black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

VITALIY PAVLENKO

PRODUCER NON-RESIDENT

License Number:
PRN194595
Status:
First Licensure:
09/23/2011
Cancel Date:
None

Mailing:
PORTLAND, OR 97236
Phone:
+1 (360) 227-8147
Fax:
+1 (360) 227-0097
Email:
lic@fortegra.com

History

License Type Start Date End Date
PRODUCER NON-RESIDENT 09/23/2011

Agency

Name Issue Date License Number Expiration Date Cancel Date
HUMANA MARKETPOINT INC
04/20/2021 AGN99986 07/28/2023

Employer

Name Issue Date License Number Expiration Date Cancel Date
AETNA HEALTH INC
03/23/2012 HMD45749 05/12/2021
AETNA LIFE INSURANCE COMPANY
03/23/2012 LHF621 05/12/2021
AMERICAN AMICABLE LIFE INSURANCE COMPANY OF TEXAS
03/25/2025 LHF1004
AMERICAN GENERAL LIFE INSURANCE COMPANY
03/28/2013 LHF119
ARCADIAN HEALTH PLAN INC
10/11/2012 HMF112421 02/12/2018
CHESAPEAKE LIFE INSURANCE COMPANY
01/30/2015 LHF699 03/03/2016
CHESAPEAKE LIFE INSURANCE COMPANY
04/26/2017 LHF699 08/30/2018
FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY
10/04/2012 LHF842 05/12/2021
GOLDEN RULE INSURANCE COMPANY
12/09/2014 LHF918 03/02/2026
HUMANA BENEFIT PLAN OF ILLINOIS INC
10/13/2014 LHF202755 01/18/2018
HUMANA INSURANCE COMPANY
10/12/2012 LHF980 02/12/2018
HUMANADENTAL INSURANCE COMPANY
04/11/2013 LHF173873 02/12/2018
JOHN HANCOCK LIFE INSURANCE COMPANY (USA)
01/02/2020 LHF210 09/25/2021
LUMICO LIFE INSURANCE COMPANY
09/11/2019 LHF300009 09/03/2020
NATIONAL HEALTH INSURANCE COMPANY
09/13/2017 LHF917
NORTH AMERICAN COMPANY FOR LIFE AND HEALTH INSURANCE
07/11/2016 LHF231 04/10/2017
TIME INSURANCE COMPANY
09/07/2012 LHF276 06/25/2015
TIME INSURANCE COMPANY
09/09/2016 LHF276 02/27/2020

Authority

Description Issue Date Termination Date Status
HEALTH 09/23/2011 Active
LIFE 09/23/2011 Active
INDEPENDENT PRODUCER 09/23/2011 09/28/2011 Terminated

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
14950056

Other Addresses

Address Type
PORTLAND, OR 97236
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: 06/06/2026 05:00:58 AM