DEPARTMENT OF INSURANCE

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
Active	Non Resident	Agent	Health	11/29/2018		5/31/2025
Active	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.

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