WA Cares Gets a Makeover: What’s Changing in 2026

Washington State enacted significant amendments to the WA Cares Fund (“WA Cares”), the nation’s first mandatory, publicly funded long-term care insurance program for workers. WA Cares was established under the Long-Term Services and Supports (LTSS) Trust Act, signed into law in April 2021. Funded by a 0.58% payroll deduction, the program began collecting premiums in July 2023. Benefits will be available starting July 2026 for eligible individuals.

Senate Bill 5291 (SB 5291), signed into law on May 20, 2025, introduces expanded participation options, new insurance frameworks, and streamlined qualification requirements. Most provisions take effect on January 1, 2026. 

Key changes under SB 5291: 

• Out-of-State Participation: Workers who relocate out of Washington may continue coverage if they’ve paid into the program for at least three years.
• Opt-in Option for Previously Exempt Workers: Those who opted out with private insurance may rejoin the program before July 1, 2028.
• Supplemental Insurance: A new framework allows private insurers to offer supplemental long-term care policies that complement WA Cares benefits.
• Simplified Qualification: The requirement for five consecutive years of contributions within a ten-year period is removed.
• Additional Provisions: These include reimbursement for ineligible tax payments, exemptions for active-duty military and temporary visa holders, annual inflation adjustments, a pilot program to test benefit delivery systems, and employer recordkeeping and reporting requirements.

Elective Coverage for Employees Who Relocate Out of State: Beginning July 1, 2026, an employee or self-employed person who relocates outside of Washington may elect to continue participation in the program under certain conditions and access benefits outside Washington starting in July 2030. The amendments also provide that an out-of-state participant who has elected to continue participation in the program may not withdraw from coverage. The Employment Security Department (ESD) must cancel out-of-state elective coverage if the out-of-state participant fails to make required payments or submit reports. 

Opportunity for Individuals with a Private Plan Exemption to Participate: Currently, individuals are only able to opt out of WA Cares only if they secured their own private long-term care insurance and they applied for an exemption by January 1, 2023. The amendments provide an opportunity for everyone who has a private long-term care insurance exemption to cancel their exemption and join the program prior to July 1, 2028. The ESD will contact workers with approved private long-term care insurance exemptions to provide more information after this part of the law takes effect on January 1, 2026. 

Supplemental Private Long-term Care Insurance Plans: SB 5291 authorizes private insurers to offer supplemental policies to WA Cares that meet certain standards. Supplemental policies must provide at least 12 months of coverage after WA Cares benefits are exhausted and allow continuity of care providers when transitioning between programs. The policies must also Include flexible premium options to prevent loss of coverage and cover care for qualified family members.

Simplifying Contribution Requirements to Qualify for Benefits: To qualify for benefits, workers must meet the contribution requirement through one of three pathways. The lifetime access pathway, which most Washingtonians will use to qualify for benefits, previously required workers to contribute for at least 10 years without a break of five or more consecutive years. The bill simplifies this requirement to apply to all workers who contribute for at least 10 years. Workers who leave the workforce for an extended time will not have to restart their progress toward earning 10 qualifying years once they return. Workers who haven’t contributed for 10 years can also meet the requirement if they have contributed for at least three of the last six years at the time of needing care. Workers born before 1968 earn pro-rated benefits for each year they contribute.

Exemption for Active-Duty Service Members: Beginning January 1, 2026, an optional exemption will be available for active-duty service members working civilian jobs in Washington (spouses of active-duty service members will continue to have access to their existing exemption option). The exemption must be discontinued within 90 days of discharge or separation from military service. 

Exemption for Temporary Worker Nonimmigrant Visa Holders: Starting January 1, 2026, an employee who holds a nonimmigrant visa for temporary workers, as recognized by federal law, is automatically exempt from the program unless they notify their employer they would like to participate. Such individuals will become subject to the program upon gaining permanent residency or citizenship. 

Annual Benefit Adjustment: The bill provides that the benefit is adjusted annually for inflation using the consumer price index for the Seattle, Washington area for urban wage earners and clerical workers.

Pilot Program: The bill provides for the development of a pilot program to pay benefits to a small group of eligible individuals (up to 500 participants) before benefits become widely available in July 2026, to enable administering agencies to test benefit delivery systems. 

Employer Recordkeeping and Reporting Requirements: Employers must make reports, furnish information, and collect and remit premiums to the ESD. Records must be retained for six years. Monetary penalties are established for an employer's willful failure to make required reports or remit premiums. If payments to the ESD have become delinquent, the ESD may issue an order and assessment for the amount due, bearing one percent per month interest. If unpaid within 10 days, the ESD is authorized to collect through seizure and sale of the property of the delinquent employer.

In response to SB 5291, employers should review payroll systems for compliance with new reporting and premium collection rules; identify employees eligible for new exemptions or opt-in opportunities; and consider offering supplemental insurance options as part of employee benefits.