black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

CHARLES WAYNE SMITH

PRODUCER NON-RESIDENT

License Number:
PRN397591
Status:
First Licensure:
09/28/2021
Cancel Date:
None

Mailing:
RICHARDSON, TX 75081
Phone:
+1 (801) 415-0579
Email:
lac@extendhealth.com

History

License Type Start Date End Date
PRODUCER NON-RESIDENT 09/28/2021

Agency

Name Issue Date License Number Expiration Date Cancel Date
EXTEND INSURANCE SERVICES LLC
09/28/2021 AGN120215

Employer

Name Issue Date License Number Expiration Date Cancel Date
AETNA HEALTH INC
11/01/2024 HMD45749
AETNA LIFE INSURANCE COMPANY
11/03/2024 LHF621
AMH HEALTH PLANS OF MAINE, INC.
09/28/2021 LHD353013
AMH HEALTH, LLC
09/28/2021 HMD329485
ANTHEM HEALTH PLANS OF MAINE INC.
09/28/2021 LHD70566
ANTHEM INSURANCE COMPANIES INC
09/28/2021 LHF125537
CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE COMPANY
09/28/2021 LHF214634 01/25/2024
CHESAPEAKE LIFE INSURANCE COMPANY
09/30/2021 LHF699 02/03/2025
CIGNA HEALTH AND LIFE INSURANCE COMPANY
10/12/2021 LHF860
EMPIRE HEALTHCHOICE HMO, INC.
09/28/2021 HMF285382
GOLDEN RULE INSURANCE COMPANY
12/17/2024 LHF918
GUARDIAN LIFE INSURANCE COMPANY OF AMERICA
10/07/2021 LHF644
HUMANA INSURANCE COMPANY
11/28/2022 LHF980 10/04/2023
LOYAL AMERICAN LIFE INSURANCE COMPANY
09/30/2021 LHF207
MEDCO CONTAINMENT LIFE INSURANCE COMPANY
12/10/2024 LHF183
SIERRA HEALTH AND LIFE INSURANCE COMPANY INC.
09/28/2021 LHF58195
UNITEDHEALTHCARE INSURANCE COMPANY
09/28/2021 LHF700
UNITEDHEALTHCARE INSURANCE COMPANY OF AMERICA
09/28/2021 LHF983 12/28/2021
UNITEDHEALTHCARE OF WISCONSIN, INC.
11/13/2024 HMF376407
WELLCARE PRESCRIPTION INSURANCE INC
01/20/2023 LHF121869

Authority

Description Issue Date Termination Date Status
HEALTH 09/28/2021 Active
LIFE 09/28/2021 Active

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
17366658

Other Addresses

Address Type
RICHARDSON, TX 75081
Office

An active license/permit may still be subject to limitations and restrictions as a result of disciplinary action imposed. Please contact the specific licensing board about specific disciplinary actions.

Date: 05/14/2025 05:19:05 AM