Long-Term Care

State LTC Program vs Private LTC Insurance - What Employers Need to Know

HBy Hollowtree
State LTC Program vs Private LTC Insurance - What Employers Need to Know article

State LTC payroll tax programs and group long-term care benefits serve the same need but operate differently. State programs are mandatory workplace-based funding mechanisms, while group guaranteed-issue life insurance with an LTC/chronic care acceleration rider makes long-term care benefits available directly to employees. For employers, the question is not whether to choose one over the other, but whether enabling access to a group LTC benefit alongside mandatory state taxes creates operational and financial value.

Quick Comparison

AspectState LTC Payroll TaxGroup Life Insurance with LTC Rider
MandatoryYes (in active states)Optional
Employee Cost0.58% payroll (WA), pending in NY/CAVaries; group rates lower than individual
Coverage AmountCapped benefit (typically $36,500 WA)Customizable per policy
Benefit TriggerLong-term care need; 90-day minimumInability to perform 2+ ADLs or significant cognitive impairment
PortabilityBenefit follows employee statewidePortable if employer ends coverage
Opt-Out AvailableYes, if private coverage held (varies by state)N/A (elected through employer-enabled access)
Employer RoleWithhold tax, report to stateEnable access, handle enrollment

State LTC Payroll Tax Programs

State programs create a public insurance fund through mandatory employee payroll deductions. Washington's Cares Fund (0.58% payroll tax through 2022, suspended 2023-2024) is the first and most developed model. New York and California have proposed or enacted similar programs with benefits beginning 2026-2027.

These are not employer-sponsored benefits. Employers are administrators and withholders, not benefit designers. Employees own the entitlement regardless of employer, making it a safety-net mechanism rather than a retention tool.

The operational burden on employers includes tax withholding, reporting, and managing employee education about the benefit.

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