black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

DOMINIQUE SIMMONS

PRODUCER NON-RESIDENT

License Number:
PRN462157
Status:
First Licensure:
09/06/2023
Cancel Date:
None

Mailing:
DETROIT, MI 48219
Phone:
+1 (248) 688-1361
Fax:
+1 (304) 929-3259
Email:
dcsimmons.1206@gmail.com

History

License Type Start Date End Date
PRODUCER NON-RESIDENT 09/06/2023

Agency

Name Issue Date License Number Expiration Date Cancel Date
HEALTH PLAN ONE LLC
09/06/2023 AGN150231

Employer

Name Issue Date License Number Expiration Date Cancel Date
AMH HEALTH PLANS OF MAINE, INC.
06/12/2024 LHD353013 05/14/2025
AMH HEALTH, LLC
06/12/2024 HMD329485 05/14/2025
ANTHEM HEALTH PLANS OF MAINE INC.
06/12/2024 LHD70566 05/14/2025
ANTHEM INSURANCE COMPANIES INC
06/12/2024 LHF125537 05/14/2025
EMPIRE HEALTHCHOICE HMO, INC.
06/12/2024 HMF285382 05/14/2025

Authority

Description Issue Date Termination Date Status
HEALTH 09/06/2023 Active

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
20382893

Other Addresses

Address Type
DETROIT, MI 48219
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: 05/17/2025 10:13:32 PM