DEPARTMENT OF INSURANCE

Affiliations

Name	Tackett, Tina Gayle	DOIID	362136	NAIC NPN	7196820

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Casualty	8/15/2000		10/31/2026
Active	Resident	Agent	Property	8/15/2000		10/31/2026
Active	Resident	Agent	Life	5/26/2005		10/31/2026
Active	Resident	Agent	Health	5/26/2005		10/31/2026
Inactive	Resident	Agent	General Lines	11/18/1999	8/15/2000
* 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	Arcadian Health Plan, Inc.	728196	Agent - Health	9/11/2020	12/13/2022
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	10/12/2018	12/13/2022
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	9/11/2020	12/13/2022
Active	Humana Insurance Company	301104	Agent - Health	4/5/2016
Active	Humana Insurance Company	301104	Agent - Life	5/1/2008
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	11/14/2006	5/28/2015
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	11/14/2006	5/28/2015
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	9/11/2020	12/13/2022
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	9/11/2020	12/13/2022
Inactive	Nationwide Mutual Fire Insurance Company	301722	Agent - Casualty	8/15/2000	9/22/2003
Inactive	Nationwide Mutual Fire Insurance Company	301722	Agent - General Lines	12/8/1999	8/15/2000
Inactive	Nationwide Mutual Fire Insurance Company	301722	Agent - Property	8/15/2000	9/22/2003
Inactive	Nationwide Mutual Insurance Company	301749	Agent - Casualty	8/15/2000	9/22/2003
Inactive	Nationwide Mutual Insurance Company	301749	Agent - General Lines	11/18/1999	8/15/2000
Inactive	Nationwide Mutual Insurance Company	301749	Agent - Property	8/15/2000	9/22/2003
Inactive	Nationwide Property and Casualty Insurance Company	300599	Agent - Casualty	8/15/2000	9/22/2003
Inactive	Nationwide Property and Casualty Insurance Company	300599	Agent - General Lines	12/8/1999	8/15/2000
Inactive	Nationwide Property and Casualty Insurance Company	300599	Agent - Property	8/15/2000	9/22/2003
Active	State Farm Fire and Casualty Company	301809	Agent - Property	1/3/2005
Inactive	State Farm General Insurance Company	301122	Agent - Property	1/3/2005	11/18/2010
Active	State Farm Life Insurance Company	301810	Agent - Life	6/7/2005
Active	State Farm Mutual Automobile Insurance Company	301732	Agent - Casualty	1/3/2005
Active	State Farm Mutual Automobile Insurance Company	301732	Agent - Health	6/7/2005
Inactive	Time Insurance Company	300683	Agent - Health	8/12/2014	6/18/2016

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Peoples Insurance Agency LLC	517977	Agent - Property
Denied	Peoples Insurance Agency LLC	517977	Agent - Casualty