DEPARTMENT OF INSURANCE

Affiliations

Name	Clark, Tiya	DOIID	1293605	NAIC NPN	20810974

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Life	8/22/2023	12/31/2024
Inactive	Non Resident	Agent	Health	8/22/2023	12/31/2024
* 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	Accendo Insurance Company	300312	Agent - Health	8/28/2023	11/17/2023
Inactive	Aetna Health Inc. (PA)	660717	Agent - Health	9/18/2023	12/31/2024
Inactive	Aetna Health and Life Insurance Company	300523	Agent - Health	8/28/2023	5/8/2024
Inactive	Aetna Health of Ohio Inc.	1065035	Agent - Health	9/18/2023	12/31/2024
Inactive	Aetna Life Insurance Company	301140	Agent - Health	9/18/2023	12/31/2024
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	8/23/2023	2/1/2024
Inactive	Anthem Health Plans of New Hampshire, Inc.	944064	Agent - Health	8/23/2023	2/1/2024
Inactive	Anthem Insurance Companies, Inc.	300941	Agent - Health	8/23/2023	2/1/2024
Inactive	Arcadian Health Plan, Inc.	728196	Agent - Health	10/23/2023	1/30/2024
Inactive	CHA HMO, Inc.	300662	Agent - Health	10/23/2023	1/30/2024
Inactive	CIGNA Health & Life Insurance Company	301783	Agent - Health	9/1/2023	12/31/2024
Inactive	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	9/25/2023	1/29/2024
Inactive	Chesapeake Life Insurance Company (The)	301017	Agent - Health	9/13/2023	2/9/2024
Inactive	Chesapeake Life Insurance Company (The)	301017	Agent - Life	9/13/2023	2/9/2024
Inactive	Cigna Healthcare of Colorado, Inc.	1098153	Agent - Health	11/24/2023	4/12/2024
Inactive	Compcare Health Services Insurance Corporation	948751	Agent - Health	8/23/2023	2/1/2024
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	8/28/2023	5/8/2024
Inactive	Guardian Life Insurance Company of America	301316	Agent - Health	9/20/2023	12/31/2024
Inactive	Guardian Life Insurance Company of America	301316	Agent - Life	9/20/2023	12/31/2024
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	1/10/2024	1/30/2024
Inactive	Humana Insurance Company	301104	Agent - Health	10/25/2023	1/30/2024
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	10/23/2023	1/30/2024
Inactive	Medco Containment Life Insurance Company	301557	Agent - Health	11/6/2023	3/5/2024
Inactive	Monitor Life Insurance Company of New York	1117550	Agent - Health	10/14/2023	1/29/2024
Inactive	Monitor Life Insurance Company of New York	1117550	Agent - Life	10/14/2023	1/29/2024
Inactive	Omaha Health Insurance Company	301296	Agent - Health	10/8/2023	2/1/2024
Inactive	SilverScript Insurance Company	663526	Agent - Health	9/18/2023	12/31/2024
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	9/25/2023	1/29/2024
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	9/25/2023	1/29/2024
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	10/21/2023	2/25/2024

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Extend Insurance Services, LLC	625753	Agent - Life	9/13/2023	2/1/2024
Inactive	Extend Insurance Services, LLC	625753	Agent - Health	9/1/2023	2/1/2024