depending on the number of benefit eligible employees, but we don’t know if this will continue. Carriers have continued to monitor the risk environment created by the WA Cares Fund, and while they are committed to offering LTC products, the significant increase in volume has exceeded their capacity for processing before the November 1^st deadline for the opt out exemption under the WA Cares Fund payroll tax. We will likely see carriers resume sales of LTC in WA after the deadline has passed, and will update our website accordingly.

Click here for the Long-Term Care buyer's guide.

The WA Cares Fund is a publicly funded insurance program that will provide a basic level of benefits for long term care services. With the passage of the Long-Term Services and Supports Trust Program, Washington is the first state in the nation to create such a program. Financing for the program will begin January 1, 2022 through a mandatory payroll tax. Employers are not required to contribute to the program, but are required to handle the collection and remittance of the employee-paid taxes.

Enrollment will be automatic for anyone receiving a W-2, as taxes will be deducted from payroll. Some self-employed people will need to actively enroll. To become vested in the program, and therefore eligible to receive benefits, someone would need to contribute for 10 years without interruption of 5 or more years or contribute for 3 of the 6 years prior to receiving benefits. For a year to qualify toward vesting, one would need to work for at least 500 hours during the year. Employees may opt out if enrolled on a qualified LTC policy prior to November 1, 2021. This may be of consideration for higher wage earners, young workers with high earning potential, those that will retire before becoming vested in the program, or those that plan to retire outside of Washington State. This can be a lengthy process, so please reach out as soon as possible if you are interested in finding out more about this option. Many self-employed individuals are exempt, but may choose to opt in. To do so, they must elect coverage by January 1, 2025 or within 3 years of becoming self-employed for the first time.

Beginning January 1, 2025, eligible beneficiaries will be able to access $100 of coverage per day for LTC services, with a lifetime cap of $36,500 per person. This amount will be adjusted at regular intervals to adjust for inflation. To be eligible, someone would require assistance with 3 out of 10 activities of daily living (ADLs).
For many people that need these services, neither the daily limit or lifetime maximum will be enough to cover all their services. Private LTC polices often have higher benefit amounts and more flexibility.

WA Cares Fund homepage
Employment Security Department newsroom
DSHS informational flyer
LTC tax webinar recordings in conjunction with The Business Guides (Click the link and the mp4 file should automatically download to your device. Open it in your media player. There are slides in addition to audio.):
- LTC tax webinar for employers (Ignore the 60 seconds of silence between minutes 1:16:22-1:17:20)
- LTC tax webinar for bookkeepers (Ignore the 40 seconds of silence between minutes 3:20-4:00)