DEPARTMENT OF INSURANCE

Affiliations

Name	Souriyavongsa, Saleumphon	DOIID	882504	NAIC NPN	17636019

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Personal Lines	4/14/2017	2/28/2025
Active	Non Resident	Agent	Life	7/7/2015	2/28/2025
Active	Non Resident	Agent	Health	7/7/2015	2/28/2025
* 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	Accendo Insurance Company	300312	Agent - Health	9/10/2021	11/17/2023
Active	Accendo Insurance Company	300312	Agent - Life	6/26/2020
Active	Aetna Health Inc. (PA)	660717	Agent - Health	6/3/2020
Active	Aetna Health and Life Insurance Company	300523	Agent - Health	6/17/2020
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	7/28/2020
Active	Aetna Life Insurance Company	301140	Agent - Health	6/3/2020
Inactive	American Continental Insurance Company	643130	Agent - Life	6/17/2020	8/11/2021
Inactive	American General Life Insurance Company	301585	Agent - Health	7/13/2015	3/28/2018
Inactive	American General Life Insurance Company	301585	Agent - Life	7/13/2015	3/28/2018
Active	Anthem Health Plans of New Hampshire, Inc.	944064	Agent - Health	9/24/2021
Active	Anthem Insurance Companies, Inc.	300941	Agent - Health	9/24/2021
Active	Anthem Life Insurance Company	301209	Agent - Health	5/13/2020
Active	Anthem Life Insurance Company	301209	Agent - Life	5/13/2020
Active	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	7/20/2022
Active	Compcare Health Services Insurance Corporation	948751	Agent - Health	9/24/2021
Active	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	6/17/2020
Active	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Life	6/1/2023
Inactive	Farmers Direct Property and Casualty Insurance Company	300957	Agent - Personal Lines	5/19/2017	9/24/2020
Inactive	Farmers Property and Casualty Insurance Company	301237	Agent - Personal Lines	5/19/2017	9/24/2020
Inactive	LM General Insurance Company	300133	Agent - Personal Lines	8/28/2017	6/20/2024
Active	Liberty Insurance Corporation	300444	Agent - Personal Lines	8/28/2017
Active	Progressive Casualty Insurance Company	300696	Agent - Personal Lines	5/22/2017
Active	SilverScript Insurance Company	663526	Agent - Health	6/3/2020
Inactive	Standard Fire Insurance Company (The)	301068	Agent - Personal Lines	12/20/2017	5/15/2020
Inactive	Travelers Commercial Insurance Company	301506	Agent - Personal Lines	2/7/2018	5/15/2020
Inactive	United States Life Insurance Company in the City of New York	301126	Agent - Health	7/13/2015	3/28/2018
Inactive	United States Life Insurance Company in the City of New York	301126	Agent - Life	7/13/2015	3/28/2018
Active	UnitedHealthcare Insurance Company	300946	Agent - Health	8/21/2020
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	8/21/2020	12/22/2022
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	8/21/2020	12/23/2021
Active	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	8/21/2020
Inactive	Unitrin Direct Property & Casualty Company	637443	Agent - Personal Lines	3/14/2018	10/2/2023
Active	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	5/1/2020
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	5/1/2020	12/29/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date
Active	Designated Agent Company Inc.	681257	Agent - Health	5/13/2020
Active	Designated Agent Company Inc.	681257	Agent - Life	5/13/2020
Denied	Mercer Health & Benefits Administration Llc	656414	Agent - Health
Denied	Mercer Health & Benefits Administration Llc	656414	Agent - Life
Active	Mercer Health & Benefits Administration Llc	656414	Agent - Personal Lines	1/28/2019