A. No person shall establish or operate a dental plan organization in theCommonwealth without first obtaining a license from the Commission. Anybusiness entity, which is neither an individual nor a sole proprietorship,may apply to the Commission for a license to establish and operate a dentalplan organization in compliance with this chapter.
B. Each application for a license shall be verified by an officer orauthorized representative of the applicant, shall be in a form prescribed bythe Commission, and shall set forth or be accompanied by the following:
1. A copy of the basic organizational documents of the applicant including,but not limited to, the articles of incorporation, articles of association,partnership agreement, trust agreement, or other applicable documents, andall amendments to those documents;
2. A copy of the bylaws, rules, and regulations, or any similar documentregulating the conduct of the internal affairs of the applicant;
3. A list of the name, address, official position, and biographicalinformation on forms acceptable to the Commission of each member of thegoverning body and any person with authority to manage or establish policy;and a full disclosure in the application of (i) any financial interestbetween such person or any dentist, organization, or corporation owned orcontrolled by such person and the dental plan organization and (ii) theextent and nature of the financial arrangements between such person and thedental plan organization;
4. A copy of any contract made or to be made between any dentist, sponsor, ororganizer of the dental plan organization, or persons listed in subdivision 3and the applicant;
5. A copy of the evidence of coverage form to be issued to subscribers andthe dental benefit contract to be issued to contract holders;
6. A copy of any group contract form that is to be issued to employers,unions, trustees, or other organizations. All group contracts shall set forththe right of subscribers to convert their coverages to an individual contractissued by the dental plan organization;
7. A financial statement or statements and any reports, certificates, orother documents the Commission considers necessary to secure a full andaccurate knowledge of the applicant's affairs and financial condition;
8. A complete description of the dental plan organization and its method ofoperation, including (i) the method of marketing the plan, (ii) a statementregarding the sources of working capital as well as any other sources offunding, and (iii) a description of any insurance, reinsurance, oralternative coverage arrangements proposed, including excess insurance orstop loss insurance;
9. A financial feasibility plan that includes, but is not limited to, (i)detailed enrollment projections, (ii) the methodology for determining premiumrates to be charged during at least the first three years of operations andextending one year beyond the anticipated break-even point certified by anactuary, and (iii) a projection, along with material assumptions, of balancesheets, cash flow statements showing capital expenditures and purchase andsale of investments, and income statements on a quarterly basis for at leastthree years and extending one year beyond the anticipated break-even point;and
10. Any other information the Commission may require to make thedeterminations required pursuant to § 38.2-6103.
A. No person shall establish or operate a dental plan organization in theCommonwealth without first obtaining a license from the Commission. Anybusiness entity, which is neither an individual nor a sole proprietorship,may apply to the Commission for a license to establish and operate a dentalplan organization in compliance with this chapter.
B. Each application for a license shall be verified by an officer orauthorized representative of the applicant, shall be in a form prescribed bythe Commission, and shall set forth or be accompanied by the following:
1. A copy of the basic organizational documents of the applicant including,but not limited to, the articles of incorporation, articles of association,partnership agreement, trust agreement, or other applicable documents, andall amendments to those documents;
2. A copy of the bylaws, rules, and regulations, or any similar documentregulating the conduct of the internal affairs of the applicant;
3. A list of the name, address, official position, and biographicalinformation on forms acceptable to the Commission of each member of thegoverning body and any person with authority to manage or establish policy;and a full disclosure in the application of (i) any financial interestbetween such person or any dentist, organization, or corporation owned orcontrolled by such person and the dental plan organization and (ii) theextent and nature of the financial arrangements between such person and thedental plan organization;
4. A copy of any contract made or to be made between any dentist, sponsor, ororganizer of the dental plan organization, or persons listed in subdivision 3and the applicant;
5. A copy of the evidence of coverage form to be issued to subscribers andthe dental benefit contract to be issued to contract holders;
6. A copy of any group contract form that is to be issued to employers,unions, trustees, or other organizations. All group contracts shall set forththe right of subscribers to convert their coverages to an individual contractissued by the dental plan organization;
7. A financial statement or statements and any reports, certificates, orother documents the Commission considers necessary to secure a full andaccurate knowledge of the applicant's affairs and financial condition;
8. A complete description of the dental plan organization and its method ofoperation, including (i) the method of marketing the plan, (ii) a statementregarding the sources of working capital as well as any other sources offunding, and (iii) a description of any insurance, reinsurance, oralternative coverage arrangements proposed, including excess insurance orstop loss insurance;
9. A financial feasibility plan that includes, but is not limited to, (i)detailed enrollment projections, (ii) the methodology for determining premiumrates to be charged during at least the first three years of operations andextending one year beyond the anticipated break-even point certified by anactuary, and (iii) a projection, along with material assumptions, of balancesheets, cash flow statements showing capital expenditures and purchase andsale of investments, and income statements on a quarterly basis for at leastthree years and extending one year beyond the anticipated break-even point;and
10. Any other information the Commission may require to make thedeterminations required pursuant to § 38.2-6103.
A. No person shall establish or operate a dental plan organization in theCommonwealth without first obtaining a license from the Commission. Anybusiness entity, which is neither an individual nor a sole proprietorship,may apply to the Commission for a license to establish and operate a dentalplan organization in compliance with this chapter.
B. Each application for a license shall be verified by an officer orauthorized representative of the applicant, shall be in a form prescribed bythe Commission, and shall set forth or be accompanied by the following:
1. A copy of the basic organizational documents of the applicant including,but not limited to, the articles of incorporation, articles of association,partnership agreement, trust agreement, or other applicable documents, andall amendments to those documents;
2. A copy of the bylaws, rules, and regulations, or any similar documentregulating the conduct of the internal affairs of the applicant;
3. A list of the name, address, official position, and biographicalinformation on forms acceptable to the Commission of each member of thegoverning body and any person with authority to manage or establish policy;and a full disclosure in the application of (i) any financial interestbetween such person or any dentist, organization, or corporation owned orcontrolled by such person and the dental plan organization and (ii) theextent and nature of the financial arrangements between such person and thedental plan organization;
4. A copy of any contract made or to be made between any dentist, sponsor, ororganizer of the dental plan organization, or persons listed in subdivision 3and the applicant;
5. A copy of the evidence of coverage form to be issued to subscribers andthe dental benefit contract to be issued to contract holders;
6. A copy of any group contract form that is to be issued to employers,unions, trustees, or other organizations. All group contracts shall set forththe right of subscribers to convert their coverages to an individual contractissued by the dental plan organization;
7. A financial statement or statements and any reports, certificates, orother documents the Commission considers necessary to secure a full andaccurate knowledge of the applicant's affairs and financial condition;
8. A complete description of the dental plan organization and its method ofoperation, including (i) the method of marketing the plan, (ii) a statementregarding the sources of working capital as well as any other sources offunding, and (iii) a description of any insurance, reinsurance, oralternative coverage arrangements proposed, including excess insurance orstop loss insurance;
9. A financial feasibility plan that includes, but is not limited to, (i)detailed enrollment projections, (ii) the methodology for determining premiumrates to be charged during at least the first three years of operations andextending one year beyond the anticipated break-even point certified by anactuary, and (iii) a projection, along with material assumptions, of balancesheets, cash flow statements showing capital expenditures and purchase andsale of investments, and income statements on a quarterly basis for at leastthree years and extending one year beyond the anticipated break-even point;and
10. Any other information the Commission may require to make thedeterminations required pursuant to § 38.2-6103.
