An application for a certificate of authority to operate a prepaid dental plan corporation in this state shall be filed with the director on a form prescribed by the director. Such application shall be verified by an officer or authorized representative of the applicant and shall set forth, or be accompanied by, the following:

(1) A duly certified copy of the corporation’s articles of incorporation or articles of association with all amendments;

Terms Used In Missouri Laws 354.704

  • Assets: (1) The property comprising the estate of a deceased person, or (2) the property in a trust account.
  • Contract: A legal written agreement that becomes binding when signed.
  • Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
  • following: when used by way of reference to any section of the statutes, mean the section next preceding or next following that in which the reference is made, unless some other section is expressly designated in the reference. See Missouri Laws 1.020
  • Liabilities: The aggregate of all debts and other legal obligations of a particular person or legal entity.
  • State: when applied to any of the United States, includes the District of Columbia and the territories, and the words "United States" includes such district and territories. See Missouri Laws 1.020

(2) A copy of the corporation’s bylaws or regulations governing the conduct of the internal affairs of the corporation;

(3) A list of the names, addresses, and official positions of the persons who are responsible for the conduct of the affairs of the corporation, including all members of the board of directors;

(4) A copy of any contract made or to be made between any providers and the applicant;

(5) A statement generally describing the prepaid dental plan to be offered and the corporation’s facilities and personnel;

(6) A copy of contracts and contract certificates to be issued to the enrollees;

(7) A copy of any group enrollee contract which is to be issued;

(8) 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 director determines that additional or more recent financial information is required;

(9) A description of the proposed method of marketing the prepaid dental plan, a financial plan which includes a three-year projection of the initial operating results anticipated, and a statement as to the sources of funding;

(10) A description of the procedures to provide emergency dental benefits;

(11) A statement reasonably describing the geographic area to be served;

(12) A fee of two hundred dollars for issuance of a certificate of authority; and

(13) Such other information as the director may require.

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