The Washington Cares fund is a long-term insurance program developed by the state legislature to address the future long-term health care crisis. The program aims to provide Washington employees with affordable, long-term care insurance benefits that any eligible member can use for a wide range of long-term health care needs.
The following guide outlines everything Washington residents, employees, and employers need to know about Washington Cares.
What is Washington Cares?
The Washington Cares Fund is a program that aims to provide affordable long-term care to eligible Washington employees while giving them the opportunity to decide when and where they receive their care.
Starting in January of 2025, eligible employees will be able to access Washington services and support costing up to $36,500 over their lifetime. (NOTE: adjustments will be made annually to account for inflation)
Employees that are eligible for Washington Cares will be able to access things such as:
- Professional personal care in your home, an assisted living facility, an adult family home, or a nursing home
- Health care equipment such as hearing devices and medication reminder devices
- Home safety evaluations
- Training and support for family members that are also care-providers (paid or unpaid)
- Home-delivered meals
- Care transition coordination
- Memory care
- Environmental modifications like wheelchair ramps
- Personal emergency response system
- Respite for family caregivers
- Dementia supports
- Education and consultation
Under Washington Cares, employees must begin contributing up to $0.58 for every $100 earned (0.58% of net earnings). This money is considered a Washington payroll, tax deduction premium, and is withheld by employers. The state’s Employment Security Department (ESD) then collects the premiums from employers and adds them to the fund.
January 2022 *UPDATE*: the state announced plans to change and improve Washington Cares during the 2022 legislative session, which is scheduled to conclude in March 2022. As a result, the state will not collect premiums from employers until April 2022 or until further direction is received.
February 2022 *UPDATE*: On January 27th Governor Inslee signed House Bill 1732, and House Bill 1733, which covered changes to the Washington Cares Program for the near future. In general, the reforms address coverage gaps and ultimately delay the implementation of the program by 18 months.
Most importantly, employees will not have to contribute to the fund until July 2023. Any employers who have collected premiums in 2022 as a precaution, must refund their employees the money.
Other notable changes include:
- Workers near retirement (born before 1968) will be able to qualify for partial benefits on a pro-rated basis
- Workers who live out of state and work in Washington, military spouses, workers on non-immigrant visas, and certain veterans with disabilities will be able to opt-out of the program if they choose
Washington employers and employees can sign up for the Washington Cares Fund mailing list in order to stay on top of any new information regarding further changes and updates.
Washington Cares Eligibility Requirements
While the Washington Cares Fund is for all working residents of the state that are 18 years or older, there are some requirements when it comes to eligibility.
For starters, in order to qualify for access to Washington Cares employees must:
- Have worked at least ten years at any point in their life without a break of five or more years within those ten years, or
- For instance, an employee who worked for three years, took four years off, then worked another seven, would be eligible.
- Have worked three of the last six years at the time they apply for the benefit, and
- Have worked at least 500 hours per year during those years
Employees must also need help with at least three activities of daily living. Activities can be three or more of the following:
- Medication management
- Personal hygiene
- Cognitive functioning
- Transfer assistance
- Bed mobility
- Body care
Washington Cares Exemptions
Washington employees who do not want to enroll in Washington Cares, or rather would like to opt-out of Washington Cares, can do so if they wish.
Employees may want to opt-out of the public benefit if they already have a long-term care plan or are considering a private one. If this is the case, employees can apply for an exemption. However, if the exemption is approved, the employee will not be able to re-enroll in Washington Cares and will be disqualified from receiving any benefits.
To apply for a permanent exemption from Washington Cares, employees must:
- Have purchased a qualifying private long-term care insurance plan before Nov. 1, 2021
- Be at least 18 years of age
- Submit an exemption application to the ESD by Dec. 31, 2022
If approved, exemptions will take effect the following quarter. Employees must also present their exemption approval letter to their current and all future employers. After presenting approval and the start of the next quarter begins, employers must stop collecting premiums from employees. If any more pay is deducted, employees are entitled to be reimbursed for the withheld pay.
Washington Cares Employer Information
Employers have a small list of responsibilities when it comes to Washington Cares. Employers also still have the option to offer private long-term care insurance if they wish.
Collecting Premiums for Washington Cares
Employers’ primary responsibility when it comes to the Washington Cares Fund is to collect employee premiums.
Employers originally were going to need to begin collecting premiums on January 1st, 2022. However, Gov. Jay Inslee, together with Senate Majority Leader Andy Billig and House Speaker Laurie Jinkins, announced plans to delay the fund. Now, the ESD will not begin collecting premiums until April 2022, or until further legislative direction is announced.
Employers will collect premiums the same way they do for paid leave. The Paid Leave reporting system has even been updated, so employers can report for both programs at the same time.
Employers may not pay for any share of the premiums for their employees. There is also no maximum limit on premiums for Washington Cares, in contrast to other types of payroll deductions.
February 2022 *UPDATE*: ESD won't accept any Washington Cares premium payments for Q1 of 2022. Employers should stop withholding premiums from employee earnings and reimburse employees for any premiums that were taken.
Tracking Washington Cares Exemptions
It is important for employers to also keep track of any employees that apply for an exemption to Washington Cares, even though it falls to the individual employee to apply, and notify employers with an approval letter (if approved).
Once an employer is notified of an approved exemption, they must:
- Not deduct Washington Cares premiums from workers who’ve provided an ESD exemption approval letter
- Note: this letter will list the effective date of the employee’s exemption
- Keep a copy of their workers’ approval letters on file
Any approved employee exemptions are permanent, so employers should continue to maintain any approval letters they receive. Employers may not apply for exemptions on behalf of their employees.
Washington Cares for Self-Employed Workers
Even if you are a self-employed worker residing in Washington, you are still eligible for Washington Cares. However, self-employed workers must opt-in to receive benefits.
Self-employed workers pay the same premium rate as normal employees. This rate is 0.58% of:
- Net earnings
- Gross wages, if any, paid to you from your business entity
Any self-employed workers who are eligible for Paid Family and Medical Leave, are also qualified for Washington Cares.
This means self-employed workers are eligible if:
- The employee is a sole proprietor
- The employee is a joint venturer or a member of a partnership
- The employee is a member of a limited liability company (LLC)
- The employee is an independent contractor
- The employee is otherwise in business for themselves
Washington Cares for Tribal Nations
Washington is one of a few states with the special circumstance of being host to 29 tribal nations.
Tribal nations may opt-in to Washington Cares and in doing so, all employees of their tribal businesses are covered. The same rules apply for premiums, eligibility, exemptions, and every other aspect of Washington Cares.
Final Thoughts on Washington Cares
Washington Cares is a great resource for employees looking for affordable, long-term care, and in comparison to many other legislative requirements for employers, is pretty easy to comply with.
However, if you are a Washington-based employer in need of assistance with Washington Cares compliance or anything else related to Washington Cares, a Northwestern-based HR and payroll provider can be of assistance. Contact GNSA today, and see how we can help with Washington Cares.