DEPARTMENT OF INSURANCE

Affiliations

Name	Mogensen, Charles R	DOIID	924599	NAIC NPN	10147598

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Health	8/15/2016	1/31/2025
Active	Non Resident	Agent	Life	8/15/2016	1/31/2025
* 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
Agent	11/15/2024	01/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Aetna Health Inc. (PA)	660717	Agent - Health	9/19/2024
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	9/19/2024
Active	Aetna Life Insurance Company	301140	Agent - Health	9/19/2024
Inactive	Aetna Life Insurance Company	301140	Agent - Life	9/19/2017	7/8/2021
Inactive	Anthem Life Insurance Company	301209	Agent - Health	11/8/2016	4/26/2021
Inactive	Anthem Life Insurance Company	301209	Agent - Life	11/8/2016	4/26/2021
Active	Arcadian Health Plan, Inc.	728196	Agent - Health	10/13/2017
Active	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	7/20/2022
Inactive	First Health Life & Health Insurance Company	301735	Agent - Health	10/3/2016	7/8/2021
Active	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	10/7/2016
Active	Humana Health Plan of Ohio Inc.	301565	Agent - Health	11/4/2019
Active	Humana Health Plan, Inc.	300142	Agent - Health	10/7/2016
Active	Humana Insurance Company	301104	Agent - Health	10/7/2016
Active	Humana Insurance Company	301104	Agent - Life	10/7/2016
Active	Humana Insurance Company of Kentucky	300826	Agent - Health	10/7/2016
Active	Humana Insurance Company of Kentucky	300826	Agent - Life	10/7/2016
Active	Humana Medical Plan, Inc.	801568	Agent - Health	10/7/2016
Active	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	10/12/2016
Active	SilverScript Insurance Company	663526	Agent - Health	9/19/2024
Active	UnitedHealthcare Insurance Company	300946	Agent - Health	11/25/2021
Inactive	UnitedHealthcare Insurance Company of America	301552	Agent - Health	9/27/2016	12/21/2018
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	11/25/2021	12/22/2022
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	11/25/2021	12/23/2021
Active	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	11/25/2021
Inactive	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	10/30/2019	4/8/2021
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	10/30/2019	4/8/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Carida Insurance Services Inc.	1119351	Agent - Life	2/3/2021
Active	Carida Insurance Services Inc.	1119351	Agent - Health	2/3/2021
Inactive	Designated Agent Company Inc.	681257	Agent - Life	11/9/2016	4/27/2021
Inactive	Designated Agent Company Inc.	681257	Agent - Health	11/9/2016	4/27/2021
Inactive	TZ Insurance Solutions LLC	727470	Agent - Life	11/12/2018	2/4/2022
Inactive	TZ Insurance Solutions LLC	727470	Agent - Health	11/12/2018	2/4/2022