DEPARTMENT OF INSURANCE

Affiliations

Name	Green, Dominique	DOIID	1057164	NAIC NPN	19019733

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Life	9/20/2019	5/27/2026
Inactive	Non Resident	Agent	Health	9/20/2019	5/27/2026
* 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	11/4/2025
Inactive	Aetna Health Inc. (PA)	660717	Agent - Health	10/3/2019	1/15/2026
Inactive	Aetna Health and Life Insurance Company	300523	Agent - Health	10/2/2019	4/16/2020
Inactive	Aetna Health of Ohio Inc.	1065035	Agent - Health	3/20/2026	5/27/2026
Inactive	Aetna Life Insurance Company	301140	Agent - Health	3/20/2026	5/27/2026
Inactive	American Continental Insurance Company	643130	Agent - Life	12/15/2020	8/11/2021
Inactive	American Financial Security Life Insurance Co.	301635	Agent - Health	12/20/2022	5/27/2026
Inactive	American General Life Insurance Company	301585	Agent - Health	11/30/2020	12/20/2023
Inactive	American General Life Insurance Company	301585	Agent - Life	11/30/2020	12/20/2023
Inactive	Anthem Health Plans of New Hampshire, Inc.	944064	Agent - Health	9/24/2021	12/20/2022
Inactive	Anthem Insurance Companies, Inc.	300941	Agent - Health	9/24/2021	12/20/2022
Inactive	Anthem Life Insurance Company	301209	Agent - Health	10/31/2019	12/20/2022
Inactive	Anthem Life Insurance Company	301209	Agent - Life	10/31/2019	12/20/2022
Inactive	Arcadian Health Plan, Inc.	728196	Agent - Health	10/24/2025	5/27/2026
Inactive	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	10/24/2024	5/27/2026
Inactive	Compcare Health Services Insurance Corporation	948751	Agent - Health	9/24/2021	12/20/2022
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	10/2/2019	4/16/2020
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Life	1/12/2024	11/4/2025
Inactive	Devoted Health Insurance Company of Kentucky, Inc.	1306593	Agent - Health	11/4/2024	5/27/2026
Inactive	Federal Life Insurance Company	300945	Agent - Health	12/20/2022	9/5/2023
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	10/24/2025	5/27/2026
Inactive	Lumico Life Insurance Company	300354	Agent - Health	9/21/2019	2/6/2025
Inactive	Medico Insurance Company	301559	Agent - Health	12/4/2019	12/28/2020
Inactive	Medico Insurance Company	301559	Agent - Life	12/4/2019	12/28/2020
Inactive	Molina Healthcare of Kentucky, Inc.	1035856	Agent - Health	4/13/2025	12/16/2025
Inactive	SilverScript Insurance Company	663526	Agent - Health	3/20/2026	5/27/2026
Inactive	Unified Life Insurance Company	543169	Agent - Health	5/18/2021	6/8/2021
Inactive	United Home Life Insurance Company	300421	Agent - Life	1/23/2024	9/23/2024
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	10/24/2024	5/27/2026
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	9/11/2022	12/22/2022
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	10/24/2024	5/27/2026
Inactive	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	8/1/2022	5/29/2024
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	10/25/2019	4/7/2021
Inactive	Wellfleet Insurance Company	300542	Agent - Health	6/16/2021	5/27/2026

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Assurance IQ, LLC	919554	Agent - Life	3/23/2023	5/15/2024
Inactive	Assurance IQ, LLC	919554	Agent - Health	3/23/2023	5/15/2024
Inactive	Designated Agent Company Inc.	681257	Agent - Life	10/31/2019	2/10/2025
Inactive	Designated Agent Company Inc.	681257	Agent - Health	10/31/2019	2/10/2025