ABOUT GROUP-SPONSORED INSURANCE COVERAGE

​We had a carrier that that we offered, which provided an employer-sponsored program that qualifies for employees to opt-out of Washington State’s Long-Term Care tax. By purchasing coverage prior to 11/1/2021, employees could then apply for a permanent tax waiver from the State. Not only did the program provide the opportunity for paying less in taxes, it includes better coverage than the State’s program. Unfortunately, this option is no longer available, since the state's deadline to enroll in coverage in order to apply to opt out has passed.

Benefits
The program is a Life insurance policy with a Long-Term Care rider, providing two types of coverage in one.  

1. Life Insurance: You choose the amount of life insurance you would like, from $40,000 to $250,000.
2. Long-Term Care: The plan will provide you a benefit for up to 25 months. The amount payable will be 4% of the Life insurance amount you chose. For example, if you choose Life benefits of $70,000 you would receive Long-Term Care payments of $2800 per month.

​Group-Sponsored Life with LTC versus the State Program - Cost​
A main difference between insurance coverage and the State’s program is the way your cost is calculated. The state will charge a tax on every dollar that you earn; as your wages increase your State tax will increase. Under the insurance plan your rate will continue at the your initial rate - based on your age at the time of purchase and your tobacco use status.

Calculate your Premium, as well as your Washington State Tax, using our easy calculators below.
FOR THE INSURANCE RATE:  Enter your AGE, whether you are a TOBACCO USER, and the amount of LIFE coverage you would like.
FOR THE STATE TAX:  Enter your ESTIMATED WAGES and your AGE.

1.  Employee can choose from $40,000 to $250,000 in benefits.  If an employee enrolls, their spouse can also enroll.
       Working spouse can choose from $40,000 to $150,000 in benefits.  Non-working spouse can choose from $40,000 to $50,000 in benefits.
2.  If older than 55, this figure assumes 10 years of payments/accumulation.
3.  Tax assumes you receive a wage increase of 2% every year.  If older than 55, this figure assumes 10 years of tax payments.

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​Group-Sponsored Life with LTC versus the State Program -  Benefits​
Below are the main differences between the group-sponsored insurance and Washington State's program:

Life with Long-Term Care	Versus	Washington State Long-Term Care
​Employees ​​age 18-70	Eligible Employees	​​All W-2 employees who do not opt out
​You choose your coverage amount from $40,000 up to a maximum of $250,000	​Life Insurance	​None included
​Provides up to the amount you choose for Life Insurance coverage. For example, if you choose $70,000 in Life coverage, you would be able to use up to $70,000 for Long-Term Care needs.	Long-Term Care Lifetime Maximum	​Provides up to $36,500 per lifetime. May increase over time if the state approves increases, which would be based on the Washington State Consumer Price Index, but there is no guaranteed increase.
​Once you qualify for benefits you would receive 4% of your life insurance benefit for up to 25 months. For example, if you choose $70,000 in Life coverage you would receive $2800/month to use for long-term care.	Long-Term Care Benefit Payments	​This is a reimbursement program. You send receipts to the state and they will reimburse you. They will require you to use certain providers and reimburse at Medicaid payment levels. Providers can bill you for charges not covered by the state program.
​You can enroll your spouse/domestic partner for coverage if you enroll on coverage yourself.	​Spouse Enrollment	Your spouse/domestic partner would only be eligible if they work as a W-2 employee and pay the state tax through their job.
Rates are based on your age and tobacco use in the last 12 months. These rates do not increase every year as you get older.  We call this “locking in” your rates at your age on the policy effective date.	Rates	​The tax is currently set to start at 0.58% of your wages. Wages include base, bonus, commission, overtime, etc. with no cap. As your wages increase, the amount you pay in tax will increase.
​You can qualify in one of two ways. Either you must have a loss of 2 of 6 Activities of Daily Living or you must have a Cognitive Impairment. Activities include bathing, continence, dressing, eating, toileting and transferring.	Needing Benefits	​You must have a loss of 3 of 10 Activities of Daily Living. Activities include medication management, personal hygiene, eating, toileting, cognitive functioning, transfer assistance, body care, bathing, ambulation/mobility, and dressing.
​You must pay the first premium through payroll deduction. Then ​as long as you continue to pay premiums for the policy you will be eligible for benefits. Note that benefits will not be paid for a period of illness that begins within the first 6 months after the policy effective date due to a pre-existing condition.	​Eligibility for Benefits	​You must pay into the program for 10 years (without more than a 5-year consecutive break in paying in) to be permanently eligible for benefits. You can become temporarily eligible for benefits once you pay into the program for at least 3 years, but there are certain requirements. There are also provisions for partial benefits (for those nearing retirement) and for temporary benefits (for those who have paid into the program for at least 3 of the 6 years prior to applying for benefits).
​This benefit is available anywhere in the US and its territories. If you retire or change employment, you can take this policy with you. The benefits and the premium would remain the same – you would just pay the premiums from your bank account rather than through payroll deduction.	​Portability	​May be able to use out of state. Starting July 2026, workers can choose to continue participating in WA Cares if they move out of state. They must have paid into the program at least 3 years (500 hours each year) prior to moving and must opt in within a year of moving out of state.
​Accumulated Cash Value if you decide to surrender (cancel) the policy.	​“Walk Away” Benefits	​None – no refund of premiums will be allowed.
Once you reach age 95. Premiums will also be waived at any time that you are receiving Long-Term Care benefits.	​Payments End	​Once retired and no longer earning W-2 wages.

Get more LTC Information