DEPARTMENT OF INSURANCE

Affiliations

Name	Ellis, Dornell	DOIID	1009635	NAIC NPN	18559051

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	9/13/2018	8/9/2021
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Aetna Health Inc. (PA)	660717	Agent - Health	12/19/2019	8/9/2021
Inactive	Aetna Health and Life Insurance Company	300523	Agent - Health	2/8/2019	7/18/2019
Inactive	Aetna Health of Ohio Inc.	1065035	Agent - Health	7/29/2020	8/9/2021
Inactive	Aetna Life Insurance Company	301140	Agent - Health	12/19/2019	8/9/2021
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	12/22/2019	12/28/2019
Inactive	Arcadian Health Plan, Inc.	728196	Agent - Health	11/6/2019	10/22/2020
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	2/8/2019	7/18/2019
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	10/25/2019	10/22/2020
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	10/28/2019	10/22/2020
Inactive	Humana Insurance Company	301104	Agent - Health	11/26/2019	10/22/2020
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	12/6/2019	10/22/2020
Inactive	Independence American Insurance Company	524747	Agent - Health	10/21/2020	12/18/2020
Inactive	Madison National Life Insurance Company Inc.	301458	Agent - Health	10/21/2020	8/9/2021
Inactive	Sierra Health and Life Insurance Company Inc.	300357	Agent - Health	7/22/2020	10/14/2020
Inactive	SilverScript Insurance Company	663526	Agent - Health	8/14/2019	8/9/2021
Inactive	United World Life Insurance Company	300532	Agent - Health	3/14/2019	7/3/2019
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	10/14/2020	3/11/2021
Inactive	UnitedHealthcare Insurance Company of America	301552	Agent - Health	9/13/2018	12/11/2018
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	10/14/2020	3/11/2021
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	10/14/2020	3/11/2021
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	10/14/2020	3/11/2021
Inactive	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	11/29/2019	8/9/2021
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	11/29/2019	8/9/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Designated Agent Company Inc.	681257	Agent - Health	12/26/2019	8/9/2021