DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Forrest, Tytianna Monique	DOIID	1219068	NAIC NPN	20387964

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	7/26/2022		6/30/2026
Active	Non Resident	Agent	Life	7/26/2022		6/30/2026
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	04/15/2026	06/30/2026

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	7/26/2022
Inactive	Anthem Life Insurance Company	301209	Agent - Health	7/26/2022	4/15/2025
Inactive	Anthem Life Insurance Company	301209	Agent - Life	7/26/2022	4/15/2025
Active	Golden Rule Insurance Company	301943	Agent - Health	8/10/2022
Active	Golden Rule Insurance Company	301943	Agent - Life	8/10/2022
Active	Molina Healthcare of Kentucky, Inc.	1035856	Agent - Health	8/30/2022
Inactive	WellCare Health Plans of Kentucky, Inc.	838592	Agent - Health	9/23/2022	12/22/2022

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	HealthMarkets Insurance Agency Inc	709727	Agent - Life	11/16/2022
Active	HealthMarkets Insurance Agency Inc	709727	Agent - Health	11/16/2022