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WashingtonSB 52912025-2026 Regular SessionSenateWALLET

Implementing the recommendations of the long-term services and supports trust commission.

Sponsored By: Steve Conway (Democratic)

Became Law

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Bill Overview

Analyzed Economic Effects

15 provisions identified: 8 benefits, 2 costs, 5 mixed.

When LTSS benefits start and who qualifies

Beginning July 1, 2026, you can get benefits in Washington if you need help with at least 3 daily activities for at least 90 days. Starting July 1, 2030, if you live outside Washington, you can qualify if you cannot do at least 2 daily activities for 90 days or need close supervision for severe memory or thinking problems. DSHS must decide if you qualify within 45 days after it gets your request. The benefit unit (up to $100) is adjusted each year using the Seattle CPI‑W, with the new amount taking effect each January 1.

Employers must withhold and face penalties

Employers must deduct employee premiums and send them to the state. Temporary help firms are the employer for their temps. Keep employment records for six years and make required reports. Penalties for willful missed reports are $75 (second), $150 (third), and $250 (fourth and later). If you do not remit premiums, you owe the unpaid amount plus interest of 1% per month. The commissioner can issue assessments, file judgment liens, and seize and sell business property after notice. A court can stop your business from operating until you pay or post a bond equal to twice the delinquent amount. The commissioner may compromise or write off amounts when full collection is not fair or cost‑effective.

Who qualifies for state long-term care

You qualify by paying into the program for 10 total years, or 3 of the last 6 years. Each counted year must include at least 500 hours of work. If you were born before 1968 and paid at least one year of premiums, you get one-tenth of the maximum benefit units for each such year. You are an eligible beneficiary at age 18 or older if you live in Washington or moved away and chose to keep coverage, you meet the program’s care-need level, and you have benefit units left. Benefits for people in Washington start July 1, 2026; for those who kept coverage after moving, benefits start July 1, 2030.

Faster claims and continuity for long-term care

For supplemental long‑term care, insurers must pay clean claims within 30 business days or send written denial reasons. Policies must let you keep your care setting and family provider used under the LTSS program unless strong clinical evidence shows it is unsafe; you get a 90‑day transition and an appeal. Policies must include inflation protection, and issuers must offer a nonforfeiture option or give a contingent benefit if you lapse after a big rate increase. With your written consent, only basic contact info may be shared between DSHS and your insurer to help coordinate care; no health or claims data is shared. If your benefit comes from accelerating a life insurance death benefit, you get monthly reports during payment.

Stronger protections for long-term care insurance

Starting May 1, 2026, the state must approve supplemental long‑term care policy forms and rates before sale. Sellers must use a best‑interest suitability standard, give you a clear outline of coverage (including that premiums can rise and that buying a policy does not exempt you from LTSS premiums), and offer a 30‑day free‑look refund. Producers must be licensed and finish approved training; the commissioner will set rules for disclosures, loss ratios, privacy, prompt payment, and producer standards. The insurance commissioner expands consumer education, with extra help for people born before 1968 and a focus on middle‑income buyers. These rules apply to policies delivered or issued in Washington on or after May 1, 2026; the new chapter’s definitions apply, and chapter 48.83 does not. The LTSS commission also works with insurers to develop products that supplement the public benefit.

Stronger protections for long-term care policies

Starting May 1, 2026, stronger rules apply to supplemental long-term care insurance. Insurers cannot cancel for age or health decline. Preexisting-condition limits cannot reach back more than six months, and policies cannot exclude losses starting after six months. Elimination periods are capped at 12 months, and certain deductibles are limited. Policies cannot require a prior hospital stay or cover only skilled care. Rescission and contest rules are tightened; after two years, only knowing, intentional misstatements allow rescission. Unfair or deceptive sales are banned, with fines of three times the commission or $10,000 per policy. Policies can be field‑issued, but pay cannot depend on how many are issued. Out-of-state group policies may be sold here only if the other state’s rules are substantially similar. Medicare supplement‑specific rules do not apply to these policies.

Partnership policies can protect your assets

Beginning May 1, 2026, qualifying long-term care partnership policies are recognized. If you buy a qualifying policy, some or all of your assets can be excluded under Medicaid rules. The insurance commissioner sets the criteria, and insurers must give notices, keep records, and file annual reports.

Pay options for family caregivers

Qualified family members can be paid for approved personal care, the same as other providers or through a licensed home care agency. A third payment option can be added if the commission recommends it and DSHS adopts it. Starting January 1, 2026, family caregivers paid through the LTSS trust are treated as personal aides under state law. On the same date, some consumer‑directed employers and certain financial services agencies serving family caregivers are exempt from specific home‑care rules.

State defines which care services are covered

DSHS writes rules that define which long-term care services and goods the program covers. The rules list what is covered and what is not to coordinate with Medicaid and other benefits.

