DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Randolph, Malaysia	DOIID	1233037	NAIC NPN	20443094

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	9/27/2022		11/30/2025
* 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
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	9/27/2022
Active	Anthem Health Plans of New Hampshire, Inc.	944064	Agent - Health	9/27/2022
Active	Anthem Insurance Companies, Inc.	300941	Agent - Health	9/27/2022
Active	Compcare Health Services Insurance Corporation	948751	Agent - Health	9/27/2022

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	TZ Insurance Solutions LLC	727470	Agent - Health	2/13/2024	6/6/2024