DEPARTMENT OF INSURANCE

Affiliations

Name	Chick, Dorothy H	DOIID	318767	NAIC NPN	1489850

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Health	12/8/2022		9/30/2026
Active	Resident	Agent	Life	12/8/2022		9/30/2026
Inactive	Resident	Temporary Agent	Ordinary Life (Temporary Life)	10/27/1998	11/24/1998
* 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	07/15/2026	09/30/2026

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	12/12/2022
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	10/3/2024
Active	Aetna Life Insurance Company	301140	Agent - Health	12/12/2022
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Health	3/6/2006	12/27/2013
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Life	3/6/2006	12/27/2013
Inactive	American Fidelity Assurance Company	301004	Agent - Health	7/1/1997	7/1/1998
Inactive	American Fidelity Assurance Company	301004	Agent - Life	7/1/1997	7/1/1998
Inactive	American Franklin Life Insurance Company (The)	301025	Agent - Health	1/25/1995	3/31/1997
Inactive	American Franklin Life Insurance Company (The)	301025	Agent - Life	1/25/1995	3/31/1997
Inactive	American Heritage Life Insurance Company	300272	Agent - Health	12/28/1995	7/1/1998
Inactive	American Heritage Life Insurance Company	300272	Agent - Life	12/28/1995	7/1/1998
Inactive	Americo Financial Life and Annuity Insurance Company	300869	Agent - Health	4/30/2001	11/1/2006
Inactive	Americo Financial Life and Annuity Insurance Company	300869	Agent - Life	4/30/2001	11/1/2006
Inactive	Anthem Health Plans of New Hampshire, Inc.	944064	Agent - Health	9/28/2021	9/30/2022
Inactive	Anthem Insurance Companies, Inc.	300941	Agent - Health	6/12/2021	9/30/2022
Inactive	Anthem Life Insurance Company	301209	Agent - Health	9/3/1996	7/1/1998
Inactive	Anthem Life Insurance Company	301209	Agent - Life	9/3/1996	7/1/1998
Inactive	Arcadian Health Plan, Inc.	728196	Agent - Health	10/18/2017	12/10/2018
Inactive	Banner Life Insurance Company	301696	Agent - Life	2/3/2012	8/21/2014
Inactive	Centennial Life Insurance Company (The)	301561	Agent - Health	12/15/1995	3/31/1997
Inactive	Centennial Life Insurance Company (The)	301561	Agent - Life	12/15/1995	3/31/1997
Inactive	Citizens Security Life Insurance Company	301257	Agent - Health	8/15/2007	9/30/2020
Inactive	Citizens Security Life Insurance Company	301257	Agent - Life	8/15/2007	9/30/2020
Inactive	Columbian Life Insurance Company	300810	Agent - Health	7/22/2004	7/1/2013
Inactive	Columbian Life Insurance Company	300810	Agent - Life	12/27/2022	7/26/2024
Inactive	Combined Insurance Company of America	301472	Agent - Health	11/19/2013	10/16/2020
Inactive	Compcare Health Services Insurance Corporation	948751	Agent - Health	9/28/2021	9/30/2022
Inactive	Conseco Health Insurance Company	301725	Agent - Health	10/27/2004	4/24/2007
Inactive	Conseco Health Insurance Company	301725	Agent - Life	10/27/2004	4/24/2007
Inactive	Continental General Insurance Company	300691	Agent - Health	2/17/1995	3/31/1997
Inactive	Continental General Insurance Company	300691	Agent - Life	2/17/1995	3/31/1997
Inactive	Encova Life Insurance Company	301818	Agent - Life	4/29/2009	9/30/2020
Inactive	Essence Healthcare, Inc.	657425	Agent - Health	12/17/2008	3/31/2011
Inactive	Family Life Insurance Company	300356	Agent - Health	11/10/2009	12/28/2012
Inactive	Family Life Insurance Company	300356	Agent - Life	11/10/2009	12/28/2012
Inactive	Fidelity & Guaranty Life Insurance Company	301359	Agent - Life	6/8/2000	3/24/2006
Inactive	First Colony Life Insurance Company	301179	Agent - Life	4/11/2005	1/1/2007
Inactive	Franklin Life Insurance Company (The)	300779	Agent - Health	1/25/1995	3/31/1997
