DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Shah, Shivam	DOIID	1218233	NAIC NPN	20385748

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	7/21/2022	11/30/2024
Inactive	Non Resident	Agent	Life	7/21/2022	11/30/2024
* 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	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	8/2/2022	11/10/2022
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	7/22/2022	11/10/2022
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	7/22/2022	11/10/2022
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	7/22/2022	11/10/2022

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Smart Match Insurance Agency LLC	829381	Agent - Life
Inactive	Smart Match Insurance Agency LLC	829381	Agent - Health	7/28/2022	8/31/2022