How the long-term care trust handles money

The trust account takes in money from employers, out‑of‑state participants, late premiums, penalties and interest, and any savings from a federal CMS waiver (starting January 1, 2026). DSHS pays benefits from the trust, and only the DSHS secretary or designee can authorize disbursements. Benefit payments do not need a budget appropriation; agency administration does. DSHS can hire a contractor to pay providers. Trust funds must expand long‑term care and cannot replace existing state or county funding for approved services.

Keep LTSS after moving, reporting rules

Starting July 1, 2026, you can keep LTSS coverage after moving out of Washington if you paid premiums for at least 3 years with 500 hours each year and you tell the Employment Security Department (ESD) within 1 year of moving. If you keep coverage, you must report your wages (even if you had none) each reporting period and submit documents as required; after age 67, you report but do not have to send documents. ESD cancels coverage if you do not pay or do not report, after a written notice and no later than 30 days later. Out‑of‑state providers must meet DSHS standards, be properly credentialed where they work, and may not discriminate based on race, gender, age, or a preexisting condition.

Who is exempt from LTSS premiums

If you work for a Washington employer but live in another state, you can apply to be exempt from LTSS premiums. Active duty service members with off‑duty civilian jobs can also apply for an exemption. Workers on nonimmigrant temporary visas are excluded unless they tell their employer they want to join; if they later become a permanent resident or U.S. citizen while working in Washington, they are covered. If you had an approved exemption, you can cancel it and join the program anytime before July 1, 2028; you start paying premiums after you notify ESD and you do not owe past premiums.

Workers pay 0.58% for long-term care

Beginning July 1, 2023, you pay a payroll premium equal to 0.58% of your wages. Starting January 1, 2026, the rate is set every two years. It cannot be higher than 0.58% and must be the lowest needed to keep the fund solvent.

2026 pilot on eligibility and payments

From January 1 to June 30, 2026, the state may run a pilot for up to 500 people to test eligibility and payment systems. Agencies must update the commission and consider its advice, then submit a summary after the pilot. The pilot authority ends July 1, 2027.

Stronger solvency checks and commission voting

Starting July 1, 2025, the state actuary audits the long-term care trust every two years. Commission votes pass only with approval from 60% of voting members present. A prior benefit‑unit adjustment statute is repealed on January 1, 2026.

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Sponsors & Cosponsors

Sponsor

  • Steve Conway

    Democratic • Senate

Cosponsors

  • Annette Cleveland

    Democratic • Senate

  • Claire Wilson

    Democratic • Senate

  • Derek Stanford

    Democratic • Senate

  • Javier Valdez

    Democratic • Senate

  • Noel Frame

    Democratic • Senate

  • Rebecca Saldaña

    Democratic • Senate

  • T'wina Nobles

    Democratic • Senate

Roll Call Votes

All Roll Calls

Yes: 151 • No: 40

Senate vote • 4/22/2025

Final Passage as Amended by the House

Yes: 35 • No: 13

House vote • 4/11/2025

Final Passage as Amended by the House

Yes: 78 • No: 16 • Other: 4

Senate vote • 3/11/2025

3rd Reading & Final Passage

Yes: 38 • No: 11

Actions Timeline

  1. Effective date 1/1/2026*.

    5/20/2025Senate

  2. Chapter 380, 2025 Laws.

    5/20/2025Senate

  3. Governor signed.

    5/20/2025legislature

  4. Delivered to Governor.

    4/25/2025legislature

  5. Speaker signed.

    4/24/2025legislature

  6. President signed.

    4/24/2025legislature

  7. Passed final passage; yeas, 35; nays, 13; absent, 0; excused, 0.

    4/22/2025Senate

  8. Senate concurred in House amendments.

    4/22/2025House

  9. Third reading, passed; yeas, 78; nays, 16; absent, 0; excused, 4.

    4/11/2025Senate

  10. Rules suspended. Placed on Third Reading.

    4/11/2025Senate

  11. Committee amendment(s) adopted with no other amendments.

    4/11/2025Senate

  12. Rules Committee relieved of further consideration. Placed on second reading.

    4/10/2025Senate

  13. Referred to Rules 2 Review.

    4/8/2025Senate

  14. Minority; without recommendation.

    4/7/2025Senate

  15. Minority; do not pass.

    4/7/2025Senate

  16. APP - Majority; do pass with amendment(s) but without amendment(s) by Early Learning & Human Services.

    4/7/2025Senate

  17. APP - Executive action taken by committee.

    4/7/2025Senate

  18. Referred to Appropriations.

    4/1/2025Senate

  19. ELHS - Executive action taken by committee.

    3/28/2025Senate

  20. ELHS - Majority; do pass with amendment(s).

    3/28/2025Senate

  21. First reading, referred to Early Learning & Human Services.

    3/13/2025Senate

  22. Third reading, passed; yeas, 38; nays, 11; absent, 0; excused, 0.

    3/11/2025Senate

  23. Rules suspended. Placed on Third Reading.

    3/11/2025Senate

  24. Floor amendment(s) adopted.

    3/11/2025Senate

  25. 1st substitute bill substituted.

    3/11/2025Senate

Bill Text

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