The Shift in Opt-Out Rules
Initially, workers with qualifying private long-term care insurance by November 1, 2021, had a limited opportunity from October 2021 to December 2022 to apply for a permanent exemption from the WA Cares Fund. This exemption, if approved by the Employment Security Department (ESD), is permanent and means the individual does not pay premiums or receive benefits. This opt-out window based on private insurance is now closed to new applicants, making participation mandatory for most Washington workers. However, legislative changes in 2022 and 2025 introduced new ongoing exemption categories for specific groups.
Who Can Still Apply for an Ongoing Exemption?
Since January 1, 2023, certain workers can apply for ongoing conditional exemptions. These exemptions are available as long as the eligibility criteria are met.
Qualifying groups include:
- Individuals whose permanent home is outside Washington state.
- Spouses or registered domestic partners of active-duty U.S. armed forces members.
- Workers holding a non-immigrant work visa.
- Veterans with a 70% or higher service-connected disability are eligible for a permanent exemption.
- Active-duty military members working civilian jobs in Washington can apply for an exemption starting January 1, 2026.
The Application Process for Ongoing Exemptions
Ongoing exemptions are managed by the ESD through the Secure Access Washington (SAW) portal. The application is accessible by adding the Paid Family and Medical Leave service to your SAW account. You will need to create a WA Cares Exemption account and submit your application, which may require documentation to verify eligibility. If approved, the ESD will issue an official exemption approval letter. You are responsible for providing this letter to your current and future employers, who will then stop withholding premiums after the exemption's effective date.
What Happens After a Conditional Exemption Ends?
If your situation changes and you no longer qualify for a conditional exemption, you must notify the ESD and your employer within 90 days. Premium payments and benefit accrual will resume on the first day of the next calendar quarter. Failure to notify the ESD within the 90-day window can result in assessed unpaid premiums plus interest.
WA Cares Participant vs. Exempt Status
Understanding the difference between participating and being exempt is important, especially for the self-employed who can voluntarily opt-in but are then committed for a specific period.
| Feature | WA Cares Fund Participant | Approved Exemption |
|---|---|---|
| Premium Contribution | Pays 0.58% of all wages with no income cap. | Pays no premiums. |
| Benefit Access | Eligible for up to $36,500 lifetime benefit (adjusted for inflation) upon qualification. | Ineligible for any WA Cares benefits. |
| Eligibility for Benefits | Must meet vesting and care needs requirements. | Not applicable. |
| Portability | Benefits will be portable for those who continue contributing after moving out of state (starting July 2030). | Not applicable. |
| Private Insurance | Can be used alongside private insurance. | Relies solely on personal funds or private insurance. |
Recent Legislative Changes: A New Opportunity for Past Opt-Outs
A recent law, signed in May 2025, provides a chance for those with previously approved private insurance exemptions to cancel their exemption and rejoin the program. The ESD will provide details closer to the opt-in window, which runs from January 1, 2026, to July 1, 2028. This aims to increase program flexibility.
Understanding the WA Cares Fund: Benefits and Contributions
For those who are not exempt, participation is mandatory and provides access to long-term care benefits starting July 1, 2026. Benefits cover various services like in-home care, assisted living, and home modifications, and are paid directly to providers. There's a lifetime maximum benefit, not a daily cap. Premiums are 0.58% of all Washington wages with no income cap. The program is not a savings account, and contributions are not refundable if benefits are not used. It serves as a funding source for the state's growing long-term care needs. More information is available on the official WA Cares Fund website.
Conclusion: Making an Informed Decision
Opting out of the WA Cares Act is only possible under specific circumstances. The initial private insurance exemption window is closed, although a new temporary opportunity to rejoin opens in 2026 for those who previously opted out. Ongoing exemptions are available for military personnel and their spouses, non-residents, temporary visa holders, and permanently for certain veterans. Otherwise, participation is required. Understanding these rules helps workers make informed long-term care planning decisions.
