Opt-out of the WA Long Term Care Tax

You have until November 1st 2021 to opt out of the Washington state long term care program to avoid the tax. 

Please fill out the form below to get the quoting process for a product that can allow you to be compliant and opt out of the LTC tax being imposed. The more detailed information you can provide will help with the accuracy of the quotes.

WA State LTC Insurance Detailed Quote Request
More detailed responses will result in more accurate quotes
Are you seeking coverage to opt-out of the WA State LTC Payroll Tax/Coverage?
What is your primary concern with the WA State LTC Payroll Tax?
What level of benefit do you want to have quoted?
Your Health Information
More detail will result in more accurate quotes.
Date of Birth:
Have you ever been declined for LTC or life insurance?
Have you used tobacco of any kind in last year?
Do you have high blood pressure?
Are you currently receiving physical or occupational therapy?

List any prescription medications not already noted including: Name, Dosage, Frequency, Condition; note if any are new or changed in last 6 months:

Describe any other medical condition(s) of significance that may be important for us to consider:

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