Long-Term Services and Supports Trust Program. In 2019, the Legislature established the Long-Term Services and Supports Trust Program (LTSS Trust Program), which provides up to $36,500, plus adjustments for inflation at the direction of the LTSS Trust Commission, in lifetime benefits for eligible beneficiaries to apply to the cost of their long-term care. The LTSS Trust Program is funded through a 0.58 percent premium assessment on an employee's wages. The premium assessment begins January 1, 2022, and eligible beneficiaries may begin receiving benefits on January 1, 2025. An individual who is a Washington resident, at least 18 years old, assessed as needing assistance with at least three activities of daily living, and paid into the program for either three of the last six or years or a total for of years with no more than a five year interruption, is eligible to receive benefits.
Self-employed individuals may elect to participate in the LTSS Trust Program according to specified time frames. Employees who attest to having purchased long-term care insurance before November 1, 2021, may apply to the Employment Security Department (ESD) by December 31, 2022, to be exempt from the LTSS Trust program. An employee who received an exemption is permanently ineligible from participating in the LTSS Trust program.
The LTSS Trust Program is administered jointly by the Department of Social and Health Services, ESD, and the Health Care Authority. Oversight is provided by the Long-Term Services and Supports Trust Commission which includes legislators, agency directors, and representatives from area agencies on aging, stakeholders, and consumers of approved services. The LTSS Trust Commission's January 1, 2022, report included recommendations for allowing residents of border states or Canada who commute to work in Washington; people working in the United States under a temporary, non-immigrant work visa; veterans with a 70 to 100 percent service-connected disability; and spouses of active-duty members of the military to opt-out of the LTSS Trust Program.
Long-Term Care Services for Veterans. Veterans with a certain level of impairment resulting from a service-connected disability may receive long-term care benefits through the federal Veteran's Administration (VA). The term veterans includes any person who served in the active military, naval, or air service during a period of war. A disability is considered to be service-connected if it was incurred or aggravated in the line of duty in the active military, naval, or air service. When determining the level of disability, the VA has a rating schedule with numerous assigned levels of disability for various injuries to all parts of the body. The ratings represent the percentage of disability that a veteran is determined to have based upon a particular injury. The rating system includes a method for combining multiple injuries to determine a single percentage of disability. Veterans with a disability rating of 70 percent or greater, and those who require nursing home services for a service-connected disability, are automatically eligible for nursing home level care through the federal VA. In addition to the nursing home program, other options are available to veterans with differing levels of eligibility and payment standards, depending on available resources.
Temporary Non-immigrant Workers. The federal government has jurisdiction over the terms and conditions for immigrants to reside in the United States. Non-citizen immigrants living permanently in the United States have immigrant status, and non-citizens who enter or stay in the United States on a temporary basis have non-immigrant status. Persons with non-immigrant status may enter the United States for tourism, business, medical treatment, or certain types of work. There are 22 different types of visas that allow persons with non-immigrant status to temporarily work in the United States. To obtain such a visa generally requires a prospective employer to file a non-immigrant petition with the United States Citizenship and Immigration Services on the temporary worker's behalf.
Four new exemption categories are established for the LTSS Trust Program. Beginning January 1, 2023, an employee may apply to ESD to be exempted from the LTSS Trust Program if they are:
An employee who receives an exemption is permanently ineligible from receiving LTSS Trust Program benefits unless their exemption is discontinued because they no longer meet the exemption criteria. An employee who has been exempted under one of the four new categories noted above, but no longer meets the exemption criteria must notify ESD and their employer within 90 days of:
Premiums must be assessed once the employee notifies their employer and ESD they no longer meet the exemption criteria. If the employee fails to begin paying premiums within 90 days of no longer meeting the exemption criteria, the employee must pay any unpaid premiums, with interest, from the date on which the premiums should have begun.
Employees who have received an exemption are responsible for notifying current and future employers they are exempt from the premium assessment. Employees are not entitled to refunds of premiums paid prior to being granted the exemption. If an employee who has received an exemption opts or fails to notify an employer of their exemption, the employee is not entitled to a refund of premiums deducted prior to the notification. Employers must not deduct premiums once an employee has notified them of the employee's exempt status.