DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Velazquez, Samuel	DOIID	1107836	NAIC NPN	19690786

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	10/28/2020	3/31/2023
* 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	Accendo Insurance Company	300312	Agent - Health	12/1/2021	3/31/2023
Inactive	Aetna Health and Life Insurance Company	300523	Agent - Health	12/18/2020	11/10/2021
Inactive	American Financial Security Life Insurance Co.	301635	Agent - Health	4/21/2022	3/31/2023
Inactive	American General Life Insurance Company	301585	Agent - Health	10/20/2021	3/31/2023
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	12/18/2020	11/10/2021
Inactive	Federal Insurance Company	301144	Agent - Health	5/6/2021	3/31/2023
Inactive	Fidelity Security Life Insurance Company	300466	Agent - Health	11/22/2021	3/31/2023
Inactive	Gerber Life Insurance Company	300529	Agent - Health	12/8/2021	6/13/2022
Inactive	Southern Guaranty Insurance Company	969411	Agent - Health	5/13/2021	2/22/2023
Inactive	Standard Life and Accident Insurance Company	301534	Agent - Health	5/12/2021	3/31/2023
Inactive	Unified Life Insurance Company	543169	Agent - Health	5/12/2021	3/31/2023
Inactive	United States Fire Insurance Company	582240	Agent - Health	5/7/2021	3/31/2023
Inactive	Wellfleet Insurance Company	300542	Agent - Health	11/12/2021	3/31/2023

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	4/18/2022