DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Tellefsen, Chad	DOIID	932214	NAIC NPN	17659237

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	10/6/2016	11/30/2022
Inactive	Non Resident	Agent	Life	10/6/2016	11/30/2022
* 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	Arcadian Health Plan, Inc.	728196	Agent - Health	10/11/2017	6/24/2021
Inactive	CompBenefits Insurance Company	301864	Agent - Health	11/15/2019	6/24/2021
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	10/11/2016	6/24/2021
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	10/11/2016	6/24/2021
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	10/26/2018	6/24/2021
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	10/11/2016	6/24/2021
Inactive	Humana Insurance Company	301104	Agent - Health	10/11/2016	6/24/2021
Inactive	Humana Insurance Company	301104	Agent - Life	10/11/2016	6/24/2021
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	10/11/2016	6/24/2021
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	10/11/2016	6/24/2021
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	10/11/2016	6/24/2021
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	10/11/2016	6/24/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Humana MarketPOINT Inc.	398092	Agent - Health	11/21/2017	6/24/2021