Inactive	Franklin Life Insurance Company (The)	300779	Agent - Life	1/25/1995	3/31/1997
Inactive	Freedom Life Insurance Company of America	300074	Agent - Health	4/21/1994	3/31/1997
Inactive	Freedom Life Insurance Company of America	300074	Agent - Life	4/21/1994	3/31/1997
Inactive	Genworth Life and Annuity Insurance Company	301276	Agent - Health	5/22/2009	12/7/2012
Inactive	Genworth Life and Annuity Insurance Company	301276	Agent - Life	1/1/2007	12/7/2012
Inactive	Government Personnel Mutual Life Insurance Company	301862	Agent - Health	11/30/2016	9/30/2020
Inactive	Government Personnel Mutual Life Insurance Company	301862	Agent - Life	11/30/2016	9/30/2020
Inactive	Great Southern Life Insurance Company	301443	Agent - Life	5/22/2000	6/7/2002
Inactive	Guarantee Trust Life Insurance Company	301043	Agent - Health	4/11/1994	3/20/1998
Inactive	Guarantee Trust Life Insurance Company	301043	Agent - Life	4/11/1994	3/20/1998
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	10/18/2017	12/10/2018
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	10/18/2017	6/15/2018
Inactive	Humana Insurance Company	301104	Agent - Health	10/18/2017	4/9/2019
Inactive	Humana Insurance Company	301104	Agent - Life	10/18/2017	4/9/2019
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	10/18/2017	12/10/2018
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	10/18/2017	12/10/2018
Inactive	Illinois Mutual Life Insurance Company	301479	Agent - Health	1/30/2007	11/10/2009
Inactive	Illinois Mutual Life Insurance Company	301479	Agent - Life	1/30/2007	11/10/2009
Inactive	Independent Order of Foresters	300743	Agent - Life	3/11/2012	12/23/2015
Inactive	Kentucky Home Life Insurance Company	300477	Agent - Health	3/3/1999	10/20/2003
Inactive	Kentucky Home Life Insurance Company	300477	Agent - Life	3/3/1999	10/20/2003
Inactive	Lafayette Life Insurance Company (The)	301039	Agent - Health	7/2/2013	9/30/2020
Inactive	Lafayette Life Insurance Company (The)	301039	Agent - Life	7/2/2013	9/30/2020
Inactive	Loyal American Life Insurance Company	301172	Agent - Health	2/24/2006	11/20/2007
Inactive	Loyal American Life Insurance Company	301172	Agent - Life	2/24/2006	11/20/2007
Inactive	Lumico Life Insurance Company	300354	Agent - Health	5/5/1994	3/31/1997
Inactive	Lumico Life Insurance Company	300354	Agent - Life	5/5/1994	3/31/1997
Inactive	Medico Corp Life Insurance Company	301777	Agent - Health	2/13/2017	4/16/2018
Inactive	Medico Corp Life Insurance Company	301777	Agent - Life	2/13/2017	4/16/2018
Inactive	Medico Life and Health Insurance Company	907406	Agent - Health	3/24/2021	9/30/2022
Inactive	Medico Life and Health Insurance Company	907406	Agent - Life	3/24/2021	9/30/2022
Inactive	Mutual Trust Life Insurance Company, A Pan-American Life Insurance Group Stock Company	300585	Agent - Life	5/24/2001	7/1/2002
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	9/15/2008	1/3/2012
Inactive	NGL Insurance Company	300596	Agent - Health	8/27/2003	10/16/2003
Inactive	NGL Insurance Company	300596	Agent - Life	8/27/2003	10/16/2003
Inactive	Nassau Life Insurance Company of Texas	300872	Agent - Health	7/17/1997	7/1/1998
Inactive	Nassau Life Insurance Company of Texas	300872	Agent - Life	7/17/1997	7/1/1998
Inactive	National Health Insurance Company	300554	Agent - Health	8/7/2021	9/30/2022
Inactive	National Health Insurance Company	300554	Agent - Life	8/7/2021	9/30/2022
Inactive	National States Insurance Company	300579	Agent - Life	1/10/2000	4/13/2000
Inactive	Occidental Life Insurance Company of North Carolina	301185	Agent - Health	7/13/2005	11/27/2006
Inactive	Occidental Life Insurance Company of North Carolina	301185	Agent - Life	7/13/2005	11/27/2006
