Sec. 38a-579. (Formerly Sec. 38-174kk). Certificate of authority. Standards for issuance and renewal.
Sec. 38a-579. (Formerly Sec. 38-174kk). Certificate of authority. Standards
for issuance and renewal. (a) The commissioner shall issue a certificate of authority
if he is satisfied that the following conditions are met: (1) The persons responsible for
conducting the affairs of the dental plan organization are competent and professionally
capable of providing, arranging for or administering the services offered by the plan;
(2) the dental plan organization constitutes an appropriate mechanism to achieve an
effective dental plan, as determined by the commissioner; (3) the dental plan organization has demonstrated the potential to provide dental services in a manner that will assure
both availability and accessibility of adequate personnel and facilities; (4) the dental
plan organization has arrangements for an ongoing quality of dental care assurance
program; (5) the dental plan organization has a procedure to establish and maintain
uniform systems of cost accounting and reports and audits that meet the requirements
of the commissioner; (6) the dental plan organization is financially responsible and may
reasonably be expected to meet its obligations to enrollees. In making this determination
the commissioner shall consider (A) the financial soundness of the dental plan's arrangements for services and the schedule of charges used, (B) any arrangement with an insurer
or hospital or medical or dental service corporation for continuation of coverage in the
event of discontinuance of the plan on an indemnity basis through a group vehicle to
the end of the period for which premiums were paid to the discontinued dental plan
organization, and (C) the sufficiency of an agreement with dentists for the provision of
dental services; (7) whether a general surplus is maintained as required in section 38a-580; and (8) the condition or methods of operation of the dental plan organization are
not such as would render its operations hazardous to its enrollees or the public.
(b) When the commissioner disapproves an application for a certificate of authority,
he shall notify the dental plan organization in writing of the reasons for the disapproval.
(c) A certificate of authority shall expire one year following the date of issuance
or previous renewal. If the dental plan organization remains in compliance with the
requirements of sections 38a-577 to 38a-590, inclusive, and has made timely payment
of the renewal fee of one hundred dollars, its certificate shall be renewed.
(P.A. 88-272, S. 3.)
History: Sec. 38-174kk transferred to Sec. 38a-579 in 1991.