DEPARTMENT OF INSURANCE

Affiliations

Name	Mendonsa, Keith Charles	DOIID	676067	NAIC NPN	10404652

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Health	7/5/2016	3/31/2024
Inactive	Non Resident	Agent	Life	12/22/2016	3/31/2024
* 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	Accendo Insurance Company	300312	Agent - Life	1/21/2021	7/26/2021
Inactive	Aetna Health Inc. (PA)	660717	Agent - Health	9/13/2019	7/6/2022
Inactive	Aetna Health and Life Insurance Company	300523	Agent - Health	6/25/2019	7/26/2021
Inactive	Aetna Health of Ohio Inc.	1065035	Agent - Health	7/24/2020	7/6/2022
Inactive	Aetna Life Insurance Company	301140	Agent - Health	9/13/2019	7/6/2022
Inactive	American Continental Insurance Company	643130	Agent - Life	6/25/2019	7/26/2021
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	8/31/2016	5/9/2019
Inactive	CIGNA Health & Life Insurance Company	301783	Agent - Health	10/8/2013	6/12/2015
Inactive	CIGNA Health & Life Insurance Company	301783	Agent - Life	10/8/2013	6/12/2015
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	2/21/2014	6/30/2015
Inactive	Connecticut General Life Insurance Company	301333	Agent - Health	10/8/2013	6/11/2014
Inactive	Connecticut General Life Insurance Company	301333	Agent - Life	10/8/2013	6/11/2014
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	6/25/2019	7/26/2021
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Life	6/23/2021	7/26/2021
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	9/19/2016	6/8/2018
Inactive	First Health Life & Health Insurance Company	301735	Agent - Health	9/15/2016	7/5/2019
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	9/19/2016	6/8/2018
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	9/19/2016	2/23/2018
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	9/19/2016	6/8/2018
Inactive	Humana Insurance Company	301104	Agent - Health	9/19/2016	6/8/2018
Inactive	Humana Insurance Company	301104	Agent - Life	2/21/2014	6/30/2015
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	9/19/2016	6/8/2018
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	2/21/2014	6/30/2015
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	9/19/2016	6/8/2018
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	10/12/2016	6/8/2018
Inactive	Kanawha Insurance Company	300127	Agent - Health	2/21/2014	6/30/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	2/21/2014	6/30/2015
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	5/28/2019	12/29/2021
Inactive	SilverScript Insurance Company	663526	Agent - Health	9/13/2019	7/6/2022
Inactive	Time Insurance Company	300683	Agent - Health	11/2/2012	5/6/2015
Inactive	Time Insurance Company	300683	Agent - Life	11/2/2012	5/6/2015
Inactive	United World Life Insurance Company	300532	Agent - Health	5/28/2019	12/29/2021
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	5/28/2019	12/29/2021
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	5/28/2019	12/29/2021
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	9/13/2016	10/23/2017
Inactive	UnitedHealthcare Insurance Company of America	301552	Agent - Health	9/13/2016	10/23/2017
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	9/13/2016	10/23/2017
Inactive	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	11/1/2019	12/29/2021
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	11/1/2019	12/29/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Carezone Financial Services LLC	897339	Agent - Health	8/31/2016	5/8/2019
Inactive	Designated Agent Company Inc.	681257	Agent - Health	9/1/2016	5/9/2019
Inactive	Qw Insurance Solutions, LLC	1047634	Agent - Health	7/16/2019	9/28/2021
Inactive	eHealthInsurance Services Inc.	514105	Agent - Health	4/6/2015	6/30/2015
Inactive	eHealthInsurance Services Inc.	514105	Agent - Life	4/6/2015	6/30/2015