This bill amends and adds multiple sections to the long-term services and supports trust (chapter 50B.04 RCW) and creates a new chapter in Title 48 RCW for supplemental long-term care insurance. It modifies eligibility rules for becoming a “qualified individual” (generally ten years of premium payments or three years in the last six), adds a reduced-duration rule for people born before January 1, 1968, and requires verification that an applicant worked at least 500 hours in each required year. It sets benefit availability dates (in‑state benefits July 1, 2026; out‑of‑state beneficiary benefits July 1, 2030), establishes a lifetime limit generally equal to the dollar equivalent of 365 benefit units, defines benefit units (up to $100 adjusted annually by the Seattle CPI‑W), and adds specific eligibility evaluation criteria: in‑state applicants must meet the program’s stated ADL threshold (text incomplete in provided facts) while out‑of‑state eligibility requires inability to perform at least two specified activities of daily living for 90 days or need for substantial supervision for safety due to severe cognitive impairment. The bill changes program administration and procedures: it allows certain people who elected coverage and then relocate outside Washington to elect to continue participation beginning July 1, 2026 (subject to three prior years of premium assessments and timely notice), requires out‑of‑state participants to report wages and submit documentation to ESD under rules, and makes such elective coverage irrevocable unless canceled for failure to pay or report. It assigns duties and rulemaking to the Employment Security Department (premium collection, verification, qualifying determinations, enforcement), Department of Social and Health Services (provider registration, payments, eligibility determinations, assessor capacity and 45‑day decision deadlines), the Health Care Authority, and the Office of the State Actuary (biennial actuarial audits beginning July 1, 2025 and solvency recommendations). It creates the trust account, directs that revenues expand long‑term care and not supplant existing state or county funds, establishes employer duties to collect and remit premiums (initial premium assessment began July 1, 2023 with an initial rate of 0.58 percent and the pension funding council to set the rate no greater than 0.58 percent beginning January 1, 2026 and biennially thereafter), and creates administrative enforcement, lien, distraint, and collection procedures including interest at 1% per month and specific penalty schedules for willful reporting failures. The bill also creates a new regulatory framework for supplemental long‑term care insurance: it establishes a new Title 48 chapter with requirements for policy form filing and approval, minimum inflation protection and nonforfeiture offers, producer education and suitability rules, consumer disclosures and return rights, claim denial timelines and appeal rights, restrictions on contestability and rescission, and enforcement powers and fines for unfair practices. It requires DSHS to ask benefit applicants about supplemental coverage and, with consent, to share basic identifying information with policy issuers for care coordination (no health or claims data). The act authorizes a limited pilot (Jan. 1–June 30, 2026, up to 500 participants) to test eligibility and payment processes, requires the commission to report on program metrics beginning Dec. 1, 2028, and takes effect January 1, 2026. Important implementation and some agency duty text was cut off in the provided materials, so several referenced subsections, full DSHS duties, certain cross‑references, and some later sections are incomplete in these facts.

If enacted, workers in Washington will start paying and being tracked under the long‑term services and supports trust with premiums collected by employers (initially set at 0.58% of wages) and deposited into a state trust to fund benefits and program administration. Employees who move out of state but have at least three years of premium assessments with at least 500 hours each year can elect to keep coverage beginning July 1, 2026, but must report earnings and submit documentation on a schedule the Employment Security Department (ESD) will set, cannot later withdraw, and face cancellation if they fail to pay or report. Benefits for Washington residents become payable July 1, 2026 and for eligible out‑of‑state beneficiaries July 1, 2030, with lifetime benefit limits equal to the dollar equivalent of 365 annual “benefit units” (each unit currently defined as up to $100 and adjusted annually for inflation). Certain workers may apply for permanent exemptions (veterans with high VA disability ratings, certain military spouses, nonimmigrant temporary workers, those with a permanent non‑Washington address, and specified service members), but exempt employees generally cannot become eligible beneficiaries unless the exemption is discontinued. The practical burden and responsibilities shift mainly to ESD (collecting premiums, enforcing compliance, verifying out‑of‑state earnings, and imposing interest, penalties, liens, and seizure remedies for delinquencies), DSHS (making eligibility determinations, registering and paying providers, establishing out‑of‑state provider standards, and completing determinations within 45 days when a benefit is requested), and employers (collecting/remitting premiums, keeping six years of records, and refunding any improper deductions). The Office of the State Actuary will audit the fund biennially and advise on solvency, while a commission will balance benefit adequacy and sustainability and oversee program rules; insurers selling supplemental long‑term care products face new consumer protections, mandatory nonforfeiture offers, and producer training requirements. Some implementation details are unclear from the provided text—DSHS’s full list of duties is cut off and certain cross‑references and exact formulas for benefit unit valuation and some amended sections are not fully shown.