Title II, SEC. 2321. REQUIREMENTS TO FACILITATE UNDERSTANDING AND COMPARISON OF BENEFITS. (a) In General. The Secretary, after considering (where appropriate) recommendations of the Advisory Council, shall promulgate regulations designed to standardize formats and terminology used in long-term care insurance policies, to require insurers to provide to customers and beneficiaries information on the range of public and private long-term care coverage available, and to establish such other requirements as may be appropriate to promote consumer understanding and facilitate comparison of benefits, which shall include at a minimum the requirements specified in this section. (b) Uniform Terms, Definitions, and Formats. Insurers shall be required to use, in long-term care insurance policies, uniform terminology, definitions of terms, and formats, in accordance with regulations promulgated by the Secretary, after considering recommendations of the Advisory Council. (c) Standard Outline of Coverage. (1) In general. Insurers shall be required to develop for each long-term care insurance policy offered or sold, to include as a part of each such policy, and to make available to each potential purchaser and furnish to each insured individual and policyholder, an outline of coverage under such policy that (A) includes the elements specified in paragraph (2), (B) is in a uniform format (as prescribed by Secretary on the basis of recommendations by the Advisory Council), (C) accurately and clearly reflects the contents of the policy, and (D) is updated periodically on such timetable as may be required by the Secretary (or more frequently as necessary to reflect significant changes in outlined information). (2) Contents of outline. The outline of coverage for each long-term care insurance policy shall include at least the following: (A) Benefits. A description of (i) the principal benefits covered, including the extent of (I) benefits for services furnished in residential care facilities, and (II) other benefits, (ii) the principal exclusions from and limitations on coverage, (iii) the terms and conditions, if any, upon which the insured individual may obtain upgraded benefits, and (iv) the threshold conditions for entitlement to receive benefits. (B) Continuation, renewal, and conversion. A statement of the terms under which a policy may be (i) returned (and premium refunded) during an initial examination period, (ii) continued in force or renewed, (iii) converted to an individual policy (in the case of coverage under a group policy), (C) Cancellation. A statement of the circumstances in which a policy may be terminated, and the refund or nonforfeitures benefits (if any) applicable in each such circumstance, including (i) death of the insured individual, (ii) nonpayment of premiums, (iii) election by the insured individual not to renew, (iv) any other circumstance. (D) Premium. A statement of (i) the total annual premium, and the portion of such premium attributable to each covered benefit, (ii) any reservation by the insurer of a right to change premiums, (iii) any limit on annual premium increases, (iv) any expected premium increases associated with automatic or optional benefit increases (including inflation protection), and (v) any circumstances under which payment of premium is waived. (E) Declaration concerning summary. A statement, in bold face type on the face of the document in language understandable to the average individual, that the outline of coverage is a summary only, not a contract of insurance, and that the policy contains the contractual provisions that govern. (F) Cost/value comparison. (i) Information on average costs (and variation in such costs) for nursing facility care (and such other care as the Secretary may specify) and information on the value of benefits relative to such costs. (ii) A comparison of benefits, over a period of at least 20 years, for policies with and without inflation protection. (iii) A declaration as to whether the amount of benefits will increase over time, and, if so, a statement of the type and amount of, any limitations on, and any premium increases for, such benefit increases. (G) Tax treatment. A statement of the Federal income tax treatment of premiums and benefits under the policy, as determined by the Secretary of the Treasury. (H) Other. Such other information as the Secretary may require. (d) Reporting to State Insurance Commissioner. Each insurer shall be required to report at least annually, to the State insurance commissioner of each State in which any long-term care insurance policy of the insurer is sold, such information, in such format, as the Secretary may specify with respect to each such policy, including (1) the standard outline of coverage required pursuant to subsection (c); (2) lapse rates and replacement rates for such policies; (3) the ratio of premiums collected to benefits paid; (4) reserves; (5) written materials used in sale or promotion of such policy; and (6) any other information the Secretary may require. (e) Comparison of Long-Term Care Coverage Alternatives. Each insurer shall be required to furnish to each individual before a long-term care insurance policy of the insurer is sold to the individual information on the conditions of eligibility for, and benefits under, each of the following: (1) Policies offered by the insurer. The standard outline of coverage, and such other information as the Secretary may specify, with respect to each long-term care insurance policy offered by the insurer. (2) Comparison to other available private insurance. Information, in such format as may be required under this part, on (A) benefits offered under long-term care insurance policies of the insurer (and the threshold conditions for receipt by an insured individual of each such benefit); and (B) additional benefits available under policies offered by other private insurers (to the extent such information is made available by the State insurance commissioner). (3) Public programs; regional alliances. Information furnished to the insurer, pursuant to section 2342(b)(2), by the State in which such individual resides, on conditions of eligibility for, and long-term care benefits (or the lack of such benefits) under (A) each public long-term care program administered by the State, (B) the Medicare programs under title XVIII of the Social Security Act; and (C) each regional alliance operating in the State.