DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Holm, Tristan Andrew	DOIID	1168313	NAIC NPN	11021510

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	3/25/2024		11/30/2026
Active	Non Resident	Agent	Life	3/25/2024		11/30/2026
Active	Non Resident	Agent	Health	3/25/2024		11/30/2026
Active	Non Resident	Agent	Property	3/25/2024		11/30/2026
* 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	AAA Life Insurance Company	300287	Agent - Health	4/11/2024	6/6/2024
Inactive	AAA Life Insurance Company	300287	Agent - Life	4/11/2024	6/6/2024
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	7/23/2024
Active	Anthem Insurance Companies, Inc.	300941	Agent - Health	7/23/2024
Inactive	Bristol West Insurance Company	301655	Agent - Casualty	4/25/2024	6/13/2024
Inactive	Bristol West Insurance Company	301655	Agent - Property	4/25/2024	6/13/2024
Inactive	CSAA Fire & Casualty Insurance Company	606666	Agent - Casualty	4/9/2024	6/4/2024
Inactive	CSAA Fire & Casualty Insurance Company	606666	Agent - Property	4/9/2024	6/4/2024
Inactive	CSAA General Insurance Company	606675	Agent - Casualty	4/9/2024	6/4/2024
Inactive	CSAA General Insurance Company	606675	Agent - Property	4/9/2024	6/4/2024
Active	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	8/6/2024
Active	Compcare Health Services Insurance Corporation	948751	Agent - Health	7/23/2024
Active	Devoted Health Insurance Company of Kentucky, Inc.	1306593	Agent - Health	8/19/2024
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	4/25/2024	6/13/2024
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	4/25/2024	6/13/2024
Inactive	Progressive Casualty Insurance Company	300696	Agent - Casualty	2/7/2022	5/23/2022
Inactive	Progressive Casualty Insurance Company	300696	Agent - Property	2/7/2022	5/23/2022
Active	UnitedHealthcare Insurance Company	300946	Agent - Health	8/6/2024
Active	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	8/6/2024

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Aca Club Insurance Agency, Inc.	1033550	Agent - Casualty	4/9/2024	5/31/2024
Inactive	Aca Club Insurance Agency, Inc.	1033550	Agent - Property	4/9/2024	5/31/2024
Inactive	Aca Club Insurance Agency, Inc.	1033550	Agent - Life	4/11/2024	5/31/2024
Inactive	Aca Club Insurance Agency, Inc.	1033550	Agent - Health	4/11/2024	5/31/2024
Pending	Gohealth LLC	691445	Agent - Life
Active	Gohealth LLC	691445	Agent - Health	8/26/2024