DEPARTMENT OF INSURANCE

Affiliations

Name	Lopez, Jennise	DOIID	850352	NAIC NPN	17350444

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Casualty	5/30/2017	9/30/2022
Inactive	Non Resident	Agent	Property	5/30/2017	9/30/2022
Inactive	Non Resident	Agent	Health	9/2/2014	9/30/2022
* 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	9/10/2019	9/30/2022
Inactive	Aetna Health of Ohio Inc.	1065035	Agent - Health	7/28/2020	9/30/2022
Inactive	Aetna Life Insurance Company	301140	Agent - Health	9/10/2019	9/30/2022
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	1/26/2018	3/6/2019
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	1/26/2018	3/6/2019
Inactive	Homesite Insurance Company	301139	Agent - Casualty	6/2/2017	11/30/2018
Inactive	Homesite Insurance Company	301139	Agent - Property	6/2/2017	11/30/2018
Inactive	Homesite Insurance Company of the Midwest	874850	Agent - Casualty	7/13/2017	11/30/2018
Inactive	Homesite Insurance Company of the Midwest	874850	Agent - Property	7/13/2017	11/30/2018
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	5/13/2016	4/20/2018
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	5/13/2016	2/23/2018
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	5/13/2016	4/20/2018
Inactive	Humana Insurance Company	301104	Agent - Health	5/13/2016	4/20/2018
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	5/13/2016	4/20/2018
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	5/13/2016	4/20/2018
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	11/2/2016	4/20/2018
Inactive	Permanent General Assurance Corporation of Ohio	709250	Agent - Casualty	7/10/2019	3/29/2022
Inactive	Sierra Health and Life Insurance Company Inc.	300357	Agent - Health	7/30/2016	9/28/2016
Inactive	SilverScript Insurance Company	663526	Agent - Health	8/23/2019	9/30/2022
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	7/25/2016	9/28/2016
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	7/25/2016	9/28/2016
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	7/25/2016	9/28/2016
Inactive	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	10/21/2019	12/29/2021
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	10/21/2019	12/29/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	General Automobile Ins Services Inc	706632	Agent - Casualty	8/1/2019	3/29/2022