                                 CODE OF VIRGINIA

LICENSE APPLICATION (§ 38.2-6102)

A. No person shall establish or operate a dental plan organization in the
Commonwealth without first obtaining a license from the Commission. Any business
entity, which is neither an individual nor a sole proprietorship, may apply to
the Commission for a license to establish and operate a dental plan organization
in compliance with this chapter.

B. Each application for a license shall be verified by an officer or authorized
representative of the applicant, shall be in a form prescribed by the
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, and all
   amendments to those documents;

   2. A copy of the bylaws, rules, and regulations, or any similar document
   regulating the conduct of the internal affairs of the applicant;

   3. A list of the name, address, official position, and biographical
   information on forms acceptable to the Commission of each member of the
   governing body and any person with authority to manage or establish policy;
   and a full disclosure in the application of (i) any financial interest between
   such person or any dentist, organization, or corporation owned or controlled
   by such person and the dental plan organization and (ii) the extent and nature
   of the financial arrangements between such person and the dental plan
   organization;

   4. A copy of any contract made or to be made between any dentist, sponsor, or
   organizer of the dental plan organization, or persons listed in subdivision 3
   and the applicant;

   5. A copy of the evidence of coverage form to be issued to subscribers and the
   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 forth
   the right of subscribers to convert their coverages to an individual contract
   issued by the dental plan organization;

   7. A financial statement or statements and any reports, certificates, or other
   documents the Commission considers necessary to secure a full and accurate
   knowledge of the applicant&#8217;s affairs and financial condition;

   8. A complete description of the dental plan organization and its method of
   operation, including (i) the method of marketing the plan, (ii) a statement
   regarding the sources of working capital as well as any other sources of
   funding, and (iii) a description of any insurance, reinsurance, or alternative
   coverage arrangements proposed, including excess insurance or stop loss
   insurance;

   9. A financial feasibility plan that includes, but is not limited to, (i)
   detailed enrollment projections, (ii) the methodology for determining premium
   rates to be charged during at least the first three years of operations and
   extending one year beyond the anticipated break-even point certified by an
   actuary, and (iii) a projection, along with material assumptions, of balance
   sheets, cash flow statements showing capital expenditures and purchase and
   sale of investments, and income statements on a quarterly basis for at least
   three years and extending one year beyond the anticipated break-even point;
   and

   10. Any other information the Commission may require to make the
   determinations required pursuant to &#xA7; 38.2-6103.

HISTORY: 2004, c. 668.