FYI
Washington State Long Term Care Program becomes mandatory deducted in a few months.

You can opt out by October 1, 2021. So decide quick if you want to opt out.

Otherwise it’s automatically deducted and you are automatically opted in.

Roughly $400 for folks making $75-$100.
If you make more there is no cap so if you make more it will cost more.

If you get a W2 you are on the hook. So heads up. I didn’t know you can opt out.

To opt out if you're W2 you need to prove you have a LT care plan that meets all their "requirements." Not sure what they are, but when I initially read them a while back it was clear they were intentionally complicated to try and stop people from being able to opt out.

Here's a list of companies authorized to sell in WA. I'm looking through this myself. No way in hell I'm paying this to the state. It's a total clusterfuck.

https://www.insurance.wa.gov/long-term- ... gton-state

Yes totally agree it’s bogged down in so much BS.

This is why you need to go to a professional insurance and get it soon. It has to be in effect before Oct 1 or it’s automatically opted in.


I knew about it but wasn’t aware one could opt out!!!

So I’m opting out!


From the little I understand… once you opt out. You are out. Once you are automatically in… you can’t opt out later.

It’s unclear once opted out how long one needs to keep it??? Meaning going back - once opted out you are out.

A few clarifications here. The opt-out is from Oct 1st to Dec 31st. You can opt out if you have "comparable" coverage bought before Nov 1st.

I called most of them AFAIK Bankers Life is currently the only one actively selling ATM as of 2 months ago.

Yup, everybody else has bailed!

New york life is still taking on new policy.

If you are Catholic.
Knights of Columbus is a great benefit.

Living on the outside looking in but to me, this sounds like an illegal TAX!?!

There are some companies still selling employer sponsored plans. My wife, due to her medical condition, has been rejected by Mutual of Omaha and Bankers. However, her employer started offering plans today, so we'll go that route.

I heard a presentation from a Fidelity guy and an insurance guy on this topic. It is possible to avoid the tax but you've only got 1 chance to do it (this year) and has to be handled by whoever provides your W2. The current requirements don't express how/if the state will monitor your LTC state so you could feasibly buy this year and then cancel. The insurance guy said he's pretty sure the state will fix that loop whole as other states already have. As you might have guessed, any insurance company that offers LTC options have or will be raising their rates to at least match the state tax. Screwed to the left, screwed to the right so I guess I'm just screwed...

Overview:
WA Long Term Services & Supports Trust Program As a first-of-its-kind program in the nation, a compulsory short-term care benefit was signed into law by Governor Jay Inslee (D-WA) effective July 28th, 2019 following approval in the House (55-41) and Senate (26-22).

What?
It provides a short-term care benefit, publicly funded by a 0.58% payroll tax on all wages and remuneration, withheld quarterly by employers The benefit is vested by individuals who work a minimum of 500-hrs/yr and who pay premiums for at least 10 years (without a break of 5 consecutive years) or for 3 within the last 6 years (from the date of application for benefits) To permanently vest, an individual must pay taxes for 10 years. Those who've paid for only 3 within the "last 6 years [from the date of application for benefits]" will vest on a temporary basis and can un-vest. This is why there will be a surge of claims on 1/1/25 (exactly three years into the program), which will then taper off. Employees who pay Trust Act taxes for fewer than 10 years (eg because they are within 9 years of retirement) run the risk of never permanently vesting for Trust Act benefits (though they may be able to qualify under the temporary rules for the first few years of retirement) Providers reimbursed directly at Medicaid-comparable rates Benefits may be constrained: "a service or supply may be limited by dollar amount, duration, or number of visits"

Who?
Mandatory for all W-2 employees in Washington State (except those not otherwise explicitly exempt) A federally-recognized tribe may elect to collect the premium assessment for its employees; such tribes may also optout of the Program at any time, for any reason Employees and employers who are parties to a collective bargaining agreement in existence as of Oct 19th, 2017 (ie unions) are not required to participate in the Trust Program unless or until the agreement is re-opened or re-negotiated, but may choose to Self-employed, independent contractors, sole proprietors, partners, and joint venturers may "opt-in" Opt-ins must be made by Jan 1st, 2025 or within 3-years of first becoming self-employed for the first time; opt-ins would be irrevocable

