DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Aetna Health Management, LLC	DOIID	565487	NAIC NPN	2257432

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Administrator	Not Applicable	3/10/2003		3/31/2025
Inactive	Non Resident	Pharmacy Benefit Managers	Not Applicable	11/22/2016	6/13/2019
* 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
Administrator	01/15/2025	03/31/2025

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Hendrix, Jonathan Scott	611168	Administrator - Not Applicable	10/24/2011	3/27/2013
Inactive	Herold, Lisa J	328546	Administrator - Not Applicable	3/27/2013	2/28/2019
Inactive	Herold, Lisa J	328546	Administrator - Not Applicable	11/22/2016	2/28/2019
Inactive	Losel, Jenni	576159	Administrator - Not Applicable	5/6/2019	6/13/2019
Active	Losel, Jenni	576159	Administrator - Not Applicable	5/6/2019
Inactive	Ryan, Laurie Stone	388458	Administrator - Not Applicable	3/10/2003	10/24/2011