Supplemental LTC Insurance is Coming to Washington

In 2025, the Washington Legislature passed a law establishing something brand new: supplemental long-term care insurance. This optional coverage would coordinate with, and extend the benefits provided by WA Cares, the state's limited long-term care program in which most employees are automatically enrolled.

What Distinguishes SLTCI?

These new policies could appear in a wide variety of forms, such as traditional LTC insurance or as life insurance with an LTC rider. They could be offered on an individual, association, or group basis; fully underwritten or field-issued; may be on an expense incurred or indemnity basis; and could Tax-Qualified, non-Qualified, or Partnership. But they must all:

• "...provide coverage for at least 12 consecutive months for a covered person after benefits provided under chapter 50B.04 RCW [WA Cares] have been exhausted."

How Would This Work?

These private policies would be designed to assume a beneficiary's claim just as their public WA Cares benefits are exhausted ($36,500 in 2025, annually adjusted.) Once the Dept of Social and Health Services notifies the insurer that the policyholder has exhausted benefits, the company is required to accept that as evidence of satisfying their deductible, though in some cases there might be gaps.*

The insurer must allow for continuity of coverage in both settings and providers, including qualified family, that a beneficiary is receiving (except if unsafe). However, the insurer:

• "...may require a policyholder to undergo a functional assessment and apply a benefit trigger for purposes of approving a claim and authorizing benefits." It's not known if any insurers would choose to do so, but WA Cares' benefit triggers are unique: needing assistance with 3 of 7 Activities of Daily Living.
  

Who is Selling These Plans?

The new law allows the market to open up as early as July 1st, 2026, for those insurers which are ready. Insurers do not have to participate in this market, and could continue offering their existing products if they choose. Although these policies are designed to be portable after issue, they can only be solicited in Washington by producers who've taken an approved 1-hour training course on SLTCI in addition to the standard 8-hr and 4-hr LTC training requirements.

What's the Advantage?

With the state covering the deductible, insurers should be able to make supplemental coverage accessible to a wide market of Washingtonians at much more affordable rates.

How Would Consumers Be Protected?

Among other things, the state will be developing a Consumer Guide exclusive to SLTCI, as well as a new Outline of Coverage required to include specific disclosures. Because this new chapter of insurance law was modeled after the existing chapter on LTC insurance, many of the same consumer protections have followed.

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* "Any period of time the policyholder is considered an eligible beneficiary as defined in RCW 50B.04.010 [WA Cares] must count toward any elimination period in a supplemental LTC insurance policy. If the policy includes a deductible and an elimination period, the policy may provide that the elimination period is satisfied after the later of when the deductible or the elimination period has been met." [emphasis added]