DEPARTMENT OF INSURANCE

Affiliations

Name	Collins, Domenique	DOIID	968189	NAIC NPN	18091267

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Life	9/17/2017	9/30/2026
Active	Non Resident	Agent	Health	9/17/2017	9/30/2026
* 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	Accendo Insurance Company	300312	Agent - Life	6/10/2020	7/26/2024
Inactive	Aetna Health Inc. (PA)	660717	Agent - Health	10/6/2017	7/8/2021
Inactive	Aetna Health and Life Insurance Company	300523	Agent - Health	12/12/2017	6/22/2019
Inactive	Aetna Life Insurance Company	301140	Agent - Health	10/6/2017	7/8/2021
Inactive	Aetna Life Insurance Company	301140	Agent - Life	10/6/2017	7/8/2021
Inactive	American Continental Insurance Company	643130	Agent - Life	6/22/2019	8/11/2021
Inactive	Arcadian Health Plan, Inc.	728196	Agent - Health	8/20/2020	10/23/2023
Active	CIGNA Health & Life Insurance Company	301783	Agent - Health	11/21/2023
Inactive	CompBenefits Insurance Company	301864	Agent - Health	8/20/2020	10/23/2023
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	12/12/2017	6/22/2019
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	10/6/2020	10/23/2023
Inactive	First Health Life & Health Insurance Company	301735	Agent - Health	10/6/2017	7/8/2021
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	10/6/2020	10/23/2023
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	10/6/2020	10/23/2023
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	10/6/2020	10/23/2023
Inactive	Humana Insurance Company	301104	Agent - Health	8/20/2020	10/23/2023
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	10/6/2020	10/23/2023
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	10/6/2020	10/23/2023
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	10/6/2020	10/23/2023
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	10/6/2020	10/23/2023

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 - Life	3/30/2021	4/8/2024
Inactive	Humana MarketPOINT Inc.	398092	Agent - Health	3/30/2021	10/23/2023