DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Daza, Carlos Guillermo	DOIID	791137	NAIC NPN	10782193

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Pending Replacement	Non Resident	Agent	Health	7/7/2022		6/30/2025
Pending Replacement	Non Resident	Agent	Life	7/7/2022		6/30/2025
* 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
Pending Replacement	Aetna Health Inc. (PA)	660717	Agent - Health	7/22/2022
Pending Replacement	Aetna Health of Ohio Inc.	1065035	Agent - Health	7/22/2022
Pending Replacement	Aetna Life Insurance Company	301140	Agent - Health	7/22/2022
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	10/24/2014	6/30/2015
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	10/24/2014	6/30/2015
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	10/24/2014	6/30/2015
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	10/24/2014	6/30/2015
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	10/24/2014	6/30/2015
Inactive	Humana Insurance Company	301104	Agent - Health	10/24/2014	6/30/2015
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	10/24/2014	6/30/2015
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	10/24/2014	6/30/2015
Inactive	Kanawha Insurance Company	300127	Agent - Health	10/24/2014	6/30/2015
Pending Replacement	SilverScript Insurance Company	663526	Agent - Health	7/22/2022
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	9/12/2012	1/30/2014
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	9/12/2012	1/30/2014

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Health Plan Intermediaries Holdings	786463	Agent - Health	10/18/2022	1/31/2023
Denied	Health Plan Intermediaries Holdings	786463	Agent - Life
Inactive	Togetherhealth Insurance LLC	1026438	Agent - Health	11/14/2022	1/24/2023
Denied	Togetherhealth Insurance LLC	1026438	Agent - Life