DEPARTMENT OF INSURANCE

Affiliations

Name	Lasaracina, Donato	DOIID	1101014	NAIC NPN	19619611

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Pending Replacement	Non Resident	Agent	Health	10/5/2020		6/30/2024
* 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	04/15/2024	06/30/2024

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Accendo Insurance Company	300312	Agent - Health	5/11/2022	6/1/2022
Pending Replacement	Aetna Health Inc. (PA)	660717	Agent - Health	5/16/2022
Inactive	Aetna Health and Life Insurance Company	300523	Agent - Health	5/11/2022	6/1/2022
Pending Replacement	Aetna Health of Ohio Inc.	1065035	Agent - Health	5/16/2022
Pending Replacement	Aetna Life Insurance Company	301140	Agent - Health	5/16/2022
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	4/20/2022	10/31/2022
Inactive	Anthem Health Plans of New Hampshire, Inc.	944064	Agent - Health	4/20/2022	10/31/2022
Inactive	Anthem Insurance Companies, Inc.	300941	Agent - Health	4/20/2022	10/31/2022
Inactive	Arcadian Health Plan, Inc.	728196	Agent - Health	10/20/2020	3/24/2022
Inactive	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	7/20/2022	11/17/2022
Inactive	Compcare Health Services Insurance Corporation	948751	Agent - Health	4/20/2022	10/31/2022
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	5/11/2022	6/1/2022
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	11/2/2020	3/24/2022
Inactive	Humana Insurance Company	301104	Agent - Health	5/23/2022	6/2/2022
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	10/26/2020	3/24/2022
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	12/30/2020	3/24/2022
Pending Replacement	SilverScript Insurance Company	663526	Agent - Health	5/16/2022
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	6/9/2022	11/17/2022
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	6/9/2022	11/17/2022
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	6/9/2022	11/17/2022

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Qw Insurance Solutions, LLC	1047634	Agent - Health	4/20/2022	6/1/2022
Inactive	Trubridge Inc	717747	Agent - Health	2/15/2022	3/1/2022