Agency Information

Healthplan Services Insurance Agency, LLC

4110 GEORGE ROAD

TAMPA, FL 33634

813-289-1000

licensing@pattoncompliance.com

953574

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Non-Res. Producer Firm	563384	10/09/2007	Active	10/09/2007	10/31/2025

Qualification Type	Original Issue Date	Status	Effective Date
Health	10/09/2007	Active	10/09/2007
Life	10/09/2007	Active	10/09/2007

Company Name	Appointment Type	Status	Active Date
770
AETNA HEALTH INSURANCE COMPANY	Health	Active	05/18/2012
	Life	Active	02/04/2009
104
Company Name	Appointment Type	Status	Active Date
AMERITAS LIFE INSURANCE CORPORATION	Health	Active	10/09/2019
	Life	Active	10/09/2019
505
Company Name	Appointment Type	Status	Active Date
CIGNA HEALTH AND LIFE INSURANCE COMPANY	Health	Active	10/08/2014
13151
Company Name	Appointment Type	Status	Active Date
CONTINENTAL LIFE INSURANCE COMPANY OF BRENTWOOD TENNESSEE	Health	Active	05/24/2013
986
Company Name	Appointment Type	Status	Active Date
GOLDEN RULE INSURANCE COMPANY	Health	Active	06/06/2008
	Life	Active	06/06/2008
1408
Company Name	Appointment Type	Status	Active Date
HUMANA HEALTH PLAN INCORPORATED	Health	Active	05/02/2019
971
Company Name	Appointment Type	Status	Active Date
HUMANA INSURANCE COMPANY	Health	Active	10/18/2007
	Life	Active	10/18/2007
1215
Company Name	Appointment Type	Status	Active Date
HUMANADENTAL INSURANCE COMPANY	Health	Active	02/05/2021
944
Company Name	Appointment Type	Status	Active Date
SIERRA HEALTH AND LIFE INSURANCE COMPANY	Life	Active	09/08/2017
1667
Company Name	Appointment Type	Status	Active Date
UNITED CONCORDIA INSURANCE COMPANY	Health	Active	10/17/2017

row(s) 1 - 14 of 14

Name	Association Type	Agent	Begin Date	End Date
RICHARD JENNINGS TATUM	Designated Resp Lic Prdcr	Yes	10/01/2021	-

1 - 1