Those who are currently retired do not pay premiums and will not qualify for benefits Private LTC insurance policyowners may "opt-out" of the program permanently by applying for an exemption between October 1st, 2021 and December 31st, 2022

LTC insurance must be owned or "purchased before November 1, 2021"

Questions & Answers-
The term "purchased" is not defined in the law, but when the Employment Security Dept was asked to clarify the deadline, they replied "an application [for insurance] alone does not provide [qualifying] coverage. Coverage must be in place." Oregon and Idaho residents who earn income in Washington are expected to pay the Trust Act payroll tax, but will not be eligible for benefits unless or until they later move to Washington. When? Office of the State Actuary must make recommendations to ensure solvency by January 1st, 2021 The State must create an educational outreach program to employers to ensure employees are aware of the Trust Program (and that payroll deductions are imminent) by October 1, 2021 First payroll deductions begin January 1st, 2022

Self-employed and independent contractors may opt-in beginning January 1st, 2022 By December 1st, 2022, the state must apply for a demonstration waiver from CMS, and report to the legislature on its status Public outreach will begin in 2024 On Jan 1st, 2024 and biennially thereafter, the tax rate is reset (see below) First claim for benefits can begin on January 1st, 2025, approved services "must be available" Trust Act Commission will issue its first report on participation, benefits paid and Medicaid savings beginning December 1st, 2026 State Auditor to complete first comprehensive evaluation of the Trust Program by December 1st, 2032 Where Only Washington residents can qualify for benefits Residents who move out of state for 5 or more years forfeit both benefits and premiums

Note: this five year "divestiture" provision does not appear in the Trust Act as enacted, but is reflected in the "Base Plan" upon which the Trust Program's payroll tax rate was modeled. Like the Act's elimination period (priced at 45-days, but enacted as 0-days), this oversight will have to be fixed, or else the tax rate raised

Why?
Washington will spend $4b/year on Medicaid-funded LTC by 2030, by which time the Trust Act is projected to save approximately $12.5m/yr, or ~0.31% of Medicaid's budget. To put these "savings" in context, in the same year, the program's administrative costs will run ~$89M (per Milliman). To put this $12.5m in context another way, the Trust Program is expected to collect approx. $1b/yr in taxes.

The state's 850,000 unpaid family caregivers face financial insecurity: nationally, 20% of family caregivers spend an average of 20% of their own income on out-of-pocket caregiving costs Family caregivers who leave work lose an average of $300,000 in income and benefits FAQs: How does the Trust Act work? Benefits are paid in $100 "stackable" units, up to a $36,500 lifetime maximum Beneficiaries must need assistance with a minimum of 3 of 10 Activities of Daily Living ("ADLs"): medication management, personal hygiene, eating, toileting, transferring, body care, bathing, ambulation/mobility, dressing, and cognitive impairment Though legislators forgot to include it in the law, the Trust Act was priced with a 45-day elimination period Providers must be on a Dept of Social and Health Services-approved list Which kinds of LTSS services are covered? Funds can be spent on nursing facilities, residential settings like assisted living and adult family homes, professional caregiving like home health care, wheelchair ramps, emergency alert devices, medication reminders, training for family, Meals on Wheels, rides to doctor appointments, dementia education, caregiver support, care coordination Family members may qualify upon receiving 21 - 35 hours of formal training (depends on situation) Audits are required to ensure that only approved services from registered providers are paid: the Health Care Authority is required to recoup inappropriate payments Will benefits increase to keep pace with inflation? The benefit unit (initially $100) "must be adjusted annually at a rate no greater than the Washington Consumer Price Index" Each year, an 8-person council will vote whether to increase or decrease the benefit unit ("to assure solvency") Will rates increase? There is no guarantee that the payroll tax will remain fixed The law sets the tax rate at 0.58% initially, then at a rate "no higher than 0.58%" as of Jan 1st, 2024 and biennially thereafter The pension funding council must set the premium rate "at the lowest amount necessary" to maintain solvency So while the rate returns to 0.58% (or lower) each Jan 1st of even-numbered years, it can rise (and may have to) during the 24-month period between "resets": "If the premiums established in this section are increased, the legislature shall notify each qualified individual...and describe the plan for restoring the funds so that premiums are returned to fifty-eight hundredths of one percent of the individual's wages."

