DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Worm, Thasha Chantelle	DOIID	1288977	NAIC NPN	17642322

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Pending Replacement	Non Resident	Agent	Life	8/1/2023		7/31/2026
Pending Replacement	Non Resident	Agent	Health	8/1/2023		7/31/2026
* 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	05/15/2026	07/31/2026

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Pending Replacement	AAA Life Insurance Company	300287	Agent - Health	8/9/2023
Pending Replacement	AAA Life Insurance Company	300287	Agent - Life	8/9/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Pending Replacement	Aaa Life Agency LLC	1063780	Agent - Life	11/16/2023
Pending Replacement	Aaa Life Agency LLC	1063780	Agent - Health	11/16/2023