DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Insurer Details

NAME	CHA HMO, Inc.
DOI ID	300662
FEIN #	611279717
ALIEN #
State of Domicile	KY
Domicile Country
Merged Into
NAIC #	95158
NAIC Group #	119
Entity Type	Insurer
Admitted	5/4/1995
AM Best Rating
President	Bruce Dale Broussard
Process Agent	CT Corporation System Date Assigned : 7/26/2022 (See address table below for process agent address)
Authorized Insurer – these insurers are authorized to do the business of insurance by holding a Kentucky Certificate of Authority. Provides insurance coverage.

Line(s) of Authority

Health Maintenance Organization

Type	Address
Annual Statement	PO Box 740036 Louisville, KY 402017436
Mailing	P.O. Box 740036 Louisville, KY 402017436
Process Agent	306 West Main Street Suite 306 Frankfort, KY 40601
Statutory Home Office	500 West Main Street Louisville, KY 40202

Type	Number
Business / Home Office	(502) 580-1000
Annual Statement - Annual Statement	(502) 580-0340
Health Complaint	(859) 328-8743

Type	Internet Information
Annual Statement - Business Email	doiinquiries@humana.com