A. An application for a certificate of authority to operate as a prepaid dental plan organization shall be filed with the superintendent in form prescribed by the superintendent, shall be verified by an officer or authorized representative of the applicant and shall set forth or be accompanied by the following:

Terms Used In New Mexico Statutes 59A-48-4

  • 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.
  • Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
  • Liabilities: The aggregate of all debts and other legal obligations of a particular person or legal entity.
  • membership coverage: means any certificate or contract issued to a member setting out the dental coverage to which such member is entitled. See New Mexico Statutes 59A-48-2
  • Partnership: A voluntary contract between two or more persons to pool some or all of their assets into a business, with the agreement that there will be a proportional sharing of profits and losses.
  • Power of attorney: A written instrument which authorizes one person to act as another's agent or attorney. The power of attorney may be for a definite, specific act, or it may be general in nature. The terms of the written power of attorney may specify when it will expire. If not, the power of attorney usually expires when the person granting it dies. Source: OCC
  • prepaid dental plan: means any contractual arrangement whereby any prepaid dental plan organization undertakes to provide directly or to arrange for prepaid dental services and to pay or make reimbursement for any remaining portion of such prepaid dental services on a prepaid basis through insurance or otherwise. See New Mexico Statutes 59A-48-2
  • prepaid dental plan organization: means any person who undertakes to conduct one or more prepaid dental plans providing only dental services. See New Mexico Statutes 59A-48-2

(1)     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 together with all amendments to such documents;

(2)     a copy of any bylaws, rules and regulations or similar document regulating the internal affairs of the applicant;

(3)     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 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;

(4)     if the prepaid dental plan organization is a corporation, evidence that the corporation’s board of directors includes:

(a) dentists, duly licensed pursuant to the provisions of the Dental Act [61-5-1 to 61-5-9, 61-5-11 to 61-5-22 N.M. Stat. Ann.][repealed], who have contracted with the corporation to render dental services to members;

(b) members of the prepaid dental plan, who shall comprise at least one-third of the members of the board; and

(c) at least one director who is a licensed dentist who has not contracted to render dental services to members;

(5)     a copy of any contract made or to be made between any providers or persons listed in Paragraph (3) of this subsection and the applicant;

(6)     a statement generally describing the prepaid dental plan organization, its dental plan or plans, facilities and personnel, as approved by the director of the health services division of the health and environmental department [department of health];

(7)     a copy of the form of membership coverage to be issued to members; (8)     a copy of the form of any group contract which is to be issued to employers, unions, trustees or other applicants;

(9)     financial statements showing the applicant’s assets, liabilities and sources of financial support. If the applicant’s financial affairs are audited by independent certified accountants, a copy of the applicant’s most recent regular certified financial statement shall satisfy this requirement unless the superintendent determines that additional or more recent financial information is required for the proper administration of this article;

(10)    a description of the proposed method of marketing the 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;

(11)    a power of attorney duly executed by the applicant, if not domiciled in New Mexico, which appoints the superintendent, his successors in office and his duly authorized deputies 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 any prepaid dental plan organization may be served in any cause of action arising in New Mexico;

(12)    a statement reasonably describing the geographic area or areas to be served, as approved by the director of health services division of the health and environment department [department of health];

(13)    a fee for filing application for certificate of authority as specified in section 101 [59A-6-1 N.M. Stat. Ann.] (fee schedule) of the Insurance Code; and

(14)    such other information as the superintendent may require.

B. Within ten (10) days following any significant modification of information previously furnished pursuant to Subsection A of this section, a prepaid dental plan organization shall file notice of such modification with the superintendent.

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