DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Chapman, Dana	DOIID	626957	NAIC NPN	720034

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	3/6/2006	7/31/2018
Inactive	Non Resident	Agent	Life	3/6/2006	7/31/2018
* 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	Anthem Life Insurance Company	301209	Agent - Health	6/25/2014	11/2/2016
Inactive	Anthem Life Insurance Company	301209	Agent - Life	6/25/2014	11/2/2016
Inactive	Companion Life Insurance Company	300191	Agent - Health	1/14/2015	9/22/2018
Inactive	Companion Life Insurance Company	300191	Agent - Life	1/14/2015	9/22/2018
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Health	10/6/2016	7/31/2018
Inactive	Transamerica Life Insurance Company	300571	Agent - Health	12/28/2006	7/31/2018
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	12/28/2006	7/31/2018
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	5/22/2014	11/30/2016
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	5/22/2014	11/30/2016
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	5/22/2014	11/30/2016
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	5/22/2014	11/30/2016

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Designated Agent Company Inc.	681257	Agent - Health	6/25/2014	11/2/2016
Inactive	Designated Agent Company Inc.	681257	Agent - Life	6/25/2014	11/2/2016
Inactive	Willis Of Illinois Inc	398318	Agent - Health	5/9/2014	12/13/2017
Inactive	Willis Of Illinois Inc	398318	Agent - Life	5/9/2014	12/13/2017