DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Chambers, Nicole Danielle	DOIID	1257395	NAIC NPN	11779995

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	2/21/2023		5/31/2026
Active	Non Resident	Agent	Life	2/21/2023		5/31/2026
* 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	03/15/2026	05/31/2026

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	3/7/2023
Inactive	Anthem Life Insurance Company	301209	Agent - Health	3/7/2023	4/15/2025
Inactive	Anthem Life Insurance Company	301209	Agent - Life	3/7/2023	4/15/2025
Active	Hartford Life and Accident Insurance Company	300878	Agent - Health	1/9/2024
Active	Hartford Life and Accident Insurance Company	300878	Agent - Life	1/9/2024

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Aon Consulting Inc NJ	399932	Agent - Life	3/23/2023	4/17/2024
Inactive	Aon Consulting Inc NJ	399932	Agent - Health	3/23/2023	4/17/2024
Active	Dental Choice Agency Inc.	398085	Agent - Health	3/24/2023