DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Lake, Tamara	DOIID	928234	NAIC NPN	18058629

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	9/9/2016		12/31/2026
* 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	10/15/2024	12/31/2024	11/04/2024	11/04/2024	Yes

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	9/20/2016	7/8/2021
Inactive	Aetna Life Insurance Company	301140	Agent - Health	9/20/2016	7/8/2021
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	9/21/2016	12/14/2016
Inactive	First Health Life & Health Insurance Company	301735	Agent - Health	9/20/2016	7/8/2021
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	9/21/2016	12/14/2016
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	9/21/2016	12/14/2016
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	9/21/2016	12/14/2016
Inactive	Humana Insurance Company	301104	Agent - Health	9/21/2016	12/14/2016
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	9/21/2016	12/14/2016
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	9/21/2016	12/14/2016
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	10/12/2016	12/14/2016
Active	UnitedHealthcare Insurance Company	300946	Agent - Health	9/26/2017
Inactive	UnitedHealthcare Insurance Company of America	301552	Agent - Health	9/26/2017	12/21/2018
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	9/27/2020	4/15/2021
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	9/27/2020	4/15/2021
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	9/27/2020	4/15/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	eHealthInsurance Services Inc.	514105	Agent - Health	9/30/2016	12/9/2016