Inactive	Old American Insurance Company	300762	Agent - Health	11/24/1998	9/21/1999
Inactive	Old American Insurance Company	300762	Agent - Life	11/24/1998	9/21/1999
Inactive	Old American Insurance Company	300762	Temporary Agent - Ordinary Life (Temporary Life)	10/27/1998	11/24/1998
Inactive	Pan-American Assurance Company	301533	Agent - Health	4/22/2003	3/9/2006
Inactive	Pan-American Assurance Company	301533	Agent - Life	4/22/2003	3/9/2006
Inactive	Pan-American Life Insurance Company	301530	Agent - Health	4/22/2003	3/9/2006
Inactive	Pan-American Life Insurance Company	301530	Agent - Life	4/22/2003	3/9/2006
Inactive	Penn Treaty Network America Insurance Company	301297	Agent - Health	2/22/2007	11/27/2008
Inactive	Penn Treaty Network America Insurance Company	301297	Agent - Life	2/22/2007	11/27/2008
Inactive	Reassure America Life Insurance Company	301902	Agent - Health	3/27/1996	7/1/1998
Inactive	Reassure America Life Insurance Company	301902	Agent - Life	3/27/1996	7/1/1998
Inactive	Security Life Insurance Company of America	300936	Agent - Health	3/25/1999	7/20/2001
Inactive	Security Life Insurance Company of America	300936	Agent - Life	3/25/1999	7/20/2001
Inactive	Senior Health Insurance Company of Pennsylvania	300251	Agent - Health	11/26/2001	7/18/2003
Inactive	Senior Health Insurance Company of Pennsylvania	300251	Agent - Life	11/26/2001	7/18/2003
Inactive	Shenandoah Life Insurance Company	300130	Agent - Health	7/29/2004	3/31/2009
Inactive	Shenandoah Life Insurance Company	300130	Agent - Life	7/29/2004	3/31/2009
Active	SilverScript Insurance Company	663526	Agent - Health	12/12/2022
Inactive	Southwestern Life Insurance Company	301343	Agent - Health	7/19/1995	7/20/1998
Inactive	Southwestern Life Insurance Company	301343	Agent - Life	7/19/1995	7/20/1998
Inactive	State Mutual Insurance Company	300359	Agent - Health	11/17/1997	7/1/1998
Inactive	State Mutual Insurance Company	300359	Agent - Life	11/17/1997	7/1/1998
Inactive	Time Insurance Company	300683	Agent - Health	10/6/2014	11/23/2019
Inactive	Time Insurance Company	300683	Agent - Life	10/6/2014	11/23/2019
Inactive	Transamerica Life Insurance Company	300571	Agent - Health	6/8/2017	8/13/2018
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	6/8/2017	8/13/2018
Inactive	Trustmark Insurance Company	300317	Agent - Health	6/5/2000	9/16/2002
Inactive	Trustmark Insurance Company	300317	Agent - Life	6/5/2000	9/16/2002
Inactive	USA Life One Insurance Company of Indiana	301570	Agent - Life	6/6/2003	3/15/2005
Inactive	Union Bankers Insurance Company	301769	Agent - Health	7/18/1995	6/12/1998
Inactive	Union Bankers Insurance Company	301769	Agent - Life	7/18/1995	6/12/1998
Inactive	United Teacher Associates Insurance Company	300747	Agent - Health	2/21/2005	11/28/2007
Inactive	United Teacher Associates Insurance Company	300747	Agent - Life	2/21/2005	11/28/2007
Inactive	United World Life Insurance Company	300532	Agent - Health	9/15/2008	12/15/2010
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	9/15/2008	1/3/2012
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	9/15/2008	1/3/2012
Inactive	Unity Financial Life Insurance Company	301054	Agent - Life	10/18/2002	3/25/2011
Inactive	West Coast Life Insurance Company	301607	Agent - Health	4/7/2009	11/16/2011
Inactive	West Coast Life Insurance Company	301607	Agent - Life	4/7/2009	11/16/2011

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Designated Agent Company Inc.	681257	Agent - Life	12/9/2013	9/30/2020
Inactive	Designated Agent Company Inc.	681257	Agent - Health	12/9/2013	9/30/2020
Inactive	Medlink Inc	400721	Agent - Life	11/24/2008	9/30/2020
Inactive	Medlink Inc	400721	Agent - Health	11/24/2008	9/30/2020