DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Domin, Derek Michael	DOIID	1423307	NAIC NPN	12128264

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	9/17/2025		4/30/2028
Active	Non Resident	Agent	Health	9/17/2025		4/30/2028
* 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
Active	Arcadian Health Plan, Inc.	728196	Agent - Health	4/6/2026
Active	Humana Insurance Company	301104	Agent - Health	4/6/2026

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Humana MarketPOINT Inc.	398092	Agent - Life
Denied	Humana MarketPOINT Inc.	398092	Agent - Health