DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	ETQ HK SPV Inc	DOIID	836619	NAIC NPN	17212993

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	3/25/2014		3/31/2026
Active	Non Resident	Agent	Life	12/5/2014		3/31/2026
* 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	01/15/2026	03/31/2026

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	10/18/2017
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	7/30/2014	2/23/2018
Active	Humana Health Plan, Inc.	300142	Agent - Health	7/25/2014
Active	Humana Insurance Company	301104	Agent - Health	7/25/2014
Active	Humana Insurance Company of Kentucky	300826	Agent - Health	7/25/2014
Active	Humana Medical Plan, Inc.	801568	Agent - Health	11/24/2015
Active	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	12/1/2016

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Chauncey, Robert Joseph	834651	Agent - Health	3/25/2014	12/12/2024
Inactive	Solazzo, Anthony Patrick	612583	Agent - Life	12/5/2014	3/31/2024
Active	Uchytil, Craig Charles	739753	Agent - Health	3/24/2023
Active	Uchytil, Craig Charles	739753	Agent - Life	3/24/2023