DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Fields, Carlos A	DOIID	893923	NAIC NPN	17721442

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	10/2/2015	4/30/2018
Inactive	Non Resident	Agent	Life	10/2/2015	4/30/2018
* 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	ACE American Insurance Company	300625	Agent - Health	2/12/2018	4/30/2018
Inactive	CIGNA Health & Life Insurance Company	301783	Agent - Health	10/2/2015	4/30/2018
Inactive	CIGNA Health & Life Insurance Company	301783	Agent - Life	10/2/2015	4/30/2018
Inactive	Federal Insurance Company	301144	Agent - Health	2/12/2018	4/30/2018

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Dentalplans Com	894687	Agent - Life	11/5/2015	5/22/2018
Inactive	Dentalplans Com	894687	Agent - Health	11/5/2015	5/22/2018