DEPARTMENT OF INSURANCE

Affiliations

Name	Clark, Latrice D	DOIID	991094	NAIC NPN	18705799

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Health	9/12/2023	2/28/2026
Active	Non Resident	Agent	Life	9/12/2023	2/28/2026
* 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	12/15/2025	02/28/2026

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Aetna Health Inc. (PA)	660717	Agent - Health	10/10/2019	2/28/2022
Inactive	Aetna Health of Ohio Inc.	1065035	Agent - Health	1/29/2021	2/28/2022
Inactive	Aetna Life Insurance Company	301140	Agent - Health	10/10/2019	2/28/2022
Inactive	Anthem Life Insurance Company	301209	Agent - Health	12/13/2019	5/1/2020
Inactive	Anthem Life Insurance Company	301209	Agent - Life	12/13/2019	5/1/2020
Inactive	CIGNA Health & Life Insurance Company	301783	Agent - Health	7/26/2024	1/10/2025
Inactive	Columbian Life Insurance Company	300810	Agent - Life	6/29/2018	2/28/2022
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	10/15/2020	2/28/2022
Active	HealthSpring Life and Health Insurance Company, Inc.	684899	Agent - Health	11/7/2024
Active	Healthspring Healthcare of Colorado, Inc.	1098153	Agent - Health	11/7/2024
Inactive	Medco Containment Life Insurance Company	301557	Agent - Health	10/19/2023	1/22/2024
Inactive	Sierra Health and Life Insurance Company Inc.	300357	Agent - Health	7/4/2018	8/10/2018
Inactive	SilverScript Insurance Company	663526	Agent - Health	10/10/2019	2/28/2022
Inactive	Transamerica Life Insurance Company	300571	Agent - Health	4/26/2018	2/28/2022
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	4/26/2018	2/28/2022
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Health	4/26/2018	10/1/2020
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Life	4/26/2018	10/1/2020
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	11/15/2018	7/6/2020
Inactive	UnitedHealthcare Insurance Company of America	301552	Agent - Health	11/15/2018	12/21/2018
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	8/6/2019	7/6/2020
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	11/15/2018	7/6/2020
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	11/15/2018	7/6/2020
Inactive	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	10/24/2019	12/28/2021
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	10/24/2019	12/29/2021

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 - Life	12/13/2019	2/28/2022
Inactive	Designated Agent Company Inc.	681257	Agent - Health	12/13/2019	2/28/2022