DEPARTMENT OF INSURANCE

Affiliations

Name	Clark, Jatoya	DOIID	794365	NAIC NPN	16725188

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Health	7/29/2020	11/30/2021
Inactive	Non Resident	Agent	Life	7/29/2020	11/30/2021
* 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	10/10/2014	11/30/2015
Inactive	Aetna Health Insurance Company	301583	Agent - Health	10/10/2014	11/30/2015
Inactive	Aetna Life Insurance Company	301140	Agent - Health	10/10/2014	11/30/2015
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	10/27/2020	4/26/2021
Inactive	Anthem Life Insurance Company	301209	Agent - Health	10/27/2020	4/26/2021
Inactive	Anthem Life Insurance Company	301209	Agent - Life	10/27/2020	11/30/2021
Inactive	Brighthouse Life Insurance Company	301829	Agent - Health	4/16/2015	9/17/2015
Inactive	Brighthouse Life Insurance Company	301829	Agent - Life	4/16/2015	9/17/2015
Inactive	First Health Life & Health Insurance Company	301735	Agent - Health	10/10/2014	11/30/2015
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	8/20/2020	1/11/2022
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	9/23/2014	3/17/2015
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	9/23/2014	3/17/2015
Inactive	Humana Insurance Company	301104	Agent - Health	9/23/2014	3/17/2015
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	9/23/2014	3/17/2015
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	10/13/2014	3/17/2015
Inactive	Medco Containment Life Insurance Company	301557	Agent - Health	9/22/2014	11/30/2015
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	10/7/2014	9/3/2015
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	10/7/2014	9/3/2015
Inactive	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	9/2/2020	12/14/2021
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	9/2/2020	11/30/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Alorica Customer Care, Inc.	800938	Agent - Health
Inactive	Red Ventures Ins LLC	794656	Agent - Life	5/19/2015	9/17/2015