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.

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	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 Guardian Life Insurance Company	300596	Agent - Health	8/27/2003	10/16/2003
Inactive	National Guardian Life Insurance Company	300596	Agent - Life	8/27/2003	10/16/2003
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