DEPARTMENT OF INSURANCE

Affiliations

Name	Johnson, Samuel Eric	DOIID	1025226	NAIC NPN	17089134

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	1/11/2019	12/31/2023
Inactive	Non Resident	Agent	Health	1/11/2019	12/31/2023
Active	Non Resident	Independent Adjuster	Property & Casualty	3/29/2022		12/31/2025
* 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
Independent Adjuster	10/15/2025	12/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Accendo Insurance Company	300312	Agent - Health	9/10/2021	11/17/2023
Inactive	Accendo Insurance Company	300312	Agent - Life	6/10/2020	12/31/2023
Inactive	Aetna Health Inc. (PA)	660717	Agent - Health	4/17/2020	7/7/2022
Inactive	Aetna Health and Life Insurance Company	300523	Agent - Health	4/23/2020	12/31/2023
Inactive	Aetna Health of Ohio Inc.	1065035	Agent - Health	7/25/2020	7/7/2022
Inactive	Aetna Life Insurance Company	301140	Agent - Health	4/17/2020	7/7/2022
Inactive	American Continental Insurance Company	643130	Agent - Life	4/23/2020	8/11/2021
Inactive	Ameritas Life Insurance Corporation	300126	Agent - Health	8/27/2020	12/31/2023
Inactive	Anthem Life Insurance Company	301209	Agent - Health	1/17/2019	1/15/2022
Inactive	Anthem Life Insurance Company	301209	Agent - Life	1/17/2019	1/15/2022
Inactive	Arcadian Health Plan, Inc.	728196	Agent - Health	2/7/2019	4/21/2020
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	4/23/2020	12/31/2023
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	7/22/2020	12/15/2020
Inactive	Humana Insurance Company	301104	Agent - Health	7/8/2020	3/24/2022
Inactive	Humana Insurance Company	301104	Agent - Life	2/1/2019	12/19/2019
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	10/12/2020	3/24/2022
Inactive	Molina Healthcare of Kentucky, Inc.	1035856	Agent - Health	10/29/2021	10/23/2022
Inactive	SilverScript Insurance Company	663526	Agent - Health	4/17/2020	7/7/2022
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	10/6/2021	1/19/2022
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	10/6/2021	1/19/2022
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	10/6/2021	12/23/2021
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	10/6/2021	1/19/2022
Inactive	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	10/17/2020	12/29/2021
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	10/14/2020	12/29/2021

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 - Life	1/17/2019	12/31/2023
Inactive	Designated Agent Company Inc.	681257	Agent - Health	1/17/2019	12/31/2023
Inactive	eHealthInsurance Services Inc.	514105	Agent - Health	10/20/2021	12/27/2021