DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Dominguez, Jordan	DOIID	1364750	NAIC NPN	21336814

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	9/30/2024		10/31/2026
Active	Non Resident	Agent	Life	9/30/2024		10/31/2026
* 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	08/15/2026	10/31/2026

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	12/4/2024	3/17/2026
Inactive	Humana Insurance Company	301104	Agent - Health	12/6/2024	3/17/2026

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	TZ Insurance Solutions LLC	727470	Agent - Life
Inactive	TZ Insurance Solutions LLC	727470	Agent - Health	3/3/2025	12/15/2025