18 Del. Admin. Code § 1402-5.0

Current through Register Vol. 28, No. 5, November 1, 2024

Section 1402-5.0 - Application procedure

5.1 Applicants for a certificate of authority as a dental plan organization shall, within 90 days of the effective date of this regulation, submit a letter of request to the Commissioner as described in 18 Del.C. § 3803.

5.2 The letter to the Commissioner requesting a certificate of authority to operate a dental service plan in Delaware shall include section 5.2.1 to 5.2.10 as listed below. The request shall be signed by an officer of the corporation, by a partner or the sole proprietor as applicable and be accompanied by:

5.2.1 Registration fee of $100.00;

5.2.2 Articles of incorporation, partnership agreement or applicable documents;

5.2.3 Corporate by-laws or other documents describing the procedure for internal control and operation of the business entity;

5.2.4 Name, address, title or nature of affiliation of each member of the board of directors, officers partners or sole proprietors involved in the direct operation of the dental service plan;

5.2.5 A synopsis of the dental plan organization including an outline of the contract for services provided consumers, the physical plant; an outline of the contract between the plan and servicing dentists, administrative staff and procedures, areas to be served, primary market target, recruiting and training of administrative staff. This synopsis shall contain sufficient details of the proposed dental service to allow the Commissioner to determine that the proposal will, if approved, provide for adequate care and be reasonably available to the consumer;

5.2.6 A financial projection covering three years (one year for currently operating plans) reviewing initial source of capital, projected operating results;

5.2.7 A current financial report certified by an independent CPA;

5.2.8 Copies of proposed contracts between dental plan and employer, union or other groups; between dental plan and individuals, if individual service is contemplated; between dental plan and dental practitioners; between plan and any service facility or administrator;

5.2.9 A certificate by the chief executive officer that the bond and malpractice coverage required by 18 Del.C. § 3806, 3807 has been provided. Each dentist shall have, as a minimum, $50,000 professional liability/medical malpractice insurance. Each officer, director or partner who receives, collects or invests money on behalf of the dental plan shall be bonded in the amount of $50,000; and

5.2.10 A biographical affidavit of each corporate officer, member of the board of directors, partner or sole proprietor.

18 Del. Admin. Code § 1402-5.0