DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Farnsworth, Elma Gatdula	DOIID	988066	NAIC NPN	4681703

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	3/19/2018	6/30/2021
Inactive	Non Resident	Agent	Health	3/19/2018	6/30/2021
* 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	American Financial Security Life Insurance Co.	301635	Agent - Health	3/24/2019	6/30/2021
Inactive	Anthem Life Insurance Company	301209	Agent - Health	10/31/2018	6/30/2021
Inactive	Anthem Life Insurance Company	301209	Agent - Life	10/31/2018	6/30/2021
Inactive	Golden Rule Insurance Company	301943	Agent - Health	3/21/2018	7/7/2021
Inactive	Golden Rule Insurance Company	301943	Agent - Life	3/21/2018	7/7/2021
Inactive	LifeShield National Insurance Company	737111	Agent - Health	1/24/2019	6/30/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Health Plan Intermediaries Holdings	786463	Agent - Health	7/10/2019	6/30/2021