DEPARTMENT OF INSURANCE

Affiliations

Name	Green, Erickson	DOIID	946292	NAIC NPN	18332701

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	7/25/2022		5/31/2025
Active	Non Resident	Agent	Life	7/25/2022		5/31/2025
Inactive	Non Resident	Agent	Personal Lines	3/1/2017	5/31/2019
* 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	03/15/2025	05/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Accendo Insurance Company	300312	Agent - Health	8/17/2022	11/16/2023
Inactive	Accendo Insurance Company	300312	Agent - Life	8/17/2022	11/16/2023
Active	Aetna Health Inc. (PA)	660717	Agent - Health	10/20/2022
Inactive	Aetna Health and Life Insurance Company	300523	Agent - Health	8/29/2022	11/16/2023
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	10/20/2022
Active	Aetna Life Insurance Company	301140	Agent - Health	10/20/2022
Inactive	American Income Life Insurance Company	300256	Agent - Health	3/17/2024	6/9/2024
Inactive	American Income Life Insurance Company	300256	Agent - Life	3/17/2024	6/9/2024
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	7/25/2022	10/30/2023
Inactive	Anthem Health Plans of New Hampshire, Inc.	944064	Agent - Health	7/25/2022	10/30/2023
Inactive	Anthem Insurance Companies, Inc.	300941	Agent - Health	7/25/2022	10/30/2023
Inactive	Arcadian Health Plan, Inc.	728196	Agent - Health	10/18/2022	8/17/2023
Inactive	Bristol West Insurance Company	301655	Agent - Personal Lines	9/1/2017	6/12/2018
Inactive	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	7/26/2022	6/15/2023
Inactive	Compcare Health Services Insurance Corporation	948751	Agent - Health	7/25/2022	10/30/2023
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	8/29/2022	11/16/2023
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Life	8/29/2022	11/16/2023
Inactive	Homesite Insurance Company	301139	Agent - Personal Lines	11/8/2017	6/5/2018
Inactive	Homesite Insurance Company of the Midwest	874850	Agent - Personal Lines	11/8/2017	6/5/2018
Inactive	Humana Insurance Company	301104	Agent - Health	3/9/2023	8/17/2023
Inactive	LM General Insurance Company	300133	Agent - Personal Lines	3/29/2017	5/31/2018
Inactive	Liberty Insurance Corporation	300444	Agent - Personal Lines	3/21/2017	5/31/2018
Inactive	Liberty Mutual Insurance Company	301159	Agent - Personal Lines	3/29/2017	5/31/2018
Inactive	Progressive Casualty Insurance Company	300696	Agent - Personal Lines	9/18/2017	7/2/2018
Active	SilverScript Insurance Company	663526	Agent - Health	10/20/2022
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	7/26/2022	6/15/2023
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	7/26/2022	12/22/2022
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	7/26/2022	6/15/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Smart Match Insurance Agency LLC	829381	Agent - Life	8/17/2022	5/30/2023
Inactive	Smart Match Insurance Agency LLC	829381	Agent - Health	7/26/2022	5/30/2023