DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Burgos-Figueroa, Dominique Jose	DOIID	1103580	NAIC NPN	19655276

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	10/7/2020	5/31/2023
* 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 and Life Insurance Company	300523	Agent - Health	8/2/2021	11/21/2022
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	8/2/2021	11/21/2022
Inactive	Federal Insurance Company	301144	Agent - Health	3/28/2022	1/27/2023
Inactive	Golden Rule Insurance Company	301943	Agent - Health	3/1/2021	6/23/2023
Inactive	Guarantee Trust Life Insurance Company	301043	Agent - Health	8/26/2022	12/7/2022
Inactive	Standard Life and Accident Insurance Company	301534	Agent - Health	5/5/2022	1/27/2023
Inactive	Unified Life Insurance Company	543169	Agent - Health	12/30/2021	5/31/2023
Inactive	United States Fire Insurance Company	582240	Agent - Health	10/29/2020	3/4/2022

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Health Plan Intermediaries Holdings	786463	Agent - Health	1/21/2021	4/28/2022