DEPARTMENT OF INSURANCE

Affiliations

Name	Thomas, Chanthol Sim	DOIID	819182	NAIC NPN	1339240

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	8/30/2013		10/31/2026
* 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	08/15/2024	10/31/2024	10/08/2024	10/08/2024	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	10/17/2022
Active	Aetna Health Insurance Company	301583	Agent - Health	9/12/2014
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	10/17/2022
Active	Aetna Life Insurance Company	301140	Agent - Health	10/17/2022
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	11/8/2014
Active	Anthem Health Plans of New Hampshire, Inc.	944064	Agent - Health	9/26/2021
Active	Anthem Insurance Companies, Inc.	300941	Agent - Health	9/26/2021
Inactive	Arcadian Health Plan, Inc.	728196	Agent - Health	3/6/2020	12/13/2022
Active	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	7/21/2022
Active	Compcare Health Services Insurance Corporation	948751	Agent - Health	9/16/2021
Active	Devoted Health Insurance Company of Kentucky, Inc.	1306593	Agent - Health	10/7/2024
Inactive	First Health Life & Health Insurance Company	301735	Agent - Health	9/12/2014	7/8/2021
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	10/13/2014	12/13/2022
Active	Humana Health Plan of Ohio Inc.	301565	Agent - Health	12/30/2021
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	7/10/2018	12/10/2018
Active	Humana Insurance Company	301104	Agent - Health	10/6/2022
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	5/30/2014	6/8/2018
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	7/6/2020	4/20/2021
Active	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	5/1/2023
Active	SilverScript Insurance Company	663526	Agent - Health	10/17/2022
Active	UnitedHealthcare Insurance Company	300946	Agent - Health	8/31/2015
Inactive	UnitedHealthcare Insurance Company of America	301552	Agent - Health	9/16/2016	12/21/2018
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	8/5/2019	12/22/2022
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	7/15/2018	12/23/2021
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	8/31/2015	12/5/2016
Active	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	9/13/2015
Inactive	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	3/27/2018	12/30/2021
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	3/7/2019	12/28/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Alorica Customer Care, Inc.	800938	Agent - Health	5/30/2014	6/4/2014