DEPARTMENT OF INSURANCE

Affiliations

Name	Tatum, Dsira	DOIID	1076035	NAIC NPN	19434609

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Personal Lines	3/7/2024		5/31/2027
Inactive	Non Resident	Agent	Health	2/27/2020	5/31/2021
Inactive	Non Resident	Agent	Life	2/27/2020	5/31/2021
* 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	03/15/2025	05/31/2025	05/16/2025	05/16/2025	Yes

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	8/12/2020	7/9/2021
Inactive	Aetna Health of Ohio Inc.	1065035	Agent - Health	8/12/2020	7/9/2021
Inactive	Aetna Life Insurance Company	301140	Agent - Health	8/12/2020	7/9/2021
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	2/14/2021	5/31/2021
Inactive	Anthem Life Insurance Company	301209	Agent - Health	2/14/2021	5/31/2021
Inactive	Anthem Life Insurance Company	301209	Agent - Life	2/14/2021	5/31/2021
Inactive	Arcadian Health Plan, Inc.	728196	Agent - Health	10/16/2020	2/4/2021
Inactive	Chesapeake Life Insurance Company (The)	301017	Agent - Health	12/3/2020	5/31/2021
Inactive	Garrison Property and Casualty Insurance Company	301957	Agent - Personal Lines	3/10/2024	10/30/2024
Inactive	Humana Insurance Company	301104	Agent - Health	1/21/2021	2/4/2021
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	1/20/2021	2/4/2021
Inactive	Lumico Life Insurance Company	300354	Agent - Health	1/25/2021	5/31/2021
Inactive	SilverScript Insurance Company	663526	Agent - Health	8/12/2020	7/9/2021
Inactive	USAA Casualty Insurance Company	300995	Agent - Personal Lines	3/10/2024	10/30/2024
Inactive	USAA General Indemnity Company	300131	Agent - Personal Lines	3/10/2024	10/30/2024
Inactive	United Services Automobile Association	300158	Agent - Personal Lines	3/10/2024	10/30/2024
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	9/27/2020	5/31/2021
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	9/27/2020	5/31/2021
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	9/27/2020	5/31/2021
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	9/27/2020	5/31/2021
Inactive	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	10/1/2020	5/31/2021
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	10/1/2020	5/31/2021

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	3/13/2020	1/28/2021
Inactive	Designated Agent Company Inc.	681257	Agent - Health	5/8/2020	1/31/2021
Inactive	Financial Insurance Services, Inc.	514710	Agent - Personal Lines	3/14/2024	10/30/2024