Employers have no obligation under Washington law to offer long-term care insurance to their employees. However, if long-term care insurance is among the benefits offered, certain state law requirements limit how the plan may be designed.
A “preexisting condition” is defined as a covered person's medical condition that caused the person to receive medical advice or treatment during the specified time period before the effective date of coverage (WA Code Sec. 48.84.020). A long-term care insurance policy may not exclude or limit coverage for preexisting conditions for a period of more than one year before the effective date of the policy or more than six months after the effective date of the policy (WA Code Sec. 48.84.040).
A long-term care insurance policy may not limit or exclude coverage by type of illness, treatment, medical condition, or accident, except for:
• Conditions arising out of war or act of war (whether declared or undeclared);
• Conditions arising out of participation in the commission of a felony, riot, or insurrection;
• Conditions resulting from suicide, attempted suicide, or an intentional self-inflicted injury;
• Benefits available under any state or federal workers' compensation, employer's liability, or occupational disease law, or any motor vehicle no-fault law;
• Services performed by a member of the covered person's immediate family;
• Services for which no charge is made in the absence of insurance;
• Dental care or treatment;
• Eyeglasses, hearing aids, and examinations for the prescription or fitting of eyeglasses or hearing aids;
• Rest cures and routine physical examinations;
• Chemical dependency;
• Treatment in a government ...