20-1001. Definitions In this article, unless the context otherwise requires: 1. " Member" means an individual who is enrolled in a group prepaid dental plan as a principal subscriber together with such person’s dependents who are entitled to dental care services under the plan solely because of their status as dependents of the principal subscriber. […]
20-1002. Establishment of prepaid dental plan organizations A. No person, unless authorized pursuant to article 3 or article 9 of this chapter, may establish or operate a prepaid dental plan organization in this state, or sell or offer to sell, or solicit offers to purchase, or receive advance or periodic consideration in conjunction with a […]
20-1003. Application for certificate of authority A. An application for a certificate of authority to operate as a prepaid dental plan organization shall be filed with the director in a form prescribed by the director, shall be verified by an officer or authorized representative of the applicant and shall set forth, or be accompanied by, […]
20-1004. Issuance of certificate of authority Issuance of a certificate of authority shall be granted by the director if the director is satisfied that the following conditions are met: 1. The persons responsible for conducting the affairs of the prepaid dental plan organization are competent and are professionally capable of providing or arranging for the […]
20-1005. Deposit requirement; exception A. A prepaid dental plan organization shall maintain on deposit with the state treasurer through the director’s office a surety bond, guaranteeing services under the plan, or cash or securities eligible for investment of capital funds, in the following amounts depending on the number of members entitled to dental care services […]
20-1006. Reserve requirement; exception A. A prepaid dental plan organization at all times shall maintain for protection of members a financial reserve consisting of two per cent of prepaid charges collected from members for the plan, until such reserve totals five hundred thousand dollars. Such reserve shall be in addition to the deposit prescribed by […]
20-1006.01. Risk-based capital requirements; minimum capital and surplus A. A prepaid dental plan organization shall comply with chapter 2, article 12 of this title. B. A prepaid dental plan organization that is exempt from the risk-based capital requirements prescribed in section 20-488.08 shall maintain unimpaired capital or surplus, or both, in an amount of at […]
20-1007. Membership coverage by prepaid dental plan organizations A. Every member in a prepaid dental plan shall be issued a membership coverage form by the prepaid dental plan organization. B. Any contract applied for that provides family coverage shall, as to such coverage of individuals in the family, also provide that the benefits applicable for […]
20-1008. Examination of prepaid dental plan organization A. The director may once in each six months for the first three years after organization and once each year thereafter, or more often if deemed necessary by the director, visit each prepaid dental plan organization organized under the laws of this state and examine its financial condition […]
20-1009. Annual report to director A. Every prepaid dental plan organization annually on or before the first day of March shall file with the director a report of its financial condition, transactions and affairs as of the preceding December 31 as prescribed in sections 20-223 and 20-234 and shall pay the annual renewal fee prescribed […]
20-1010. Taxes A. On the tax payment dates prescribed in section 20-224, each prepaid dental plan organization shall pay to the director for deposit, pursuant to sections 35-146 and 35-147, in a form prescribed by the director a tax for transacting a prepaid dental plan in the amount of 2.0 percent of prepaid net charges […]
20-1011. Operational expenses No more than thirty per cent of prepaid charges in the first year of operation, twenty-five per cent of prepaid charges in the second year of operation and twenty per cent of prepaid charges in any subsequent year shall be used for the marketing and administrative expenses of a prepaid dental plan […]
20-1012. Prohibited practices Chapter 2, article 6 of this title, relating to unfair trade practices and frauds, shall apply to prepaid dental plan organizations, except to the extent the director determines that the nature of prepaid dental plan organizations render particular provisions inappropriate.
20-1013. Regulation of agents The director shall, after notice and hearing, promulgate such rules and regulations as are necessary to provide for the licensing of agents which shall include provisions for examination, licensing, annual fees and disciplinary procedures similar to those provided in chapter 2, article 3 of this title.
20-1014. Examination The director may conduct an examination of the affairs of any prepaid dental plan organization as often as the director deems it necessary for the protection of the interests of the people of this state.
20-1015. Suspension or revocation of certificate of authority; civil penalties A. The director may suspend or revoke any certificate of authority issued to a prepaid dental plan organization pursuant to this article if the director finds that any of the following conditions exists: 1. The prepaid dental plan organization is operating significantly in contravention of […]
20-1016. Rehabilitation, liquidation or conservation of prepaid dental plan organization Any rehabilitation, liquidation or conservation of a prepaid dental plan organization shall be deemed to be the rehabilitation, liquidation or conservation of an insurer and shall be conducted pursuant to chapter 3, article 4 of this title.
20-1018. Advertising matter or sales materials A prepaid dental plan organization shall not issue or deliver any advertising matter or sales material to any person in this state until the prepaid dental plan organization files the advertising matter or sales material with the director. This section does not require a prepaid dental plan to have […]
20-1019. Order of benefit determination for dental care A. If a person receiving dental care is a member of a prepaid dental plan and is an insured or certificate holder under an indemnity health insurance policy which provides benefits for the same treatment as the person’s prepaid dental plan, the indemnity health insurance policy, if […]
