Washingtonians can opt out of state-managed longterm care program for a private plan until Nov. 1

BOSTON, MA - SEPTEMBER 2: A resident in a wheelchair at an assisted living facility in Boston, MA on September 02, 2020. In the Commonwealth’s senior care sites, the coronavirus took a particularly insidious hold in the spring and early summer, and t

From now until Nov. 1, Washingtonians can opt-out of a state-managed longterm care program in favor of a private plan, if they choose to do so, before a payroll deduction hits their paychecks starting in January. 

Back in 2019, Washington became the first state in the nation to establish a defined benefit to help offset the costs of long-term care. 

Under the program, called WA Cares Fund, workers will pay a premium of .58% of total pay per paycheck, meaning an employee with a salary of $50,000 will pay $290 a year. Starting Jan. 1, 2025, people who need assistance with at least three "activities of daily living" such as bathing, dressing or administration of medication, can tap into the fund to pay for things like in-home care, home modifications like a wheelchair ramp and rides to the doctor. The benefit also covers home-delivered meals, and reimbursement to unpaid family caregivers. The lifetime maximum of the benefit is $36,500, with annual increases to be determined based on inflation.

Under an update to the law, passed by the Legislature this year, people who want to opt-out of the state-managed program must have a private long-term-care insurance plan in place before Nov. 1, and then apply for an exemption to avoid having the automatic deduction from their paychecks starting in January 2022.

Those wishing to opt-out must also submit an exemption application to the Employment Security Department (ESD). Those applications will be available as of Oct. 1. ESD will only accept exemption applications through Dec. 31, 2022. 

If your application is approved, you'll get an approval letter and at that point, you'll be expelled from the program with no option to re-enroll 

Even though a private policy must be purchased before Nov. 1 to opt out, people have until Dec. 31, 2022 to apply for an exemption — which means they may pay a year of the premium unless they opt out before the payroll deduction starts. No rebates are offered for any premiums already paid, and once a person receives an exemption, they are not able to opt back into the state program, even if they change jobs.

To be eligible, workers will have had to have paid the premium working at least 500 hours per year for three of the previous six years in which they’re seeking the benefit or for a total of 10 years, with at least five of those paid without interruption.

The benefit is not portable, so people who pay into the program but later move out of state will not be able to access it, and it only covers the taxpayer, not a spouse or dependent. The benefit also isn’t available to those who work in Washington and will pay the deduction but live in neighboring states, like Oregon. Macri said the commission is looking at addressing the issue of allowing the benefit across state lines.

Learn more about WA Cares here.  You can file for an exemption here

The Associated Press contributed to this report. 

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