black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

GENET MEKONNEN GIZAW

PRODUCER NON-RESIDENT

License Number:
PRN254449
Status:
First Licensure:
08/15/2015
Cancel Date:
None

Mailing:
TAMPA, FL 33624
Phone:
+1 (813) 289-1000
Fax:
+1 (800) 235-5023
Email:
ggizaw@healthplan.com

History

License Type Start Date End Date
PRODUCER NON-RESIDENT 08/15/2015

Agency

Name Issue Date License Number Expiration Date Cancel Date
ENSUREM II LLC
04/26/2023 AGN264805

Employer

Name Issue Date License Number Expiration Date Cancel Date
AMERICAN PROGRESSIVE LIFE & HEALTH INS COMPANY OF NEW YORK
02/23/2024 LHF374 08/21/2024
AMH HEALTH PLANS OF MAINE, INC.
05/17/2023 LHD353013 11/05/2024
AMH HEALTH, LLC
05/17/2023 HMD329485 11/05/2024
ANTHEM HEALTH PLANS OF MAINE INC.
05/17/2023 LHD70566 11/05/2024
ANTHEM INSURANCE COMPANIES INC
05/17/2023 LHF125537 11/05/2024
CIGNA HEALTH AND LIFE INSURANCE COMPANY
01/26/2016 LHF860 04/11/2017
CIGNA HEALTH AND LIFE INSURANCE COMPANY
05/08/2017 LHF860
MEDCO CONTAINMENT LIFE INSURANCE COMPANY
03/20/2025 LHF183
WELLCARE OF MAINE, INC.
02/23/2024 HMD305081 08/21/2024
WELLCARE PRESCRIPTION INSURANCE INC
02/23/2024 LHF121869 08/21/2024

Authority

Description Issue Date Termination Date Status
HEALTH 08/15/2015 Active
LIFE 08/15/2015 Active

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
8530710

Other Addresses

Address Type
6700 LAKEVIEW CENTER DR
TAMPA, FL 33619-1108
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: 06/09/2025 11:29:32 PM