DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Mellquist, Matthew	DOIID	1018520	NAIC NPN	18895559

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	11/8/2018	3/31/2020
* 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	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	4/12/2019	9/16/2019
Inactive	American Financial Security Life Insurance Co.	301635	Agent - Health	3/24/2019	9/13/2019
Inactive	LifeShield National Insurance Company	737111	Agent - Health	1/30/2019	9/12/2019
Inactive	Standard Life and Accident Insurance Company	301534	Agent - Health	3/26/2019	11/29/2019
Inactive	Unified Life Insurance Company	543169	Agent - Health	10/22/2019	3/31/2020
Inactive	United States Fire Insurance Company	582240	Agent - Health	9/11/2019	3/31/2020

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Health Plan Intermediaries Holdings	786463	Agent - Health	4/5/2019	3/31/2020