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Washington state has finalized new rules governing supplemental long-term care insurance under the WA Cares program, creating a clearer framework for insurers and better protections for residents. These rules, which go into effect on March 7, 2026, outline how supplemental policies interact with WA Cares benefits and set standards for coverage, eligibility, and consumer protections.

What Are Supplemental Long-Term Care Policies?

Supplemental long-term care insurance provides coverage after WA Cares benefits are used up. This ensures that residents who require extended care, such as in-home support or nursing facility services, are not left with uncovered costs. The new rules clarify which services qualify and define how policies must be structured.

Key Changes and Updates

The Washington Office of the Insurance Commissioner (OIC), led by Patty Kuderer, updated the administrative code to improve clarity, align language with existing laws, and address gaps in earlier proposals. Some of the major updates include:

• Consistent Terminology: Policies now uniformly use the term “long-term care services,” ensuring clear understanding for consumers and insurers.

• Family Coverage Protections: Supplemental policies cannot exclude qualified family members, offering broader coverage for dependents.

• Eligibility Verification: Insurance producers may confirm applicants’ eligibility and premium payment status through self-attestation, simplifying the process.

• Rider Options: Accelerated death benefit riders are permitted for both supplemental and traditional long-term care insurance, providing flexibility for policyholders.

• Benefit Dispute Rules: Appeals of benefit decisions are separated from continuity-of-care reviews, which are limited to specific coverage disputes.

Consumer Protections

The new rules also place a strong emphasis on consumer education and protection. Insurance companies are required to provide a dedicated Consumer’s Guide to Supplemental Long-Term Care Insurance to all applicants. This guide is separate from the existing guide for traditional long-term care policies and helps residents make informed decisions about coverage.

Additionally, policies must include inflation protection, allowing either a fixed 3% annual increase or an adjustment linked to the Seattle-area consumer price index for urban wage earners and clerical workers. These measures help ensure that benefits maintain their value over time.

Producer Responsibilities

Insurance producers must adhere to minimum best-interest standards, including:

• Identifying and avoiding conflicts of interest.

• Disclosing relationships with applicants, including any financial connections.

• Ensuring recommendations are suitable for each individual’s needs.

These requirements aim to foster transparency and fairness in the long-term care insurance market.

Oversight and Compliance

The OIC will oversee the implementation of these rules across multiple divisions, including:

• Rates, Forms, and Provider Networks – supervising policy standards.

• Consumer Protection – assisting policyholders with questions or complaints.

• Company Supervision and Legal Affairs – ensuring compliance with state law and enforcement of regulations.

Why This Matters?

Long-term care can be costly, and gaps in coverage can leave families with significant financial burdens. By providing supplemental insurance options and clear regulations, Washington is helping residents prepare for extended care needs while holding insurers accountable.

“With these rules, residents have stronger protections, and insurers have clear standards to follow,” said Patty Kuderer, Washington Insurance Commissioner. “This ensures fairness, transparency, and long-term stability in care coverage.”

What Residents Should Know

• The rules take effect March 7, 2026.

• Supplemental policies only pay after WA Cares benefits are exhausted.

• Policies must cover qualified family members and provide inflation protection.

• Applicants will receive a dedicated Consumer Guide to help understand coverage.

• Insurance producers must follow strict best-interest standards.

These measures aim to protect Washington residents from rising long-term care costs and provide clear guidance for both insurers and consumers.