DEPARTMENT OF INSURANCE

Affiliations

Name	Rivera, Kenneth D	DOIID	974366	NAIC NPN	17995923

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Health	10/25/2017	9/30/2024
Active	Non Resident	Agent	Life	10/25/2017	9/30/2024
* 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	07/15/2024	09/30/2024

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	10/31/2017	7/8/2021
Inactive	Aetna Life Insurance Company	301140	Agent - Health	10/31/2017	7/8/2021
Inactive	Aetna Life Insurance Company	301140	Agent - Life	10/31/2017	7/8/2021
Inactive	Anthem Life Insurance Company	301209	Agent - Health	11/9/2017	1/1/2019
Inactive	Anthem Life Insurance Company	301209	Agent - Life	11/9/2017	1/1/2019
Active	Arcadian Health Plan, Inc.	728196	Agent - Health	7/20/2018
Active	CHA HMO, Inc.	300662	Agent - Health	3/13/2024
Active	CompBenefits Insurance Company	301864	Agent - Health	11/13/2019
Active	Dental Concern Inc. (The)	301641	Agent - Health	7/20/2018
Inactive	First Health Life & Health Insurance Company	301735	Agent - Health	10/31/2017	7/8/2021
Active	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	7/20/2018
Active	Humana Health Plan of Ohio Inc.	301565	Agent - Health	10/15/2018
Active	Humana Health Plan, Inc.	300142	Agent - Health	7/20/2018
Active	Humana Insurance Company	301104	Agent - Health	7/20/2018
Active	Humana Insurance Company	301104	Agent - Life	7/20/2018
Active	Humana Insurance Company of Kentucky	300826	Agent - Health	7/20/2018
Active	Humana Insurance Company of Kentucky	300826	Agent - Life	7/20/2018
Active	Humana Medical Plan, Inc.	801568	Agent - Health	7/20/2018
Active	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	7/20/2018
Inactive	S.USA Life Insurance Company, Inc.	301774	Agent - Life	4/5/2018	5/1/2018
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	10/25/2017	5/22/2018
Inactive	UnitedHealthcare Insurance Company of America	301552	Agent - Health	10/25/2017	5/22/2018
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	10/25/2017	5/22/2018

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	11/9/2017	1/2/2019
Inactive	Designated Agent Company Inc.	681257	Agent - Health	11/9/2017	1/2/2019
Active	Humana MarketPOINT Inc.	398092	Agent - Health	6/18/2019