The good news: Washington is the first state in the country to offer long-term care insurance for its aging residents. The bad news: As with most brand-new ideas, there are a few kinks in the system.

What the Washington Cares Act does is provide long-term care benefits—including home care—of up to a lifetime maximum of $36,500 per person. That amount will increase with inflation. However, notes Seattle attorney Tamara Roe, “This is an earned benefit program—only those who contribute premiums are eligible for benefits.”

How do I qualify?

To be eligible, you must have qualifying health needs and be vested in the fund, which requires working at least 500 hours per year in Washington state. “Once you have paid into the program for at least 10 years, without more than a five-year consecutive break in paying into the program, you will be permanently vested,” says Roe, who practices employment and labor law at Montgomery Purdue.

Temporary vesting is another option: “If you need benefits before becoming permanently vested, the state will look back six years from the date you apply for benefits. If you have paid in for at least three of those six years, you will be eligible for benefits.”

What if I’m retiring soon?

If you retire in less than three years from the date you start contributing to the plan, you will not be eligible for benefits. However, even if you know you will be retiring before eligibility, you are still required to start contributing as of Jan. 1, 2022, when Washington state employers will start taking a payroll tax tax out of paychecks.

How much will it cost me?

“Washington State employees will  be assessed a premium equal to $0.58 per $100 of earnings—for example, if an employee earns $1,500 per biweekly pay period, they would be assessed a premium of $8.70 per pay period,” Roe explains. “There is no cap on the amount of premiums that can be collected from Washington workers—this means highly compensated employees will pay more into the fund than moderately compensated employees, but will only be eligible to receive the same lifetime benefit of $36,500.

“The premium rate will be reassessed every two years, but it is capped at 0.58% and may not ever exceed that amount.”

Can I opt out?

The only way to opt out of paying the tax is to have a qualified private long-term care insurance in place by Nov. 1, 2021, and apply for an exemption through Washington’s Employment Security Department. If you don’t opt out by that deadline, warns Roe, “you cannot ever opt out of the program.” On the other hand, if you do get an approved exemption and opt out, you’re permanently out. If you have a private policy, you can still consider opting in to the Wa Cares Funds, because it is possible that the state plan may give you additional benefits.

“It depends on your specific circumstances and the benefits offered under your policy,” Roe says. “We recommend speaking with your insurance broker to find out more information in this situation.” 

Is everything set in stone?

As it stands, only people who live in Washington when they retire can access benefits under the plan. But a state panel is considering a few sticking points such as: people who work in Washington and will pay into the program, but live in border states like Oregon; people who move out of Washington when they retire; people who will be retiring in less than three years from Jan. 1, 2022, before being vested in the program. Roe says the rules are still being tweaked and she expects updates in the future.

If you have questions about Washington Cares, contact the state Employment Security Department or an experienced Washington state employment and labor attorney. For additional general information on the workplace, see our employment law overview.