Title II, SEC. 2302. NATIONAL LONG-TERM CARE INSURANCE ADVISORY COUNCIL. (a) Appointment. The Secretary shall appoint an advisory board to be known as the National Long-Term Care Insurance Advisory Council. (b) Composition. (1) Number and qualifications of members. The Advisory Council shall consist of 5 members, each of whom has substantial expertise in matters relating to the provision and regulation of long-term care insurance. At least one member shall have experience as a State insurance commissioner or legislator with expertise in policy development with respect to, and regulation of, long-term care insurance. (2) Terms of Office. (A) In general. Except as otherwise provided in this subsection, members shall be appointed for terms of office of 5 years. (B) Initial members. Of the initial members of the Council, one shall be appointed for a term of 5 years, one for 4 years, one for 3 years, one for 2 years, and one for 1 year. (C) Two-term limit. No member shall be eligible to serve in excess of two consecutive terms, but may continue to serve until such member's successor is appointed. (3) Vacancies. Any member appointed to fill a vacancy occurring before the expiration of the term of such member's predecessor shall be appointed for the remainder of such term. (4) Removal. No member may be removed during the member's term of office except for just and sufficient cause. (c) Chairperson. The Secretary shall appoint a Chairperson from among the members. (d) Compensation. (1) In general. Except as provided in paragraph (3), members of the Advisory Council, while serving on business of the Advisory Council, shall be entitled to receive compensation at a rate not to exceed the daily equivalent of the rate specified for level V of the Executive Schedule under section 5316 of title 5, United States Code. (2) Travel. Except as provided in paragraph (3), members of the Advisory Council, while serving on business of the Advisory Council away from their homes or regular places of business, may be allowed travel expenses (including per diem in lieu of subsistence) as authorized by section 5703(b) of title 5, United States Code, for persons in the Government service employed intermittently. (3) Restriction. A member of the Advisory Council may not be compensated under this section if the member is receiving compensation or travel expenses from another source while serving on business of the Advisory Council. (e) Meetings. The Advisory Council shall meet not less often than 2 times a year at the direction of the Chairperson. (f) Staff and Support. (1) In general. The Advisory Council shall have a salaried executive director appointed by the Chairperson, and staff appointed by the executive director with the approval of the Chairperson. (2) Federal entities. The head of each Federal department and agency shall make available to the Advisory Council such information and other assistance as it may require to carry out its responsibilities. (g) General Responsibilities. The Advisory Council shall (1) provide advice, recommendations, and assistance to the Secretary on matters relating to long-term care insurance as specified in this part and as otherwise required by the Secretary; (2) collect, analyze, and disseminate information relating to long-term care insurance in order to increase the understanding of insurers, providers, consumers, and regulatory bodies of the issues relating to, and to facilitate improvements in, such insurance; (3) develop for the Secretary's consideration proposed models, standards, requirements, and procedures relating to long-term care insurance, as appropriate, with respect to the content and format of insurance policies, agent and insurer practices concerning the sale and servicing of such policies, and regulatory activities; and (4) monitor the development of the long-term care insurance market (including policies, marketing practices, pricing, eligibility and benefit preconditions, and claims payment procedures) and advise the Secretary concerning the need for regulatory changes. (h) Specific Matters for Consideration. The Advisory Council shall consider, and provide views and recommendations to the Secretary concerning, the following matters relating to long-term care insurance: (1) Uniform terms, definitions, and formats. The Advisory Council shall develop and propose to the Secretary uniform terminology, definitions, and formats for use in long-term care insurance policies. (2) Standard outline of coverage. The Advisory Council shall develop and propose to the Secretary a standard format for use by all insurers offering long-term care policies for the outline of coverage required pursuant to section 2321(c). (3) Premiums. (A) Consideration of federal requirements. The Advisory Council shall consider, and make recommendations to the Secretary concerning (i) whether Federal standards should be established governing the amounts of and rates of increase in premiums in long-term care policies, and (ii) if so, what factors should be taken into account (and whether such factors should include the age of the insured, actuarial information, cost of care, lapse rates, financial reserve requirements, insurer solvency, and tax treatment of premiums, and benefits. (4) Upgrades of coverage. The Advisory Council shall consider, and make recommendations to the Secretary concerning, whether Federal standards are needed governing the terms and conditions insurers may place on insured individuals' eligibility to obtain improved coverage (including any restrictions considered advisable with respect to premium increases, agent commissions, medical underwriting, and age rating). (5) Threshold conditions for payment of benefits. The Advisory Council shall (A) consider, and make recommendations to the Secretary concerning, the advisability of establishing standardized sets of threshold conditions (based on degrees of functional or cognitive impairment or on other conditions) for payment of covered benefits; (B) to the extent found appropriate, recommend to the Secretary specific sets of threshold conditions to be used for such purpose; (C) develop and propose to the Secretary, with respect to assessments of insured individuals' levels of need for purposes of receipt of covered benefits (i) professional qualification standards applicable to individuals making such determinations; and (ii) uniform procedures and formats for use in performing and documenting such assessments. (6) Dispute resolution. The Advisory Council shall consider, and make recommendations to the Secretary concerning, procedures that insurers and States should be required to implement to afford insured individuals a reasonable opportunity to dispute denial of benefits under a long-term care insurance policy. (7) Sales and servicing of policies. The Advisory Council shall consider, and make recommendations to the Secretary concerning (A) training and certification to be required of agents involved in selling or servicing long-term care insurance policies; (B) appropriate limits on commissions or other compensation paid to agents for the sale or servicing of such policies; (C) sales practices that should be prohibited or limited with respect to such policies (including any financial limits that should be applied concerning the individuals to whom such policies may be sold); and (D) appropriate standards and requirements with respect to sales of such policies by or through employers and other entities, to employees, members, or affiliates of such entities. (8) Continuing care retirement communities. The Advisory Council shall consider, and make recommendations to the Secretary concerning, the extent to which the long-term care insurance aspects of continuing care retirement community arrangements should be subject to regulation under this part (and the Secretary, in consultation with the Secretary of the Treasury, shall consider such recommendations and promulgate appropriate regulations). (i) Activities. In order to carry out its responsibilities under this part, the Advisory Council is authorized to (1) consult individuals and public and private entities with experience and expertise in matters relating to long-term care insurance (and shall consult the National Association of Insurance Commissioners); (2) conduct meetings and hold hearings; (3) conduct research (either directly or under grant or contract); (4) collect, analyze, publish, and disseminate data and information (either directly or under grant or contract); and (5) develop model formats and procedures for insurance policies and marketing materials; and develop proposed standards, rules, and procedures for regulatory programs. (j) Authorization of Appropriations. There are authorized to be appropriated, for activities of the Advisory Council, $1,500,000 for fiscal year 1995, and $2,000,000 for each succeeding fiscal year.