Illinois Statutes Chapter 215. Insurance § 110/21. Information furnished director prior to issuance of charter

(a) The occupation, qualifications and place of residence and professional or business address, if any, of each of the incorporators;

(b) The name of each contributor to the capital of the corporation, the amount contributed by him and the terms of such contribution;

(c) A copy of the by-laws to be adopted by the Board of Trustees upon the issuance of a charter;

(d) Specimen copies of all subscription certificates which it is proposed the corporation shall issue to subscribers, which certificates shall set forth in detail the rates to be charged subscribers and the nature and extent of the dental service which the subscriber or other beneficiary shall be entitled to receive at the expense of the corporation;

(e) Copies of all agreements to be entered into between the dental service plan corporation and participating dentists, which shall set forth in detail the terms and conditions upon which a participating dentist shall render dental service to subscribers of the corporation;

(f) A detailed statement as to the dental service plan or plans which the corporation proposes to offer, including the rates to be charged and the benefits to be provided;

(g) Proof satisfactory to the Director that in the geographic area in which it is proposed that the dental service plan corporation shall operate, at least a majority of the licensed dentists residing and in active practice in such geographic area have agreed to become participating dentists in association with the dental service plan corporation;

(h) The name and business address of the person who shall be the initial registered agent of the corporation and the address of its initial registered office;

(i) Such other information as the Director determines to be necessary or advisable.