DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Clark, Taqurilla	DOIID	1003745	NAIC NPN	18811943

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	9/29/2023		1/31/2025
* 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	11/15/2024	01/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Arcadian Health Plan, Inc.	728196	Agent - Health	9/29/2024
Active	CompBenefits Insurance Company	301864	Agent - Health	9/29/2024
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	8/7/2018	10/12/2021
Active	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	9/29/2024
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	10/3/2018	10/12/2021
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	8/7/2018	10/12/2021
Active	Humana Insurance Company	301104	Agent - Health	9/29/2024
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	8/7/2018	10/12/2021
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	8/7/2018	10/12/2021
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	8/7/2018	10/12/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Humana MarketPOINT Inc.	398092	Agent - Health	6/18/2019	10/12/2021