641—201.3 (135,75GA,ch158) Application. An ODS shall not operate in Iowa without an approved application from the department. An application on forms provided by the department accompanied by a filing fee of $2,000 (a portion of this fee is for the solvency review) payable to the department, shall be completed by an authorized representative of the organized delivery system. The application shall be submitted in duplicate. An application shall not be deemed to be filed until all information necessary to properly process said application has been received by the department; this includes information that addresses rules 201.4(135,75GA,ch158) through 201.15(135,75GA,ch158). The application shall set forth or be accompanied by the following:
	  1. 	 A copy of the basic organizational document of the applicant such as the articles of incorporation, articles of association, partnership agreement, trust agreement, or other applicable documents and all of its amendments.
	  2. 	 A copy of the bylaws, rules or similar document, if any, regulating the governance and the conduct of the internal affairs of the applicant.
	  3. 	 A list of names, addresses and official position of the persons who are to be responsible for the conduct of the affairs of the applicant, including all members of the board of directors, board of trustees, executive committee, or other governing board or committee, the principal officers of a corporation and the partners or members if a partnership or association.
	  4. 	 A copy of the form of evidence of coverage.
	  5. 	 A copy of the form of the group contract, if any, which is to be issued to employers, unions, trustees or other organizations.
	  6. 	 Financial statements showing the applicant’s current assets, liabilities and sources of financial support. If the applicant’s financial affairs are audited by an independent certified public accountant, a copy of the applicant’s most recent regular certified financial statement shall satisfy this requirement unless the department directs that additional financial information is required.
	  7. 	 A description of the proposed method of marketing the plan, a financial plan which includes a three-year projection of operating results anticipated, and a statement as to the sources of funding.
	  8. 	 A statement describing the geographic area to be served.
	  9. 	 A description of the complaint procedures to be utilized.
	  10. 	 A sample copy of the provider contract for risk-bearing providers.