DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Lacey, Monique Shiree	DOIID	965386	NAIC NPN	18504096

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	8/28/2017		6/30/2026
* 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	04/15/2024	06/30/2024	05/02/2024	05/02/2024	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Arcadian Health Plan, Inc.	728196	Agent - Health	5/14/2018
Active	CompBenefits Insurance Company	301864	Agent - Health	11/12/2019
Active	Dental Concern Inc. (The)	301641	Agent - Health	5/14/2018
Active	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	5/14/2018
Active	Humana Health Plan of Ohio Inc.	301565	Agent - Health	10/23/2018
Active	Humana Health Plan, Inc.	300142	Agent - Health	5/14/2018
Active	Humana Insurance Company	301104	Agent - Health	5/14/2018
Active	Humana Insurance Company of Kentucky	300826	Agent - Health	5/14/2018
Active	Humana Medical Plan, Inc.	801568	Agent - Health	5/14/2018
Active	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	5/14/2018
Inactive	Kanawha Insurance Company	300127	Agent - Health	8/30/2017	12/12/2017

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Humana MarketPOINT Inc.	398092	Agent - Health	6/18/2019