DEPARTMENT OF INSURANCE

Affiliations

Name	Fredericks, Donna	DOIID	716289	NAIC NPN	8917044

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Personal Lines	6/4/2021		9/30/2024
Inactive	Non Resident	Agent	Life	8/22/2018	6/16/2023
Inactive	Non Resident	Agent	Health	8/22/2018	6/16/2023
Denied	Non Resident	Life & Health Consultant	Not Applicable
* 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	07/15/2024	09/30/2024

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	5/22/2019	6/16/2023
Inactive	Aetna Health of Ohio Inc.	1065035	Agent - Health	8/19/2020	6/16/2023
Inactive	Aetna Life Insurance Company	301140	Agent - Health	5/22/2019	6/16/2023
Inactive	Aetna Life Insurance Company	301140	Agent - Life	5/22/2019	6/16/2023
Inactive	American National Insurance Company	301861	Agent - Health	3/23/2016	9/30/2016
Inactive	American National Insurance Company	301861	Agent - Life	3/23/2016	9/30/2016
Inactive	CMFG Life Insurance Company	300929	Agent - Health	2/11/2011	2/11/2015
Inactive	CMFG Life Insurance Company	300929	Agent - Life	4/1/2011	2/11/2015
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	3/11/2013	5/1/2014
Inactive	Continental American Insurance Company	301700	Agent - Health	9/5/2018	6/16/2023
Inactive	Continental American Insurance Company	301700	Agent - Life	9/5/2018	6/16/2023
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	3/11/2013	5/1/2014
Inactive	Electric Insurance Company	301758	Agent - Personal Lines	6/8/2021	10/30/2023
Active	Farmers Direct Property and Casualty Insurance Company	300957	Agent - Personal Lines	3/14/2024
Active	Farmers Property and Casualty Insurance Company	301237	Agent - Personal Lines	3/14/2024
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	3/11/2013	5/1/2014
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	3/11/2013	5/1/2014
Inactive	Humana Insurance Company	301104	Agent - Health	3/11/2013	5/1/2014
Inactive	Humana Insurance Company	301104	Agent - Life	3/11/2013	5/1/2014
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	3/11/2013	5/1/2014
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	3/11/2013	5/1/2014
Inactive	Kanawha Insurance Company	300127	Agent - Health	3/11/2013	5/1/2014
Inactive	Kanawha Insurance Company	300127	Agent - Life	3/11/2013	5/1/2014
Inactive	Lumico Life Insurance Company	300354	Agent - Health	7/16/2020	11/24/2020
Inactive	Sierra Health and Life Insurance Company Inc.	300357	Agent - Health	8/18/2014	2/29/2016
Inactive	SilverScript Insurance Company	663526	Agent - Health	8/23/2019	6/16/2023
Active	Travelers Personal Insurance Company	705785	Agent - Personal Lines	11/17/2021
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	8/18/2014	2/29/2016
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	8/18/2014	2/29/2016
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	9/12/2015	2/29/2016
Inactive	Unitrin Direct Property & Casualty Company	637443	Agent - Personal Lines	8/30/2021	10/2/2023
Inactive	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	10/27/2019	12/29/2021
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	10/27/2019	12/30/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Mercer Health & Benefits Administration Llc	656414	Agent - Health	2/1/2019	6/16/2023
Inactive	Mercer Health & Benefits Administration Llc	656414	Agent - Life	2/1/2019	6/16/2023