DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Chan, Jazmin A	DOIID	1020534	NAIC NPN	18737374

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Pending Replacement	Non Resident	Agent	Health	11/29/2018		5/31/2025
Pending Replacement	Non Resident	Agent	Life	11/29/2018		5/31/2025
* 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	03/15/2025	05/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	1/29/2019	7/31/2023
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	1/29/2019	7/31/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Paychex Insurance Agency Inc	509469	Agent - Life	1/29/2019	5/15/2023
Inactive	Paychex Insurance Agency Inc	509469	Agent - Health	1/29/2019	5/15/2023