black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

VIVEK AJAY SHAH

PRODUCER NON-RESIDENT

License Number:
PRN230915
Status:
First Licensure:
04/02/2014
Cancel Date:
None

Mailing:
COVINA, CA 91723
Phone:
+1 (888) 584-7457
Fax:
+1 (415) 890-0856
Email:
regulatory@simplyinsured.com

History

License Type Start Date End Date
PRODUCER NON-RESIDENT 04/02/2014

Agency

Name Issue Date License Number Expiration Date Cancel Date
TEN 250 CORPORATION
05/07/2015 AGN250009

Employer

Name Issue Date License Number Expiration Date Cancel Date
AETNA HEALTH INC
09/02/2015 HMD45749
AETNA LIFE INSURANCE COMPANY
09/02/2015 LHF621
ALL SAVERS INSURANCE COMPANY
09/27/2022 LHF233900
AMERICAN FAMILY LIFE ASSURANCE COMPANY OF COLUMBUS
06/08/2023 LHF306110 07/14/2023
AMICA LIFE INSURANCE COMPANY
07/31/2024 LHF896
ANTHEM HEALTH PLANS OF MAINE INC.
09/01/2020 LHD70566
ANTHEM LIFE INSURANCE COMPANY
09/01/2020 LHF70467 04/11/2025
ARCADIAN HEALTH PLAN INC
11/08/2022 HMF112421 02/28/2024
ARCADIAN HEALTH PLAN INC
06/14/2024 HMF112421
HUMANA INSURANCE COMPANY
06/03/2014 LHF980 10/28/2015
HUMANA INSURANCE COMPANY
11/08/2022 LHF980
HUMANADENTAL INSURANCE COMPANY
03/04/2015 LHF173873 10/28/2015
HUMANADENTAL INSURANCE COMPANY
11/08/2022 LHF173873
PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY
12/16/2024 LHF250
STARMOUNT LIFE INSURANCE COMPANY
12/16/2024 LHD131525
UNITEDHEALTHCARE INSURANCE COMPANY
05/30/2014 LHF700
UNITEDHEALTHCARE OF NEW ENGLAND, INC.
11/01/2021 HMF393375
UNUM INSURANCE COMPANY
12/16/2024 LHD241
UNUM LIFE INSURANCE COMPANY OF AMERICA
12/16/2024 LHD145

Authority

Description Issue Date Termination Date Status
HEALTH 04/02/2014 Active
LIFE 04/24/2015 Active

Responsible For

Name License Number
TEN 250 CORPORATION AGN250009

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
16841690

Other Addresses

Address Type
4909 CENTRAL AVE STE B-5
RICHMOND, CA 94804-5803
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: 05/20/2025 10:42:12 PM