DEPARTMENT OF INSURANCE

Affiliations

Name	Wallace, Nicole M	DOIID	971293	NAIC NPN	17747803

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Life	10/5/2017	5/25/2022
Inactive	Non Resident	Agent	Health	10/5/2017	5/25/2022
* 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	Aetna Health Inc. (PA)	660717	Agent - Health	10/19/2017	5/25/2022
Inactive	Aetna Health of Ohio Inc.	1065035	Agent - Health	7/28/2020	5/25/2022
Inactive	Aetna Life Insurance Company	301140	Agent - Health	10/19/2017	5/25/2022
Inactive	Aetna Life Insurance Company	301140	Agent - Life	10/19/2017	5/25/2022
Inactive	Americo Financial Life and Annuity Insurance Company	300869	Agent - Health	5/25/2018	12/27/2018
Inactive	Americo Financial Life and Annuity Insurance Company	300869	Agent - Life	5/25/2018	12/27/2018
Inactive	Anthem Life Insurance Company	301209	Agent - Health	10/26/2017	6/1/2022
Inactive	Anthem Life Insurance Company	301209	Agent - Life	10/26/2017	6/1/2022
Inactive	Arcadian Health Plan, Inc.	728196	Agent - Health	11/14/2017	5/20/2022
Inactive	Compcare Health Services Insurance Corporation	948751	Agent - Health	9/16/2021	6/1/2022
Inactive	Everly Life Insurance Company	561641	Agent - Life	11/7/2017	11/14/2018
Inactive	First Health Life & Health Insurance Company	301735	Agent - Health	10/19/2017	5/25/2022
Inactive	Gerber Life Insurance Company	300529	Agent - Health	12/11/2017	12/12/2020
Inactive	Gerber Life Insurance Company	300529	Agent - Life	12/11/2017	12/12/2020
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	11/14/2017	6/8/2018
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	11/14/2017	6/8/2018
Inactive	Humana Insurance Company	301104	Agent - Health	11/14/2017	6/8/2018
Inactive	Humana Insurance Company	301104	Agent - Life	11/14/2017	6/8/2018
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	11/14/2017	6/8/2018
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	11/14/2017	6/8/2018
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	11/14/2017	5/9/2019
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Health	5/7/2019	9/25/2021
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Life	5/7/2019	9/25/2021
Inactive	SilverScript Insurance Company	663526	Agent - Health	8/23/2019	5/25/2022
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	10/17/2017	1/20/2021
Inactive	UnitedHealthcare Insurance Company of America	301552	Agent - Health	10/17/2017	12/21/2018
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	8/6/2019	1/20/2021
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	7/15/2018	1/20/2021
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	10/17/2017	1/20/2021

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 - Life	10/27/2017	5/25/2022
Inactive	Designated Agent Company Inc.	681257	Agent - Health	10/27/2017	5/25/2022