Is it a good deal?
Well, that depends. According to the outside actuarial firm contracted by the state to review the Trust Program, approximately 45% of state residents (representing 75% of our wage base) could receive comparable coverage on the private market for equal or less money. The analysis above examined only dollars and cents: it did not make a qualitative comparison between the state's pilot project vs coverage available on the private market. For example, some consumers will value the following features, which the Trust Act does not provide:
• portability outside Washington
• coverage outside the United States • inflation protection greater or less than CPI • elimination period options • ability to cover partners and spouses • ability to cover retirees and non-working applicants • cash benefits • return of premium • shared care
• partnership protection • contracts under jurisdiction of the Insurance Department, underwritten by authorized carriers, via licensed, trained and regulated producers

A new tax-- did voters approve this?
Washingtonians rendered their verdict when they voted on Advisory Vote #20 during the November 2019 General Election: "The legislature imposed, without a vote of the people, an additional wage premium for long-term care services, costing an indeterminate amount in its first ten years, for gov't spending. Should this tax increase be repealed or maintained?" This Advisory Vote failed badly in 38 of 39 counties across the State-- King County being the lone outlier. As an Advisory Vote, it carried nothing more than symbolic weight-- a message to Olympia. Doesn't Medicaid already cover LTC? Why do we need the Trust Act? Medicaid does pay for most long-term care received in Washington State To receive Medicaid-covered long-term care, an individual must generally have home equity no greater than $603,000 (2021) and annual income no greater than $85,788 (2020); there is no limit on uncountable assets Because of its generous allowances, Medicaid has been dubbed "free inheritance insurance" for the middle-class and wealthy, whose easy access creates a chronically-underfunded program that struggles to care for the truly needy The state could collect nearly $47m/yr in non-tax revenue by enforcing estate recovery (as required by federal law), refilling Medicaid's coffers for future beneficiaries Since our taxes fund Medicaid, some consumers eschew private LTC insurance, not wishing to "pay double" (this is the infamous "Medicaid Crowd-Out Effect") Some debate whether the Trust Act will create another "crowd-out effect" or worse-- lead some Washingtonians to believe they are covered for long-term care when they are not Washington splits the cost of its Medicaid provider reimbursements 50/50 with the federal government, but pays 100% of the cost of its Trust Act reimbursements

That is, on a dollar-for-dollar basis, Trust Act benefits are twice as costly for each resident

Do linked-benefit, life with accelerated riders for LTC, or short-term care policies qualify for an exemption?
The Trust Act limits the exemption to policyowners of "long-term care insurance" but does not define the term. The Employment Security Department's proposed exemption rules require an employee to attest they own LTC insurance "as defined in RCW 48.83.020."

When asked about minimum benefits, the Trust Commission has reported "there are no standards of equivalent coverage that have to be met," and ESD has stated, "there is no minimum requirement of coverage under RCW 50B.04.085 for private long term care insurance policies." Where can I read the full text of the Trust Act for myself? The Washington State Legislature houses links to both the "adopted and engrossed" version of the Bill (1087-S2 AMS ENGR S3352.E), as well as an amendment (SB 6267) which substantially modified the original Bill. (1087-S2 AMS ENGR S3352.E): http://lawfilesext.leg.wa.gov/biennium/ ... 3352.E.pdf (SB 6267): https://legiscan.com/WA/text/SB6267/id/2175263 On 4/21/21, Gov. Inslee signed SHB 1323, enacting a package of recommendations forwarded to the Legislature by the Trust Commission. (SHB 1323) : https://app.leg.wa.gov/committeeschedul ... ent/234033 SJR 8200 is the proposed Constitutional Amendment allowing Trust Funds to be invested in equities-- since residents failed to ratify it in Nov 2020, stakeholders intend to put it back on the ballot in Nov 2021 (update: it failed to advance in the 2021-22 session). (SJR 8200): https://app.leg.wa.gov/billsummary?Bill ... &Year=2021

Like I said, 'an illegal tax'.

Then drop it November 2...