DEPARTMENT OF INSURANCE

Affiliations

Name	Dominique, Serina	DOIID	1079324	NAIC NPN	19389108

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Life	3/25/2020	2/29/2024
Inactive	Non Resident	Agent	Health	3/25/2020	2/29/2024
* 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 - Health	6/21/2022	11/17/2023
Inactive	Accendo Insurance Company	300312	Agent - Life	6/21/2022	2/29/2024
Inactive	Aetna Health Inc. (PA)	660717	Agent - Health	8/14/2020	2/29/2024
Inactive	Aetna Health and Life Insurance Company	300523	Agent - Health	6/21/2022	2/29/2024
Inactive	Aetna Health of Ohio Inc.	1065035	Agent - Health	8/14/2020	2/29/2024
Inactive	Aetna Life Insurance Company	301140	Agent - Health	8/14/2020	2/29/2024
Inactive	American General Life Insurance Company	301585	Agent - Health	1/18/2022	10/14/2023
Inactive	American General Life Insurance Company	301585	Agent - Life	1/18/2022	10/14/2023
Inactive	Americo Financial Life and Annuity Insurance Company	300869	Agent - Life	1/20/2022	9/20/2022
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	6/23/2020	11/10/2022
Inactive	Anthem Health Plans of New Hampshire, Inc.	944064	Agent - Health	9/24/2021	11/10/2022
Inactive	Anthem Insurance Companies, Inc.	300941	Agent - Health	9/24/2021	11/10/2022
Inactive	Compcare Health Services Insurance Corporation	948751	Agent - Health	9/24/2021	11/10/2022
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	6/21/2022	2/29/2024
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Life	6/21/2022	2/29/2024
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	6/15/2020	12/15/2020
Inactive	SilverScript Insurance Company	663526	Agent - Health	8/14/2020	2/29/2024
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	3/16/2022	6/6/2022
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	3/16/2022	6/6/2022
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	3/16/2022	6/6/2022

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Designated Agent Company Inc.	681257	Agent - Life
Inactive	Designated Agent Company Inc.	681257	Agent - Health	6/24/2020	11/11/2022
Inactive	Ensurem II LLC	908041	Agent - Life	3/30/2022	5/24/2022
Inactive	Ensurem II LLC	908041	Agent - Health	3/30/2022	5/24/2022
Inactive	Qw Insurance Solutions, LLC	1047634	Agent - Health	5/14/2021	1/28/2022