DEPARTMENT OF INSURANCE
Affiliations
NameMitchener, Clarone TiwayneDOIID1063544NAIC NPN18871170
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
InactiveNon ResidentAgentHealth10/30/20195/4/2022 
* 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
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveAetna Health Inc. (PA)660717Agent - Health11/4/20195/4/2022
InactiveAetna Health of Ohio Inc.1065035Agent - Health7/29/20205/4/2022
InactiveAetna Life Insurance Company301140Agent - Health11/4/20195/4/2022
InactiveAnthem Health Plans of Kentucky, Inc.300999Agent - Health11/5/20195/4/2022
InactiveChesapeake Life Insurance Company (The)301017Agent - Health1/6/20203/19/2021
InactiveSilverScript Insurance Company663526Agent - Health11/4/20195/4/2022
InactiveWellCare Health Insurance Company of Kentucky, Inc.301478Agent - Health11/25/20195/4/2022
InactiveWellCare Prescription Insurance Inc.654329Agent - Health11/25/20195/4/2022
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveDesignated Agent Company Inc.681257Agent - Health11/5/20195/4/2022
InactiveHealth Plan Intermediaries Holdings786463Agent - Health12/17/20194/28/2022

© Commonwealth of Kentucky. All rights reserved.