Implementation of ESSB 5291 (Chapter 380, Laws of 2025) Supplemental Long-term Care Insurance (R 2025-06)

Supplemental long-term care insurance is a new product type that pays for long-term care expenses once benefits under the WA Cares program have been exhausted. Since it was a new product, no rules existed for supplemental long-term care. The adopted rule provides necessary clarity so that affected parties understand their rights and obligations under the new law.

Specifically, ESSB 5291 directed the Commissioner to write rules that include the following provisions related to supplemental long-term care insurance: 

• Mandatory disclosures to supplemental long-term care consumers; 
• Loss ratio standards; 
• Consumer protections related to premium adequacy and large rate increases;  
• Marketing practices; 
• Producer education, compensation, and testing; 
• Penalties; 
• Reporting practices; 
• Patient privacy & confidentiality rights; 
• Prompt payment requirements, and timely review standards for denied claims; and 
• Other reasonable rules to carry out the new chapter.