DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	ETQ HK SPV Inc	DOIID	836619	NAIC NPN	17212993

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	3/25/2014		3/31/2026
Active	Non Resident	Agent	Life	12/5/2014		3/31/2026
* 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
Active	Arcadian Health Plan, Inc.	728196	Agent - Health	10/18/2017
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	7/30/2014	2/23/2018
Active	Humana Health Plan, Inc.	300142	Agent - Health	7/25/2014
Active	Humana Insurance Company	301104	Agent - Health	7/25/2014
Active	Humana Insurance Company of Kentucky	300826	Agent - Health	7/25/2014
Active	Humana Medical Plan, Inc.	801568	Agent - Health	11/24/2015
Active	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	12/1/2016

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Chauncey, Robert Joseph	834651	Agent - Health	3/25/2014
Inactive	Solazzo, Anthony Patrick	612583	Agent - Life	12/5/2014	3/31/2024
Active	Uchytil, Craig Charles	739753	Agent - Health	3/24/2023
Active	Uchytil, Craig Charles	739753	Agent - Life	3/24/2023