DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Mandapathil, Tom	DOIID	1057626	NAIC NPN	19051874

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	9/24/2019	7/31/2022
* 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	Aetna Health Inc. (PA)	660717	Agent - Health	9/2/2021	7/31/2022
Inactive	Aetna Health and Life Insurance Company	300523	Agent - Health	9/28/2021	7/31/2022
Inactive	Aetna Health of Ohio Inc.	1065035	Agent - Health	9/2/2021	7/31/2022
Inactive	Aetna Life Insurance Company	301140	Agent - Health	9/2/2021	7/31/2022
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	10/4/2019	5/8/2021
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	9/28/2021	7/31/2022
Inactive	SilverScript Insurance Company	663526	Agent - Health	9/2/2021	7/31/2022
Inactive	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	10/28/2019	6/2/2020
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	10/28/2019	6/2/2020

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 - Health	10/10/2019	5/8/2021
Inactive	Ins Dialogue Agency LLC	798353	Agent - Health	11/12/2019	5/8/2021