DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Chacon-Romero, Carla A	DOIID	1191358	NAIC NPN	19051262

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	3/3/2022		12/31/2024
* 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	10/15/2024	12/31/2024

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Aetna Health Inc. (PA)	660717	Agent - Health	3/17/2022
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	3/17/2022
Active	Aetna Life Insurance Company	301140	Agent - Health	3/17/2022
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	3/3/2022	11/10/2022
Inactive	Anthem Health Plans of New Hampshire, Inc.	944064	Agent - Health	3/3/2022	11/10/2022
Inactive	Anthem Insurance Companies, Inc.	300941	Agent - Health	3/3/2022	11/10/2022
Inactive	Compcare Health Services Insurance Corporation	948751	Agent - Health	3/3/2022	11/10/2022
Active	SilverScript Insurance Company	663526	Agent - Health	3/17/2022

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Purpose Insurance Agency, LLC	1213960	Agent - Health	11/21/2023