DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Gonzalez, Nicole Lizama	DOIID	1026615	NAIC NPN	18876043

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	1/25/2019		5/31/2025
* 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	03/15/2025	05/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	American Financial Security Life Insurance Co.	301635	Agent - Health	3/24/2019
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	9/11/2022	12/16/2024
Active	Molina Healthcare of Kentucky, Inc.	1035856	Agent - Health	10/6/2022
Active	North River Insurance Company (The)	301739	Agent - Health	9/10/2024
Inactive	Washington National Insurance Company	300587	Agent - Health	9/9/2021	11/2/2021

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	4/16/2019	4/21/2022