(a)  An application for registration as a provider must be in a form prescribed by the director.

(b)  Subject to adjustment of dollar amounts pursuant to § 19-14.8-32(f), an application for registration as a provider must be accompanied by:

(1)  The fee established by chapter 14 of this title;

(2)  The bond required by § 19-14.8-13;

(3)  Identification of all trust accounts required by § 19-14.8-22 and an irrevocable consent authorizing the director to review and examine the trust accounts;

(4)  Evidence of insurance in the amount of two hundred fifty thousand dollars ($250,000):

(A)  Against the risks of dishonesty, fraud, theft, and other misconduct on the part of the applicant or a director, employee, or agent of the applicant;

(B)  Issued by an insurance company authorized to do business in this state and rated at least “A” by a nationally recognized rating organization;

(C)  With a deductible of not more than ten thousand dollars ($10,000);

(D)  Payable to the applicant, the individuals who have agreements with the applicant, and this state, as their interests may appear; and

(E)  Not subject to cancellation by the applicant without the approval of the director;

(5)  If the applicant is a foreign corporation, proof that the applicant holds a certificate of authority to conduct affairs in this state, as required by chapter 6 of Title 7; and

(6)  If the applicant is organized as a not-for-profit entity or is exempt from taxation, evidence of not-for-profit and tax-exempt status applicable to the applicant under the Internal Revenue Code, 26 U.S.C. § 501, as amended.