DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Smith, Justin James	DOIID	1014825	NAIC NPN	18938714

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	4/4/2022		3/31/2025
Active	Non Resident	Agent	Life	4/4/2022		3/31/2025
Inactive	Non Resident	Agent	Personal Lines	10/12/2018	3/31/2021
* 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	01/15/2025	03/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Aetna Health Inc. (PA)	660717	Agent - Health	4/7/2022
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	4/7/2022
Active	Aetna Life Insurance Company	301140	Agent - Health	4/7/2022
Inactive	Bristol West Insurance Company	301655	Agent - Personal Lines	11/1/2018	12/27/2018
Active	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	9/11/2022
Inactive	Encompass Indemnity Company	546376	Agent - Personal Lines	11/12/2018	7/31/2020
Inactive	Encompass Insurance Company of America	556578	Agent - Personal Lines	11/12/2018	12/13/2018
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Personal Lines	11/1/2018	12/27/2018
Inactive	Progressive Casualty Insurance Company	300696	Agent - Personal Lines	11/12/2018	1/29/2019
Active	SilverScript Insurance Company	663526	Agent - Health	4/7/2022
Active	UnitedHealthcare Insurance Company	300946	Agent - Health	9/11/2022
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	9/11/2022	12/22/2022
Active	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	9/11/2022

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Assurance IQ, LLC	919554	Agent - Life
Inactive	Assurance IQ, LLC	919554	Agent - Health	3/28/2023	5/15/2024