DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Fay, Chaquita Monique	DOIID	686943	NAIC NPN	8956229

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	1/29/2013		11/30/2025
Active	Non Resident	Agent	Health	8/13/2008		11/30/2025
* 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	09/15/2025	11/30/2025

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	10/13/2017
Active	CHA HMO, Inc.	300662	Agent - Health	12/20/2023
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	8/25/2008	3/14/2019
Active	CompBenefits Insurance Company	301864	Agent - Health	11/13/2019
Active	Dental Concern Inc. (The)	301641	Agent - Health	3/21/2009
Active	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	10/13/2014
Active	Humana Health Plan of Ohio Inc.	301565	Agent - Health	10/3/2018
Active	Humana Health Plan, Inc.	300142	Agent - Health	8/25/2008
Active	Humana Insurance Company	301104	Agent - Health	8/25/2008
Active	Humana Insurance Company	301104	Agent - Life	2/13/2013
Active	Humana Insurance Company of Kentucky	300826	Agent - Health	8/25/2008
Active	Humana Insurance Company of Kentucky	300826	Agent - Life	2/13/2013
Active	Humana Medical Plan, Inc.	801568	Agent - Health	10/13/2014
Active	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	10/12/2016
Inactive	HumanaDental Insurance Company	301457	Agent - Health	9/1/2011	5/13/2013
Inactive	Kanawha Insurance Company	300127	Agent - Health	9/28/2011	10/22/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	2/13/2013	10/22/2015

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Humana MarketPOINT Inc.	398092	Agent - Health	4/1/2009