Okla. Stat. tit. 36, § 36-6144

A. An application for a certificate of authority to operate as

a prepaid dental plan organization shall be filed with the

Commissioner in a form prescribed by the Commissioner. The

application shall be verified by an officer or authorized

representative of the applicant, and shall set forth or be

accompanied by:

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, with all amendments to such documents;

2. A copy of any bylaws, rules or regulations, or similar

documents regulating the conduct of 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 business

affairs of the applicant, including all members of the board of

directors, board of trustees, executive committee or other governing

board or committee, and the principal officers in the case of a

Oklahoma Statutes - Title 36. Insurance Page 1153

corporation, and the partners or members in the case of a

partnership or association;

4. A copy of any contract made or to be made between any

providers of dental services or persons listed in paragraph 3 of

this subsection and the applicant;

5. A statement generally describing the prepaid dental plan

organization, all prepaid dental plans offered by said

organizations, and facilities, and personnel;

6. A copy of the form of individual or group membership

coverage or a copy of the contract to be issued to the members;

7. Financial statements showing assets, liabilities, and

sources of financial support of the applicant. If the financial

affairs of the applicant are audited by independent certified public

accountants, a copy of the most recent regular certified financial

statement for the applicant shall satisfy this requirement unless

the Commissioner determines that additional or more recent financial

information is required;

8. A description of the proposed method of marketing the

prepaid dental plan, a financial prospectus which includes a three-

year projection of the initial operating results anticipated, and a

statement as to the sources of working capital available for the

operation of the prepaid dental plan as well as any other sources of

funding;

9. A power of attorney, duly executed by said applicant if not

domiciled in this state appointing the Commissioner, as the true and

lawful representative for service of process for said applicant in

this state, upon whom all lawful process in any legal action or

proceeding against the prepaid dental plan organization on a cause

of action arising in this state may be served;

10. A fee of One Hundred Dollars ($100.00) for issuance of a

certificate of authority; and

11. Such other information as the Commissioner may require.

B. Within ten (10) days following any said modification of

information previously furnished as required by subsection A of this

section, a prepaid dental plan organization shall file notice of

said modification with the Commissioner.