DEPARTMENT OF INSURANCE

Affiliations

Name	Samuelson, Brian A	DOIID	805358	NAIC NPN	16610999

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	9/28/2020		8/31/2024
Inactive	Non Resident	Agent	Life	3/8/2013	8/31/2014
* 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

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	4/12/2021
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	10/2/2020
Active	Aetna Life Insurance Company	301140	Agent - Health	4/12/2021
Active	Arcadian Health Plan, Inc.	728196	Agent - Health	10/13/2022
Active	CHA HMO, Inc.	300662	Agent - Health	12/20/2023
Active	CompBenefits Insurance Company	301864	Agent - Health	10/13/2022
Active	Dental Concern Inc. (The)	301641	Agent - Health	3/7/2023
Inactive	Fidelity Life Association, A Legal Reserve Life Insurance Company	300774	Agent - Life	3/11/2013	7/11/2014
Active	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	11/21/2022
Active	Humana Health Plan of Ohio Inc.	301565	Agent - Health	1/9/2023
Active	Humana Health Plan, Inc.	300142	Agent - Health	1/18/2024
Active	Humana Insurance Company	301104	Agent - Health	10/13/2022
Active	Humana Medical Plan, Inc.	801568	Agent - Health	11/21/2022
Active	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	1/9/2023
Inactive	MetLife Investors USA Insurance Company	300845	Agent - Life	12/3/2013	7/14/2014
Inactive	Omaha Health Insurance Company	301296	Agent - Health	10/12/2020	5/15/2023
Active	SilverScript Insurance Company	663526	Agent - Health	10/2/2020
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	10/19/2020	10/15/2021
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	10/19/2020	10/15/2021
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	10/19/2020	10/15/2021
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	10/19/2020	10/15/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Alight Health Market Insurance Solutions Inc	643602	Agent - Health	10/22/2020	2/17/2021
Inactive	Efinancial LLC	598419	Agent - Life	1/6/2014	7/14/2014
Denied	Efinancial LLC	598419	Agent - Health
Active	Humana MarketPOINT Inc.	398092	Agent - Health	6/2/2023