(a) The applicant’s name, fictitious name, assumed business name and any other identity the applicant uses in conducting business.
(b) The applicant’s business address, mailing address, electronic mail address and the Internet address of any website the applicant maintains for public access.
(c) The applicant’s federal employer identification number or Internal Revenue Service taxpayer identification number.
(d) The applicant’s principal place of business inside or outside this state.
(e) The name of and contact information for a person that the applicant has designated to provide information to consumers or answer consumer questions.
(f) The name and address of the applicant’s agent for the service of process, notice or demand, or a power of attorney that the applicant has executed and by which the applicant appoints the director as the applicant’s agent for the service of process, notice or demand.
(g) A list of individual providers or providers included in the provider network that provide services in this state and a list of the medical and ancillary services the applicant offers or intends to offer to plan members as part of a discount medical plan or the Internet address of a website that lists the providers and services offered.
(h) A list of the persons that the applicant has authorized or intends to authorize to market a discount medical plan in this state under a name that is different from the applicant’s name.
(i) The name, trade name, service mark or other means by which a consumer can identify the discount medical plan the applicant offers or intends to offer and any different name, trade name, service mark or other means the applicant uses to identify the same discount medical plan to persons other than consumers.
(j) A statement that discloses:
(A) Any criminal conviction in the five-year period before the date of application involving the applicant, a member of the board of directors or an officer of the applicant and any person owning or having the right to acquire 10 percent or more of the voting securities of the applicant; and
(B) Any pending investigation into the applicant’s business activities brought by a licensing, regulatory or law enforcement authority in any jurisdiction.
(k) A statement in which the applicant agrees to submit to the personal jurisdiction of the courts of this state.
(L) A statement that discloses any instance in which another jurisdiction has denied the applicant a license or other authority to operate as a discount medical plan organization or has suspended or revoked any such license or other authority after issuance.
(m) Other information the director may require that enables the director, after reviewing all of the information submitted under this subsection, to determine whether the applicant:
(A) Is financially responsible;
(B) Has adequate experience and expertise to operate a discount medical plan organization; and
(C) Is of good character.
(2) Upon receipt of a completed application for a license to operate as a discount medical plan organization, the director may investigate the applicant as necessary to verify the information contained in the application. Except as provided in subsection (3) of this section, if the director is satisfied that the information contained in the application is accurate and complete, the director shall issue a license to the applicant.
(3) The director may deny a license to any applicant if the director finds in writing that:
(a) The applicant has provided false, misleading, incomplete or inaccurate information in the application; or
(b) The applicant is not qualified to operate as a discount medical plan organization because the applicant is not financially responsible, does not have adequate experience or expertise, or has engaged in dishonest, fraudulent or illegal practices or conduct in any business or profession.
(4) If the director denies a license under this section, the applicant may request a hearing under ORS 183.435. Upon receiving the applicant’s request, the director shall grant the applicant a hearing under ORS 183.413 to 183.470. [2007 c.272 §5]
Note: See note under 742.420.