DEPARTMENT OF INSURANCE

Affiliations

Name	Forman, Malinda Theresa	DOIID	1025519	NAIC NPN	19019071

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Life	2/1/2019	12/31/2021
Inactive	Resident	Agent	Health	2/8/2019	12/31/2021
* 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	Accendo Insurance Company	300312	Agent - Life	6/10/2020	12/31/2021
Inactive	Aetna Health Inc. (PA)	660717	Agent - Health	10/15/2019	12/31/2021
Inactive	Aetna Health and Life Insurance Company	300523	Agent - Health	3/12/2019	12/31/2021
Inactive	Aetna Health of Ohio Inc.	1065035	Agent - Health	7/30/2020	12/31/2021
Inactive	Aetna Life Insurance Company	301140	Agent - Health	10/15/2019	12/31/2021
Inactive	American Continental Insurance Company	643130	Agent - Life	3/12/2019	8/11/2021
Inactive	American General Life Insurance Company	301585	Agent - Health	3/11/2019	12/31/2021
Inactive	American General Life Insurance Company	301585	Agent - Life	3/11/2019	12/31/2021
Inactive	Americo Financial Life and Annuity Insurance Company	300869	Agent - Health	2/18/2019	1/25/2022
Inactive	Americo Financial Life and Annuity Insurance Company	300869	Agent - Life	2/18/2019	1/25/2022
Inactive	Anthem Health Plans of New Hampshire, Inc.	944064	Agent - Health	9/26/2021	12/31/2021
Inactive	Anthem Insurance Companies, Inc.	300941	Agent - Health	9/26/2021	12/31/2021
Inactive	Anthem Life Insurance Company	301209	Agent - Health	10/12/2019	12/31/2021
Inactive	Anthem Life Insurance Company	301209	Agent - Life	10/12/2019	12/31/2021
Inactive	Arcadian Health Plan, Inc.	728196	Agent - Health	10/23/2019	12/31/2021
Inactive	Compcare Health Services Insurance Corporation	948751	Agent - Health	9/16/2021	12/31/2021
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	3/12/2019	12/31/2021
Inactive	Gerber Life Insurance Company	300529	Agent - Health	6/12/2019	12/31/2021
Inactive	Gerber Life Insurance Company	300529	Agent - Life	6/12/2019	12/31/2021
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	10/23/2019	12/31/2021
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	10/23/2019	12/31/2021
Inactive	Humana Insurance Company	301104	Agent - Health	10/23/2019	12/31/2021
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	10/23/2019	12/31/2021
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	10/23/2019	12/31/2021
Inactive	Independent Order of Foresters	300743	Agent - Life	4/12/2019	12/23/2020
Inactive	Minnesota Life Insurance Company	300488	Agent - Life	3/5/2019	12/31/2021
Inactive	Protective Life Insurance Company	300638	Agent - Health	2/14/2021	12/31/2021
Inactive	Protective Life Insurance Company	300638	Agent - Life	2/14/2021	12/31/2021
Inactive	Royal Neighbors of America	301646	Agent - Life	5/28/2019	5/29/2020
Inactive	Sagicor Life Insurance Company	300459	Agent - Life	3/18/2019	6/2/2020
Inactive	SilverScript Insurance Company	663526	Agent - Health	10/15/2019	12/31/2021
Inactive	Transamerica Life Insurance Company	300571	Agent - Health	2/27/2019	11/10/2020
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	2/27/2019	11/10/2020
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Health	2/27/2019	10/1/2020
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Life	2/27/2019	10/1/2020
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	3/29/2019	7/22/2020
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	3/29/2019	7/22/2020
Inactive	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	10/18/2019	12/29/2021
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	10/18/2019	12/30/2021

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	10/16/2019	12/31/2021
Inactive	Designated Agent Company Inc.	681257	Agent - Health	10/16/2019	12/31/2021