DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Long, Jitzel C	DOIID	605153	NAIC NPN	8416460

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	9/29/2017	7/31/2021
Inactive	Non Resident	Agent	Property	3/16/2005	6/24/2009
Inactive	Non Resident	Agent	Casualty	3/16/2005	6/24/2009
Inactive	Non Resident	Agent	Life	9/29/2017	7/31/2021
* 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
Inactive	Allstate Indemnity Company	300778	Agent - Casualty	3/28/2005	9/25/2007
Inactive	Allstate Indemnity Company	300778	Agent - Property	3/28/2005	9/25/2007
Inactive	Allstate Insurance Company	300773	Agent - Casualty	3/28/2005	9/25/2007
Inactive	Allstate Insurance Company	300773	Agent - Property	3/28/2005	9/25/2007
Inactive	Allstate Property and Casualty Insurance Company	300593	Agent - Casualty	7/26/2005	9/25/2007
Inactive	Allstate Property and Casualty Insurance Company	300593	Agent - Property	7/26/2005	9/25/2007
Inactive	Anthem Life Insurance Company	301209	Agent - Health	11/2/2018	7/31/2021
Inactive	Anthem Life Insurance Company	301209	Agent - Life	11/2/2018	7/31/2021
Inactive	Golden Rule Insurance Company	301943	Agent - Health	6/11/2018	8/3/2021
Inactive	Golden Rule Insurance Company	301943	Agent - Life	6/11/2018	8/3/2021
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	10/5/2017	3/20/2018
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	10/5/2017	3/20/2018
Inactive	Humana Insurance Company	301104	Agent - Health	10/5/2017	3/20/2018
Inactive	Humana Insurance Company	301104	Agent - Life	10/5/2017	3/20/2018
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	10/5/2017	3/20/2018
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	10/5/2017	3/20/2018
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	10/5/2017	3/20/2018
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	10/5/2017	3/20/2018

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	11/5/2018	7/31/2021
Inactive	Designated Agent Company Inc.	681257	Agent - Health	11/5/2018	7/31/2021
Inactive	Gohealth LLC	691445	Agent - Life	11/29/2018	7/31/2021
Inactive	Gohealth LLC	691445	Agent - Health	11/29/2018	7/31/2021
Inactive	Health Plan Intermediaries Holdings	786463	Agent - Health	9/28/2018	7/31/2021