DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Anderson, Dominique	DOIID	1349327	NAIC NPN	21205069

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	7/10/2024		1/31/2027
* 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	11/15/2026	01/31/2027

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	7/30/2024
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	7/30/2024
Active	Aetna Life Insurance Company	301140	Agent - Health	7/30/2024
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	7/10/2024
Active	Anthem Insurance Companies, Inc.	300941	Agent - Health	7/10/2024
Active	Arcadian Health Plan, Inc.	728196	Agent - Health	12/6/2024
Active	Compcare Health Services Insurance Corporation	948751	Agent - Health	7/10/2024
Active	Emphesys Insurance Company	300598	Agent - Health	12/26/2025
Active	Humana Insurance Company	301104	Agent - Health	10/24/2024
Active	Humana Medical Plan, Inc.	801568	Agent - Health	3/18/2025
Active	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	2/14/2025
Inactive	Sierra Health and Life Insurance Company Inc.	300357	Agent - Health	10/11/2024	2/16/2026
Active	SilverScript Insurance Company	663526	Agent - Health	7/30/2024

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	TZ Insurance Solutions LLC	727470	Agent - Health	12/26/2024