Staffing Administration Insights

Washington Cares Fund - The Complete Guide

Written by GNSA | Feb 28, 2023 5:38:00 PM

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 healthcare needs.

The following guide outlines everything Washington residents, employees, and employers need to know about the Washington Cares Fund.

What is the Washington Cares Fund?

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 July of 2026, eligible employees will be able to access Washington services and support costing up to $36,500 over their lifetime and other related benefits under the Washington Cares Fund. (NOTE: adjustments will be made annually to account for inflation)

Employees who are nearly retired and have earned partial benefits under Washington Cares will have access to a percentage of the total amount depending on how many years they worked.  

Employees that are eligible for benefits under the Washington Cares Fund 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
  • Healthcare 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
  • Transportation
  • Dementia supports
  • Education and consultation

Washington Cares Fund Contributions

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. 

Who is Eligible for the Washington Cares Fund

While the Washington Cares Fund is for all working residents of the state there are three different types of eligibility when it comes to Washington Cares benefits, and each has its own set of requirements. However, generally, working residents in the state must at least work 500 hours per year (about 10 hours per week) in order to qualify at all.

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
  • Eating
  • Toileting
  • Cognitive functioning
  • Transfer assistance
  • Bed mobility
  • Body care
  • Bathing
  • Ambulation/Mobility
  • Dressing

Here is a rundown on how to qualify for access to Washington Cares Fund Benefits.

Full Benefit, Early Access

After employees contribute for three years, they will have earned temporary coverage. Temporary coverage gives employees access to the full benefit amount if they need care, for only as long as they need care while working or soon after they stop working. Afterward, contributions will resume upon returning to work. 

In order to qualify for temporary coverage, employees must:

  • Contributed for three out of the last six years  
  • Worked at least 500 hours per year

Full Benefit, Lifetime Access

Employees can earn lifetime coverage by contributing to the Washington Cares Fund for 10 years (working at least 500 hours per year) at any point during their life. However, employees can not have a break from working that lasted five or more years. Once an employee earns lifetime coverage they can access the full benefit amount at any point when they need care.

Employees who take a break of five or more consecutive years before reaching the 10-year mark must restart their progress toward lifetime coverage.

Partial Benefit, Lifetime Access

Employees near retirement (those who were born before 1968) that have contributed to Washington Cares Fund for at least one year will have permanent access to a partial benefit.

For each year an employee works at least 500 hours (out of the 10 required years), they will earn 10% of the full benefit amount.  

Washington Cares Fund Exemptions

Under Washington Cares, there are several exemption pathways for Washington workers who aren’t likely to use their benefits under the new program.

In order to be eligible for a Washington Cares exemption, workers must have one of the following apply to them:

  • Live outside of Washington.
  • Are the spouse or registered domestic partner of an active-duty service member of the United States armed forces.
  • Have non-immigrant work visas.
  • Veterans with a 70% service-connected disability rating or higher.

There are also certain workers who are automatically exempt from Washington Cares, these include: 

  • Federal employees who work in Washington
  • Employees of tribal businesses in which the tribe has not opted in
  • People who are self-employed who have not opted in
  • Retired and non-working Washingtonians

Employees can find more information on Washington Cares exemptions here as well older standards for exemptions. Workers can apply online here for an exemption.

Washington Cares Fund 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 the Washington Cares Fund

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 will 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 Fund 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 Fund 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 Fund 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 the Washington Cares Fund

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.