Ariz. Admin. Code § R20-6-1802 - Application for Certificate of Authority

A. A person who wishes to operate as prepaid dental plan organization in Arizona shall file an application for certificate of authority under A.R.S. § 20-1003 for the director's Director's review and approval under A.R.S. § 20-1004. The application shall contain all the information required in A.R.S. § 20-1003 and this Section.

B. An authorized insurer shall issue the fidelity bond required under A.R.S. § 20-1004(A)(4).

C. An Organization shall not commence operation of, or service under, a prepaid dental plan without approval of the Director under A.R.S. § 20-1004.

D. An application is deemed filed with the Director when the Director receives it.

E. An applicant not domiciled in this state shall file a power of attorney as required by A.R.S. § 20-1003(A)(11) on a Department-prescribed form, with the application.

F. Within 180 days after the director Director issues a certificate of authority to an Organization, the Organization shall notify the director Director in writing of each member appointed to the board of directors for the Organization under A.R.S. § 20-1003(A)(4) .

G. At the time it submits its application for certificate of authority, an Organization shall submit a written program of compliance with supporting documents that specify how the Organization will comply with the provisions of this Article. The written program of compliance shall contain the following:

1. The responsibilities of and qualifications for the following positions:

a. The Organization's chief executive officer, and

b. The Organization's dental director;

2. A plan for provision of basic dental services required under subsection R20-6-1806(A) and a copy of the schedule of benefits required under subsection R28-6-1806(B);

3. A description of the system for delivery of services under Section R20-6-1807;

4. A description of the geographic area designated under Section R20-6-1808;

5. A plan for compliance with contract requirements under Section R20-6-1809 and a copy of a contract with a general dentist and a specialist;

6. A plan for compliance with records requirements under Section R20-6-1810; and

7. The Organization's quality improvement plan under Section R20-6-1811.

H.G. An application shall include the following information:

1. The proposed number of members, and

2. A copy of a letter from each network dentist that documents the dentist's intent to contract with the Organization to provide services to patients under the Organization's prepaid dental plan.

I.H. The Director may require that an applicant for a certificate of authority under A.R.S. § 20-1003(A)(14) submit information that discloses biographical, employment and business financial history, criminal activity, fingerprints, or any information that relates to the ability to operate a prepaid dental plan for principals, principal officers, controlling persons, and insurance producers of the applicant, if necessary for the protection of residents of this State.

Notes

Ariz. Admin. Code § R20-6-1802

New Section made by final rulemaking at 8 A.A.R. 463, effective January 10, 2002 (Supp. 02-1). Amended by final rulemaking at 27 A.A.R. 654, effective 5/7/2022.