PUBLIC PROTECTION
CABINET
DEPARTMENT OF INSURANCE
Affiliations
NameFuenzalida, Samuel EduardoDOIID791544NAIC NPN7732959
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveNon ResidentAgentHealth9/30/2021 8/31/2025
ActiveNon ResidentAgentLife9/30/2021 8/31/2025
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.
License Renewal Information
ClassInvoice DateResponse Due / Expiration DateResponse Received DatePayment Received DateRenewal Complete
Agent06/15/202508/31/2025   
Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveAccendo Insurance Company300312Agent - Health2/24/202211/17/2023
ActiveAccendo Insurance Company300312Agent - Life2/24/2022 
InactiveAetna Health Inc. (PA)660717Agent - Health10/5/201212/24/2012
ActiveAetna Health and Life Insurance Company300523Agent - Health2/24/2022 
InactiveAetna Life Insurance Company301140Agent - Health10/5/201212/24/2012
InactiveAetna Life Insurance Company301140Agent - Life10/5/201212/24/2012
InactiveAnthem Life Insurance Company301209Agent - Health10/15/201212/1/2012
InactiveAnthem Life Insurance Company301209Agent - Life10/15/201212/1/2012
InactiveCompBenefits Dental, Inc.591692Agent - Health9/20/201211/28/2012
ActiveContinental Life Insurance Company of Brentwood Tennessee301526Agent - Health2/24/2022 
ActiveContinental Life Insurance Company of Brentwood Tennessee301526Agent - Life2/24/2022 
InactiveDental Concern Inc. (The)301641Agent - Health9/20/201211/28/2012
InactiveGreat Western Insurance Company501693Agent - Life12/8/202112/21/2022
InactiveHumana Health Plan of Ohio Inc.301565Agent - Health10/10/201211/28/2012
InactiveHumana Health Plan, Inc.300142Agent - Health9/20/201211/28/2012
InactiveHumana Insurance Company301104Agent - Health9/20/201211/28/2012
InactiveHumana Insurance Company301104Agent - Life9/20/201211/28/2012
InactiveHumana Insurance Company of Kentucky300826Agent - Health9/20/201211/28/2012
InactiveHumana Insurance Company of Kentucky300826Agent - Life9/20/201211/28/2012
InactiveLiberty Bankers Life Insurance Company542461Agent - Life12/28/202112/20/2022
InactiveMutual of Omaha Insurance Company301012Agent - Health10/15/20128/22/2013
InactiveOmaha Insurance Company751908Agent - Health10/15/20128/22/2013
ActiveRoyal Neighbors of America301646Agent - Life11/11/2022 
InactiveUnited of Omaha Life Insurance Company300156Agent - Health4/8/20233/22/2024
InactiveUnited of Omaha Life Insurance Company300156Agent - Life4/8/20233/22/2024
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveDesignated Agent Company Inc.681257Agent - Health10/15/201212/11/2012
InactiveDesignated Agent Company Inc.681257Agent - Life10/15/201212/11/2012

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