DEPARTMENT OF INSURANCE

Affiliations

Name	Velasquez, Rosa Esmeralda	DOIID	727792	NAIC NPN	15695868

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Health	5/5/2010	10/31/2022
Inactive	Non Resident	Agent	Life	5/5/2010	10/31/2022
* 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	Boston Mutual Life Insurance Company	300143	Agent - Health	9/14/2017	10/31/2022
Inactive	Boston Mutual Life Insurance Company	300143	Agent - Life	9/14/2017	10/31/2022
Inactive	Combined Insurance Company of America	301472	Agent - Health	3/26/2012	10/31/2022
Inactive	Combined Insurance Company of America	301472	Agent - Life	3/26/2012	10/31/2022
Inactive	Continental American Insurance Company	301700	Agent - Health	4/1/2013	10/31/2022
Inactive	Continental American Insurance Company	301700	Agent - Life	4/1/2013	10/31/2022
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Health	10/12/2017	11/30/2022
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Life	10/12/2017	11/30/2022
Inactive	Kanawha Insurance Company	300127	Agent - Health	1/13/2011	4/25/2013
Inactive	Kanawha Insurance Company	300127	Agent - Life	1/13/2011	4/25/2013
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	8/24/2010	10/31/2022
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	8/24/2010	10/31/2022
Inactive	ReliaStar Life Insurance Company	301712	Agent - Health	4/6/2021	10/31/2022
Inactive	ReliaStar Life Insurance Company	301712	Agent - Life	4/6/2021	10/31/2022
Inactive	Starmount Life Insurance Company	628031	Agent - Health	11/21/2018	10/31/2022
Inactive	Texas Life Insurance Company	300345	Agent - Life	9/18/2017	2/21/2019
Inactive	Trustmark Insurance Company	300317	Agent - Health	9/26/2011	10/31/2022
Inactive	Trustmark Insurance Company	300317	Agent - Life	9/26/2011	10/31/2022
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	8/24/2010	10/31/2022
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	8/24/2010	10/31/2022
Inactive	Unum Insurance Company	301499	Agent - Health	11/21/2018	10/31/2022
Inactive	Unum Insurance Company	301499	Agent - Life	11/21/2018	10/31/2022

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Forum Benefits, LLC	1115625	Agent - Life	7/7/2021	8/5/2021
Inactive	Forum Benefits, LLC	1115625	Agent - Health	7/7/2021	8/5/2021