DEPARTMENT OF INSURANCE

Affiliations

Name	Collins, Chaz	DOIID	1147616	NAIC NPN	20003555

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Health	8/5/2021		9/30/2024
* 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	07/15/2024	09/30/2024

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	9/9/2021	7/15/2022
Inactive	Aetna Health and Life Insurance Company	300523	Agent - Health	10/7/2021	9/7/2023
Inactive	Aetna Health of Ohio Inc.	1065035	Agent - Health	9/9/2021	7/15/2022
Inactive	Aetna Life Insurance Company	301140	Agent - Health	9/9/2021	7/15/2022
Active	Arcadian Health Plan, Inc.	728196	Agent - Health	9/16/2022
Active	CHA HMO, Inc.	300662	Agent - Health	12/19/2023
Active	CompBenefits Insurance Company	301864	Agent - Health	9/16/2022
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	10/7/2021	9/7/2023
Active	Dental Concern Inc. (The)	301641	Agent - Health	12/7/2023
Active	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	8/25/2022
Active	Humana Health Plan of Ohio Inc.	301565	Agent - Health	8/25/2022
Active	Humana Health Plan, Inc.	300142	Agent - Health	1/2/2024
Active	Humana Insurance Company	301104	Agent - Health	8/25/2022
Active	Humana Medical Plan, Inc.	801568	Agent - Health	9/16/2022
Active	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	8/25/2022
Inactive	Molina Healthcare of Kentucky, Inc.	1035856	Agent - Health	9/21/2021	10/18/2022
Inactive	SilverScript Insurance Company	663526	Agent - Health	9/9/2021	7/15/2022
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	8/22/2021	6/9/2022
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	8/22/2021	6/9/2022
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	8/22/2021	12/23/2021
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	8/22/2021	6/9/2022
Inactive	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	1/17/2022	8/29/2022

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Humana MarketPOINT Inc.	398092	Agent - Health	5/30/2023
Inactive	eHealthInsurance Services Inc.	514105	Agent - Health	10/22/2021	5/6/2022