DEPARTMENT OF INSURANCE

Affiliations

Name	Phonthipsavath, Chintana	DOIID	761110	NAIC NPN	13551271

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	8/17/2011		8/31/2026
* 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	06/15/2024	08/31/2024	07/09/2024	07/09/2024	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Aetna Health Inc. (PA)	660717	Agent - Health	7/26/2018
Inactive	Aetna Health and Life Insurance Company	300523	Agent - Health	3/30/2018	11/10/2022
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	7/11/2022
Active	Aetna Life Insurance Company	301140	Agent - Health	7/26/2018
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	4/3/2020
Active	Anthem Health Plans of New Hampshire, Inc.	944064	Agent - Health	6/24/2021
Active	Anthem Insurance Companies, Inc.	300941	Agent - Health	6/12/2021
Inactive	Bankers Fidelity Assurance Company	554627	Agent - Health	7/15/2019	12/21/2022
Inactive	Bankers Fidelity Life Insurance Company	300193	Agent - Health	7/15/2019	12/21/2022
Inactive	CIGNA Health & Life Insurance Company	301783	Agent - Health	3/20/2019	12/22/2020
Active	Compcare Health Services Insurance Corporation	948751	Agent - Health	10/7/2021
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	3/30/2018	11/10/2022
Inactive	Coventry Health and Life Insurance Company	301771	Agent - Health	7/26/2018	6/15/2022
Inactive	First Health Life & Health Insurance Company	301735	Agent - Health	10/13/2018	7/7/2022
Inactive	GPM Health and Life Insurance Company	927255	Agent - Health	10/29/2019	2/20/2022
Inactive	Heartland National Life Insurance Company	948749	Agent - Health	9/6/2019	7/23/2020
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	4/3/2018	10/16/2018
Inactive	Humana Insurance Company	301104	Agent - Health	4/5/2019	12/15/2020
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	4/3/2018	10/16/2018
Inactive	Massachusetts Mutual Life Insurance Company	300445	Agent - Health	4/6/2018	12/29/2018
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	2/26/2020	1/23/2023
Inactive	Omaha Insurance Company	751908	Agent - Health	11/25/2013	8/8/2018
Active	SilverScript Insurance Company	663526	Agent - Health	7/11/2022
Inactive	Standard Life and Accident Insurance Company	301534	Agent - Health	8/16/2018	12/23/2021
Inactive	United World Life Insurance Company	300532	Agent - Health	10/31/2018	1/23/2023
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	9/23/2011	5/22/2013
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	10/1/2018	1/20/2021
Inactive	UnitedHealthcare Insurance Company of America	301552	Agent - Health	10/1/2018	12/21/2018
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	8/6/2019	1/20/2021
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	10/1/2018	1/20/2021
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	10/1/2018	1/20/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	TZ Insurance Solutions LLC	727470	Agent - Health	4/4/2016	2/18/2019