WA| Washington’s new supplemental long‑term care (LTC) framework under ESSB 5291 is moving into effect on March 7, 2026, and it clarifies how supplemental LTC products must be designed, sold, and administered in coordination with WA Cares, including expectations for underwriting, disclosures, suitability, loss ratios, and oversight. See Concise Explanatory Statement linked below.
Key Points:
- Product positioning and triggers: Supplemental LTC is formally defined as a distinct product that begins paying only after WA Cares benefits are exhausted, so insurers must design forms, benefits, and administration to coordinate cleanly with WA Cares rather than duplicate traditional LTC.
- Form and coverage standards: New WAC sections clarify terminology (e.g., “long‑term care services”), prohibit excluding “qualified family members,” and expressly permit accelerated death benefit riders, requiring insurers to update policy forms, riders, and filings to align with these standards
- Underwriting and suitability duties: Medical underwriting remains permitted under statute, but producers must apply new best‑interest suitability standards, document due diligence, identify and avoid conflicts, and use an updated personal worksheet (including applicant attestation of WA Cares qualification/premium status).
- Consumer disclosure and education: Issuers must provide a new Consumer’s Guide to Supplemental Long‑Term Care Insurance to all prospective supplemental LTC applicants (in addition to the existing traditional LTC guide where applicable) and ensure marketing and outlines of coverage meet specific statutory disclosure requirements.
- Pricing, compliance, and oversight: The rule establishes loss ratio standards for supplemental LTC and ties inflation protection offers to either 3% or the Seattle CPI‑W index used for WA Cares, while signaling active OIC enforcement by Rates/Forms, Legal Affairs, and Company Supervision divisions and ongoing monitoring of compliance and market practices.