(1)An application for a
certificate of authority to operate as a prepaid dental care plan organization formed
under part 1 of this article 16 and this part 5 shall be filed with the commissioner on
a form prescribed by the commissioner. Such application shall be verified by an
officer or authorized representative of the applicant and shall set forth, or be
accompanied by, the following:
(a)A copy of any basic organizational document of the applicant such as the
articles of incorporation, articles of association, partnership agreement, trust
agreement, or other applicable documents and all amendments to such documents;
(b)A copy of all bylaws, rules and regulations, or similar documents
regulating the conduct of the internal affairs of the applicant;
(c)A list of the names, a
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(1) An application for a
certificate of authority to operate as a prepaid dental care plan organization formed
under part 1 of this article 16 and this part 5 shall be filed with the commissioner on
a form prescribed by the commissioner. Such application shall be verified by an
officer or authorized representative of the applicant and shall set forth, or be
accompanied by, the following:
(a) A copy of any basic organizational document of the applicant such as the
articles of incorporation, articles of association, partnership agreement, trust
agreement, or other applicable documents and all amendments to such documents;
(b) A copy of all bylaws, rules and regulations, or similar documents
regulating the conduct of the internal affairs of the applicant;
(c) A list of the names, addresses, and official positions of the persons who
are responsible for the conduct of the affairs of the applicant, including, but not
limited to, all members of the board of directors, board of trustees, executive
committee, or other governing board or committee, the principal officers in the case
of a corporation, and the partners or members in the case of a partnership or
association;
(d) If the prepaid dental care plan organization is a corporation, evidence
that the board of directors of such corporation includes:
(I) Dentists, duly licensed pursuant to article 220 of title 12, who have
contracted with the corporation to render dental care services to enrollees;
(II) Enrollees of the prepaid dental care plan, who shall comprise at least
one-third of the members of the board;
(e) A copy of any contract made or to be made between any providers or
persons listed in paragraph (c) of this subsection (1) and the applicant;
(f) A statement generally describing the prepaid dental care plan
organization and its dental plan or plans, facilities, and personnel;
(g) A copy of the form of enrollee coverage to be issued to the enrollees;
(h) A copy of the form of any group contract which is to be issued to
employers, unions, trustees, or other applicants;
(i) Financial statements showing the applicant's assets, liabilities, and
sources of financial support. If the applicant's financial affairs are audited by
independent certified public accountants, a copy of the applicant's most recent
regular certified financial statement shall satisfy this requirement unless the
commissioner determines that additional or more recent financial information is
required for the proper administration of part 1 of this article and this part 5.
(j) A description of the proposed method of marketing the prepaid dental
care plan, a financial plan which includes a three-year projection of the initial
operating results anticipated, and a statement as to the sources of working capital
as well as any other sources of funding;
(k) A power of attorney duly executed by such applicant, if not domiciled in
this state, appointing the commissioner as the true and lawful attorney of such
applicant in and for this state, upon whom all lawful process in any legal action or
proceeding against the prepaid dental care plan organization on a cause of action
arising in this state may be served;
(l) Repealed.
(m) Such other information as the commissioner may require.
(2) Any existing domestic prepaid dental care plan organization with fifteen
hundred or more dental plan enrollees on January 1, 1980, shall have three years to
meet the requirements of sections 10-16-505 and 10-16-506. However, such
organization shall submit with its application or certificate of authority, a plan
approved by the commissioner to meet the requirements of sections 10-16-505 and
10-16-506 at ten percent the first year of operation, fifty percent the second year of
operation, and one hundred percent the third year of operation. In addition to
exemptions provided elsewhere in this subsection (2), the commissioner may grant
a one-year waiver from the provisions of this subsection (2).
(3) Within ten days following any significant modification of any matter
furnished pursuant to subsection (1) of this section, a prepaid dental care plan
organization shall file notice of such modification together with such supporting
documents as are necessary to fully explain the modification with the
commissioner.