DEPARTMENT OF INSURANCE

Affiliations

Name	Aetna Medicaid Administrators LLC	DOIID	864675	NAIC NPN	8034127

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Administrator	Not Applicable	12/30/2014		3/31/2026
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Herold, Lisa J	328546	Administrator - Not Applicable	12/30/2014	2/28/2019
Active	Losel, Jenni	576159	Administrator - Not Applicable	5/6/2019