DEPARTMENT OF INSURANCE

Affiliations

Name	Chakchakov, Uri Mike	DOIID	700237	NAIC NPN	11434343

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Health	5/30/2019	6/30/2021
Inactive	Non Resident	Agent	Life	5/30/2019	6/30/2021
* 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	Aetna Health Inc. (PA)	660717	Agent - Health	11/15/2011	6/30/2015
Inactive	Aetna Life Insurance Company	301140	Agent - Health	11/15/2011	6/30/2015
Inactive	Aetna Life Insurance Company	301140	Agent - Life	11/15/2011	6/30/2015
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	7/19/2019	11/12/2019
Inactive	American Financial Security Life Insurance Co.	301635	Agent - Health	12/21/2012	6/30/2015
Inactive	American Financial Security Life Insurance Co.	301635	Agent - Life	12/21/2012	6/30/2015
Inactive	American Medical and Life Insurance Company	301598	Agent - Health	4/27/2009	6/14/2012
Inactive	Chesapeake Life Insurance Company (The)	301017	Agent - Health	7/1/2014	6/30/2015
Inactive	Chesapeake Life Insurance Company (The)	301017	Agent - Life	7/1/2014	6/30/2015
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	9/30/2011	12/3/2012
Inactive	Companion Life Insurance Company	300191	Agent - Health	4/21/2010	6/6/2012
Inactive	Companion Life Insurance Company	300191	Agent - Life	4/5/2011	6/6/2012
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	9/30/2011	12/3/2012
Inactive	Federal Insurance Company	301144	Agent - Health	6/18/2019	6/30/2021
Inactive	Freedom Life Insurance Company of America	300074	Agent - Health	2/25/2013	4/23/2013
Inactive	Freedom Life Insurance Company of America	300074	Agent - Life	2/25/2013	4/23/2013
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	9/30/2011	12/3/2012
Inactive	Humana Insurance Company	301104	Agent - Health	9/28/2011	12/3/2012
Inactive	Humana Insurance Company	301104	Agent - Life	9/28/2011	12/3/2012
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	9/30/2011	12/3/2012
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	9/30/2011	12/3/2012
Inactive	Kanawha Insurance Company	300127	Agent - Health	9/30/2011	12/3/2012
Inactive	Kanawha Insurance Company	300127	Agent - Life	9/30/2011	12/3/2012
Inactive	National Health Insurance Company	300554	Agent - Health	10/31/2014	6/30/2015
Inactive	National Health Insurance Company	300554	Agent - Life	10/31/2014	6/30/2015
Inactive	Standard Life and Accident Insurance Company	301534	Agent - Health	6/4/2019	6/30/2021
Inactive	Time Insurance Company	300683	Agent - Health	11/14/2011	12/20/2014
Inactive	Time Insurance Company	300683	Agent - Life	11/14/2011	12/20/2014
Inactive	Unified Life Insurance Company	543169	Agent - Health	7/16/2019	10/22/2020
Inactive	United States Fire Insurance Company	582240	Agent - Health	12/28/2012	6/30/2015

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Health Plan Intermediaries Holdings	786463	Agent - Health	7/11/2019	6/30/2021