DEPARTMENT OF INSURANCE

Affiliations

Name	Tackett, Tina Gayle	DOIID	362136	NAIC NPN	7196820

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Casualty	8/15/2000		10/31/2024
Active	Resident	Agent	Health	5/26/2005		10/31/2024
Active	Resident	Agent	Life	5/26/2005		10/31/2024
Active	Resident	Agent	Property	8/15/2000		10/31/2024
Inactive	Resident	Agent	General Lines	11/18/1999	8/15/2000
* 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	08/15/2024	10/31/2024

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	9/11/2020	12/13/2022
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	10/12/2018	12/13/2022
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	9/11/2020	12/13/2022
Active	Humana Insurance Company	301104	Agent - Health	4/5/2016
Active	Humana Insurance Company	301104	Agent - Life	5/1/2008
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	11/14/2006	5/28/2015
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	11/14/2006	5/28/2015
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	9/11/2020	12/13/2022
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	9/11/2020	12/13/2022
Inactive	Nationwide Mutual Fire Insurance Company	301722	Agent - Casualty	8/15/2000	9/22/2003
Inactive	Nationwide Mutual Fire Insurance Company	301722	Agent - General Lines	12/8/1999	8/15/2000
Inactive	Nationwide Mutual Fire Insurance Company	301722	Agent - Property	8/15/2000	9/22/2003
Inactive	Nationwide Mutual Insurance Company	301749	Agent - Casualty	8/15/2000	9/22/2003
Inactive	Nationwide Mutual Insurance Company	301749	Agent - General Lines	11/18/1999	8/15/2000
Inactive	Nationwide Mutual Insurance Company	301749	Agent - Property	8/15/2000	9/22/2003
Inactive	Nationwide Property and Casualty Insurance Company	300599	Agent - Casualty	8/15/2000	9/22/2003
Inactive	Nationwide Property and Casualty Insurance Company	300599	Agent - General Lines	12/8/1999	8/15/2000
Inactive	Nationwide Property and Casualty Insurance Company	300599	Agent - Property	8/15/2000	9/22/2003
Active	State Farm Fire and Casualty Company	301809	Agent - Property	1/3/2005
Inactive	State Farm General Insurance Company	301122	Agent - Property	1/3/2005	11/18/2010
Active	State Farm Life Insurance Company	301810	Agent - Life	6/7/2005
Active	State Farm Mutual Automobile Insurance Company	301732	Agent - Casualty	1/3/2005
Active	State Farm Mutual Automobile Insurance Company	301732	Agent - Health	6/7/2005
Inactive	Time Insurance Company	300683	Agent - Health	8/12/2014	6/18/2016

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Peoples Insurance Agency LLC	517977	Agent - Property
Denied	Peoples Insurance Agency LLC	517977	Agent - Casualty