DEPARTMENT OF INSURANCE

Affiliations

Name	Prince, Tristen	DOIID	970014	NAIC NPN	18542303

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Life	9/29/2017	12/31/2019
Inactive	Non Resident	Agent	Health	9/29/2017	12/31/2019
* 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	Aetna Health Inc. (PA)	660717	Agent - Health	11/8/2017	12/31/2019
Inactive	Aetna Life Insurance Company	301140	Agent - Health	11/8/2017	12/31/2019
Inactive	Aetna Life Insurance Company	301140	Agent - Life	11/8/2017	12/31/2019
Inactive	Anthem Life Insurance Company	301209	Agent - Health	11/10/2017	12/31/2019
Inactive	Anthem Life Insurance Company	301209	Agent - Life	11/10/2017	12/31/2019
Inactive	Arcadian Health Plan, Inc.	728196	Agent - Health	11/3/2017	6/8/2018
Inactive	CIGNA Health & Life Insurance Company	301783	Agent - Health	11/13/2018	12/31/2019
Inactive	Coventry Health and Life Insurance Company	301771	Agent - Health	11/14/2017	12/31/2019
Inactive	First Health Life & Health Insurance Company	301735	Agent - Health	11/8/2017	12/31/2019
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	11/3/2017	6/8/2018
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	11/3/2017	6/8/2018
Inactive	Humana Insurance Company	301104	Agent - Health	11/3/2017	3/26/2019
Inactive	Humana Insurance Company	301104	Agent - Life	11/3/2017	3/26/2019
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	12/4/2017	3/26/2019
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	11/3/2017	6/8/2018
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	11/3/2017	6/8/2018
Inactive	Loyal American Life Insurance Company	301172	Agent - Health	1/16/2018	12/31/2019
Inactive	Medco Containment Life Insurance Company	301557	Agent - Health	11/28/2017	12/17/2019
Inactive	SilverScript Insurance Company	663526	Agent - Health	8/23/2019	12/31/2019
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	10/8/2017	3/27/2019
Inactive	UnitedHealthcare Insurance Company of America	301552	Agent - Health	10/8/2017	12/21/2018
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	7/15/2018	3/27/2019
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	10/8/2017	3/27/2019
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	3/8/2019	12/31/2019

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Designated Agent Company Inc.	681257	Agent - Health	11/14/2017	12/31/2019
Inactive	Designated Agent Company Inc.	681257	Agent - Life	11/14/2017	12/31/2019
Inactive	Mercer Health & Benefits Administration Llc	656414	Agent - Health	1/28/2019	12/31/2019
Inactive	Mercer Health & Benefits Administration Llc	656414	Agent - Life	1/28/2019	12/31/2019