DEPARTMENT OF INSURANCE

Affiliations

Name	Tully, Aviva	DOIID	1038655	NAIC NPN	19101104

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	4/30/2019		1/31/2025
* 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	11/15/2024	01/31/2025

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	10/14/2022
Active	Aetna Health Inc. (PA)	660717	Agent - Health	3/16/2021
Inactive	Aetna Health and Life Insurance Company	300523	Agent - Health	5/8/2019	10/14/2022
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	3/16/2021
Active	Aetna Life Insurance Company	301140	Agent - Health	3/16/2021
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	8/5/2019	10/25/2023
Inactive	Anthem Health Plans of New Hampshire, Inc.	944064	Agent - Health	9/24/2021	10/25/2023
Inactive	Anthem Insurance Companies, Inc.	300941	Agent - Health	9/24/2021	10/25/2023
Active	Anthem Life Insurance Company	301209	Agent - Health	8/5/2019
Inactive	Arcadian Health Plan, Inc.	728196	Agent - Health	9/15/2021	1/19/2024
Active	CIGNA Health & Life Insurance Company	301783	Agent - Health	9/25/2019
Inactive	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	8/16/2022	2/19/2024
Inactive	Compcare Health Services Insurance Corporation	948751	Agent - Health	9/24/2021	10/25/2023
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	5/8/2019	10/14/2022
Inactive	GPM Health and Life Insurance Company	927255	Agent - Health	1/29/2021	10/17/2022
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	11/24/2021	1/19/2024
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	6/23/2021	12/13/2022
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	8/28/2019	12/19/2019
Inactive	Humana Insurance Company	301104	Agent - Health	8/13/2021	1/19/2024
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	4/30/2019	1/23/2023
Active	SilverScript Insurance Company	663526	Agent - Health	3/16/2021
Active	United World Life Insurance Company	300532	Agent - Health	10/27/2023
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	4/30/2019	1/23/2023
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	8/16/2022	2/19/2024
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	8/16/2022	12/22/2022
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	8/16/2022	2/19/2024
Inactive	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	2/11/2021	12/28/2021
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	2/11/2021	12/23/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Carida Insurance Services Inc.	1119351	Agent - Health	4/18/2023	6/5/2023
Active	Designated Agent Company Inc.	681257	Agent - Health	8/16/2019
Inactive	Trubridge Inc	717747	Agent - Health	7/15/2022	12/2/2023