DEPARTMENT OF INSURANCE

Affiliations

Name	Gomez, Husseim	DOIID	783387	NAIC NPN	16628444

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Life	6/6/2012	12/31/2017
Inactive	Non Resident	Agent	Health	6/6/2012	12/31/2017
* 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	CompBenefits Dental, Inc.	591692	Agent - Health	6/8/2013	2/9/2018
Inactive	Continental American Insurance Company	301700	Agent - Health	6/28/2014	12/31/2017
Inactive	Continental American Insurance Company	301700	Agent - Life	6/28/2014	12/31/2017
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	6/8/2013	2/9/2018
Inactive	Gerber Life Insurance Company	300529	Agent - Health	10/2/2012	8/22/2013
Inactive	Gerber Life Insurance Company	300529	Agent - Life	10/2/2012	8/22/2013
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	10/13/2014	2/9/2018
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	10/10/2012	2/9/2018
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	7/20/2012	2/9/2018
Inactive	Humana Insurance Company	301104	Agent - Health	7/13/2012	2/9/2018
Inactive	Humana Insurance Company	301104	Agent - Life	7/13/2012	2/9/2018
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	7/20/2012	2/9/2018
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	7/20/2012	2/9/2018
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	10/13/2014	2/9/2018
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	10/12/2016	2/9/2018
Inactive	Kanawha Insurance Company	300127	Agent - Health	6/8/2013	10/22/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	6/8/2013	10/22/2015
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	10/4/2012	10/22/2013
Inactive	Omaha Insurance Company	751908	Agent - Health	10/4/2012	10/22/2013
Inactive	Trustmark Insurance Company	300317	Agent - Health	10/23/2015	3/9/2017
Inactive	Trustmark Insurance Company	300317	Agent - Life	10/23/2015	3/9/2017
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	10/4/2012	10/22/2013
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	10/4/2012	10/22/2013
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	11/26/2012	4/14/2014
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	11/26/2012	4/14/2014

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	AmWINS Group Benefits, LLC	521331	Agent - Life	7/25/2014	12/2/2016
Inactive	AmWINS Group Benefits, LLC	521331	Agent - Health	2/27/2014	12/2/2016