DEPARTMENT OF INSURANCE

Affiliations

Name	Johnson, Monica Alicia	DOIID	887212	NAIC NPN	17583524

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	8/17/2015	10/31/2016
Inactive	Non Resident	Agent	Life	8/17/2015	10/31/2016
Active	Non Resident	Independent Adjuster	Property & Casualty	8/17/2021		10/31/2024
Inactive	Non Resident	Staff Adjuster	Property & Casualty	5/23/2016	10/31/2018
* 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
Independent Adjuster	08/15/2024	10/31/2024

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	8/18/2015	10/31/2016
Inactive	Aetna Life Insurance Company	301140	Agent - Health	8/18/2015	10/31/2016
Inactive	Aetna Life Insurance Company	301140	Agent - Life	8/18/2015	10/31/2016
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	8/29/2015	5/1/2016
Inactive	CIGNA Health & Life Insurance Company	301783	Agent - Health	8/19/2015	10/31/2016
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	9/4/2015	11/2/2016
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	9/4/2015	11/2/2016
Inactive	First Health Life & Health Insurance Company	301735	Agent - Health	8/18/2015	10/31/2016
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	9/4/2015	11/2/2016
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	9/4/2015	11/2/2016
Inactive	Humana Insurance Company	301104	Agent - Health	9/4/2015	11/2/2016
Inactive	Humana Insurance Company	301104	Agent - Life	9/9/2015	11/2/2016
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	9/4/2015	11/2/2016
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	9/9/2015	11/2/2016
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	10/12/2016	11/2/2016
Inactive	Kanawha Insurance Company	300127	Agent - Health	9/4/2015	10/22/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	9/4/2015	10/22/2015
Inactive	Loyal American Life Insurance Company	301172	Agent - Health	9/14/2015	11/14/2016
Inactive	Medco Containment Life Insurance Company	301557	Agent - Health	9/25/2015	10/31/2016
Inactive	SilverScript Insurance Company	663526	Agent - Health	9/3/2015	10/31/2016
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	8/20/2015	3/31/2016
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	8/20/2015	3/31/2016
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	9/12/2015	3/31/2016

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Extend Insurance Services, LLC	625753	Agent - Health	11/17/2015	10/31/2016
Inactive	Extend Insurance Services, LLC	625753	Agent - Life	11/17/2015	10/31/2016