DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Clark, Amy	DOIID	1227487	NAIC NPN	20349915

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	9/6/2022		4/30/2025
* 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	02/15/2025	04/30/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Arcadian Health Plan, Inc.	728196	Agent - Health	11/7/2022	5/15/2024
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	9/30/2022	5/15/2024
Inactive	Humana Insurance Company	301104	Agent - Health	11/21/2022	5/15/2024
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	1/24/2023	5/15/2024

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Trubridge Inc	717747	Agent - Health	10/26/2022	12/2/2023