Frequently Asked Questions

Whether you participate in WA Cares depends on whether your work is localized in Washington state. WA Cares uses the same localization definitions as the state’s Paid Family and Medical Leave program (found in RCW 50A.05.010). If you are included in Paid Leave, you will also be included in WA Cares unless you have an approved exemption. 

Yes, part-time workers contribute to WA Cares. You only need to contribute 500 hours per year to earn a qualifying year for meeting contribution requirements, which is about 10 hours per week. 

Workers contribute to WA Cares regardless of age. Like all working Washingtonians, each year workers under 18 work at least 500 hours will earn them a qualifying year. Once they turn 18, they can use benefits when they need them if they’ve contributed for at least three years out of the last six from the date of application for benefits or after contributing for 10 years.
 

WA Cares is not available to federal government employees, including active-duty military employees. If, however, you work for a military department that is considered a Washington state employer, you will be included in the WA Cares Fund.

WA Cares is a social insurance program like Social Security, not a savings account. Everyone who meets contribution requirements and has a care need gets access to the same lifetime benefit amount ($36,500, adjusted annually for inflation). 

WA Cares is working with the insurance industry to develop a market for supplemental private long-term care insurance policies. These policies would allow people who want more coverage to use their WA Cares benefit as the deductible for their private policy. The WA Cares oversight body, the LTSS Trust Commission, made recommendations to the legislature in its January 2023 report about creating a market for supplemental private insurance. As more information becomes available, WA Cares will update the website and send a notification to the WA Cares mailing list. 

By law, the premium rate cannot exceed 0.58%. The legislature would need to change the law to increase the premium rate. However, actuarial analysis completed in 2022 showed that under most scenarios, the WA Cares Fund is projected to be fully solvent through 2098 (the full period evaluated in the report) at the current premium rate. 
 

Typically, these are your gross wages. The Employment Security Department (ESD) is using the same wage definition as they do for Paid Family and Medical Leave. However, unlike Paid Leave, the income to which WA Cares premiums are applied is not capped at the taxable maximum for Social Security.  

You can find more detail in WAC 192-510-025 and employers can use ESD’s premium calculator to calculate premium amounts for both WA Cares and Paid Leave. 

The Department of Social and Health Services (DSHS) will ask questions about your activities of daily living and the support you need. If you need assistance with at least three activities of daily living, you are eligible for benefits. This may be based on self-report and could be verified by a health professional.

The types of activities DSHS will ask you about are eating, bathing, walking or moving around in a wheelchair, getting in and out of a chair and your ability to move around once you are in bed, using the bathroom, managing your medications, personal hygiene and body care. DSHS will also ask about cognition and any memory/cognitive impairments that impact your daily life. 
 

Starting in July 2026, Washington workers can choose to continue participating in the WA Cares Fund if they move out of state. To become an out-of-state participant, workers must have contributed to WA Cares for at least three years (in which they worked at least 500 hours per year) and must opt in within a year of leaving Washington.

Like other workers, out-of-state participants will keep contributing to the fund during their working years. The state will create a process for out-of-state participants to report their earnings and pay premiums, with a focus on making it easy for participants.

Learn more.

In a previous version of the law, there was a $100 per day cap (“benefit unit”) on the usage of WA Cares benefits. That cap was eliminated and no longer applies. 

No. WA Cares Fund is a flexible benefit you can use to meet your care needs up to $36,500 with no daily limit.

The benefit amount will be adjusted annually up to the rate of inflation starting in 2026. Even after you retire and stop contributing, your benefit amount will continue to be adjusted for inflation. A benefit council will determine the amount of the increase each year. 

The lifetime benefit amount is only available to eligible beneficiaries who have contributed to the fund and cannot be transferred to another family member. By all of us pooling a small amount of our paychecks into one fund throughout our careers, the program can remain affordable and cover more people in the long term. If WA Cares benefits were transferrable to a spouse or family member, the premium would need to be much higher. 

WA Cares works like an insurance program, not a savings account. By all of us pooling a small amount of our paychecks into one fund throughout our careers, the program can provide access to long-term care for the people who need it. There is no option to cash out the contributions you’ve made if you do not use benefits.

WA Cares benefits are not subject to estate recovery (the requirement that state Medicaid programs recover certain Medicaid benefits paid on behalf of a Medicaid enrollee from their estate).

The WA Cares Fund is a universal long-term care program that works like Social Security, where all workers participate and earn coverage over the course of their careers.  This program does not have underwriting and is fully funded by pooling worker’s wages and investing them with the State of Washington for WA Cares Fund beneficiaries to use when they need long-term care.

Premium withholding began July 1, 2023.

Yes. Employers began withholding premiums July 1, 2023.
 

No. Unlike Paid Family and Medical Leave, premium contributions do not top out at the taxable maximum for Social Security.

It is the employee’s responsibility to notify and give you a copy of their approval letter from ESD, which contains the date their exemption goes into effect. Once you are provided the letter and the effective date has passed, you must stop withholding premiums. Employers must return incorrectly withheld premiums to the employee.

