DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Johnson, Petagay	DOIID	927559	NAIC NPN	18061005

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	9/1/2016		5/31/2027
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Arcadian Health Plan, Inc.	728196	Agent - Health	10/11/2017	12/19/2017
Active	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	7/21/2022
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	9/6/2016	12/19/2017
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	9/6/2016	12/19/2017
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	9/6/2016	12/19/2017
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	9/6/2016	12/19/2017
Inactive	Humana Insurance Company	301104	Agent - Health	9/6/2016	12/19/2017
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	9/6/2016	12/19/2017
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	9/6/2016	12/19/2017
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	10/12/2016	12/19/2017
Active	Sierra Health and Life Insurance Company Inc.	300357	Agent - Health	8/24/2022
Active	UnitedHealthcare Insurance Company	300946	Agent - Health	4/29/2018
Inactive	UnitedHealthcare Insurance Company of America	301552	Agent - Health	4/29/2018	12/21/2018
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	8/6/2019	12/22/2022
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	7/15/2018	12/23/2021
Active	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	4/29/2018

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Humana MarketPOINT Inc.	398092	Agent - Health	11/21/2017	12/19/2017