DEPARTMENT OF INSURANCE

Affiliations

Name	Foreman Sr, Hassan Darryl	DOIID	759370	NAIC NPN	16307511

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Health	12/21/2016	3/31/2018
Inactive	Non Resident	Agent	Life	12/21/2016	3/31/2018
Inactive	Non Resident	Agent	Personal Lines	7/27/2011	3/31/2014
* 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	1/8/2015	3/31/2016
Inactive	Aetna Life Insurance Company	301140	Agent - Health	1/8/2015	3/31/2016
Inactive	Aetna Life Insurance Company	301140	Agent - Life	1/8/2015	3/31/2016
Inactive	Anthem Life Insurance Company	301209	Agent - Health	11/7/2014	6/23/2015
Inactive	Anthem Life Insurance Company	301209	Agent - Life	11/7/2014	6/23/2015
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	9/3/2015	3/31/2016
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	9/3/2015	3/31/2016
Inactive	Esurance Insurance Company	301072	Agent - Personal Lines	8/25/2011	5/15/2013
Inactive	First Health Life & Health Insurance Company	301735	Agent - Health	4/18/2015	3/31/2016
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	9/3/2015	3/31/2016
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	9/3/2015	3/31/2016
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	9/3/2015	3/31/2016
Inactive	Humana Insurance Company	301104	Agent - Health	9/3/2015	3/31/2016
Inactive	Humana Insurance Company	301104	Agent - Life	9/4/2015	3/31/2016
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	9/3/2015	3/31/2016
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	9/4/2015	3/31/2016
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	9/3/2015	3/31/2016
Inactive	Kanawha Insurance Company	300127	Agent - Health	9/3/2015	11/3/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	9/3/2015	11/3/2015
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	12/2/2014	7/2/2015
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	12/2/2014	7/2/2015

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	11/7/2014	6/23/2015
Inactive	Designated Agent Company Inc.	681257	Agent - Health	11/7/2014	6/23/2015
Inactive	Esurance Ins Services Inc	709770	Agent - Personal Lines	8/25/2011	5/15/2013
Denied	TZ Insurance Solutions LLC	727470	Agent - Life
Denied	TZ Insurance Solutions LLC	727470	Agent - Health