What is the refund process if an employer overpays WA Cares premiums? If the employer does not owe outstanding WA Cares premiums, refunds are available for overpayments of more than fifty dollars upon request.

Refunds will not be processed for overpayments of less than fifty dollars unless

• The employer does not owe outstanding WA Cares premiums

and

• The business is closed, or
• The business does not anticipate future payroll

If the employer does not request a refund, overpayments of any amount will be credited toward future payments due.

Beginning with your Quarter 3 2023 report, there are new file specifications (v8) that incorporate all that is required for WA Cares. Visit the Paid Family and Medical Leave website for the most up to date information.

To stay up to date on WA Cares news, including any updates for providers, you can subscribe to our mailing list. 

New legislation in 2022 created additional exemption types. You can apply for these exemptions starting Jan. 1, 2023. The new exemptions are for people who are:

• Living out of state – your primary residence must be outside of Washington.
  • You will no longer qualify if you change your primary residence to Washington.

• Temporarily working in Washington with a nonimmigrant visa – you must hold a nonimmigrant visa for temporary workers.
  • You will no longer qualify if your nonimmigrant visa status changes and you become a permanent resident or citizen employed in Washington.

• A spouse or registered domestic partner of an active-duty military member – you must be married to or have a registered domestic partnership with an active-duty service member in the U.S. armed forces.
  • You will no longer qualify if your spouse or domestic partner is discharged or separated from military service or upon dissolution of the marriage or registered domestic partnership.

• A veteran with a 70% or greater service-connected disability – you must be rated by the U.S. Department of Veterans Affairs as having a service-connected disability of 70% or greater.
  • This exemption is permanent.

We need to verify certain documents when you submit your exemption application. Make sure you’re fully prepared.

Your exemption will be discontinued when you no longer qualify for an exemption, and you will begin paying premiums and earning coverage for WA Cares Fund.  You will be required to notify the Employment Security Department and your employer within 90 days of no longer qualifying.  Failure to notify the Employment Security Department and your employer within 90 days will result in the payment of any unpaid premiums with interest at the rate of 1% per month to the Employment Security Department.

No. Those who had private long-term care insurance on or before Nov. 1, 2021, were able to apply for an exemption from the WA Cares Fund from Oct. 1, 2021, until Dec. 31, 2022. This opt-out provision is no longer available.

If you already have an approved exemption, it’s up to you to decide to maintain or cancel your private long-term care policy. You should speak with your broker or agent who sold you the policy about options.

Purchasing a private policy to qualify for a WA Cares exemption was a voluntary decision by individuals wishing to opt out of the program. If individuals have already received an approval letter from ESD exempting them from the WA Cares program, their exemption is still approved and will still be effective once premium assessment begins on July 1, 2023.

The laws passed in 2022 did not change the requirements for private long-term care insurance and exemption status in RCW 50B.04.085. It is up to individuals to decide whether they wish to maintain or cancel their private long-term care policies. The laws also did not provide for reimbursement of the cost of long-term care insurance voluntarily obtained by individuals.

The purchase of a private policy is between the customer and their private insurance provider. Customers should contact their insurance provider with questions.

Long-term care insurance benefits help pay for services needed by people who cannot perform everyday tasks themselves. 

Disability insurance benefits cover part of a worker’s income when they have an illness or injury and need to take time off from work because they’re unable to do their job. Disability insurance can be short-term or long-term, depending on the length of time it is intended to provide benefits.

Many employees have access to disability insurance through their employer. Washington workers also have access to Paid Family and Medical Leave to get paid time off if they have a serious health condition that prevents them from working, need time off to care for a family member or welcome a new child, or for certain military-related events.
 

WA Cares benefits are not considered income or resources for eligibility determinations for other state programs or benefits. 

WA Cares will have little to no impact on Medicaid eligibility and will be treated like a third-party payer for services (like private insurance now). People who meet WA Cares contribution requirements and need care will generally use their WA Cares benefit first. After they have used their WA Cares benefits, they will be able to apply for Medicaid long-term services and supports if they still need care.

Medicaid will determine if they qualify financially. Having access to WA Cares benefits will give families breathing room to plan how they will pay for future long-term care costs, including learning about how to qualify for Medicaid long-term services and supports.

There may be an impact for people who are already receiving Medicaid long-term services and supports and work enough to qualify for WA Cares. If individuals receiving Medicaid use their WA Cares benefit for some of their care and no longer pay “participation” for Medicaid long-term services and supports, it may result in excess countable resources for Medicaid. Workers who receive Medicaid long-term services and supports and become eligible for WA Cares benefits should keep this in mind when planning how to use their benefits. 

Yes, you can use WA Cares in combination with private long-term care insurance. WA Cares is also working with the insurance industry to develop a market for supplemental private long-term care insurance policies. These policies would allow people who want more coverage to use their WA Cares benefit as the deductible for their private policy. The WA Cares oversight body, the LTSS Trust Commission, made recommendations to the legislature in its January 2023 report about creating a market for supplemental private insurance. As more information becomes available, WA Cares will update the website and send a notification to the WA Cares mailing list.