DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Martin, Madison	DOIID	1005058	NAIC NPN	18874373

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	8/15/2018	4/30/2020
Inactive	Non Resident	Agent	Life	8/15/2018	4/30/2020
* 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	Continental American Insurance Company	301700	Agent - Health	9/6/2018	4/30/2020
Inactive	Continental American Insurance Company	301700	Agent - Life	9/6/2018	4/30/2020
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	11/1/2018	4/30/2020
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	11/1/2018	4/30/2020
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	11/1/2018	4/30/2020
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	11/1/2018	4/30/2020
Inactive	Unum Insurance Company	301499	Agent - Health	11/1/2018	4/30/2020
Inactive	Unum Insurance Company	301499	Agent - Life	11/1/2018	4/30/2020

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Mercer Health & Benefits Administration Llc	656414	Agent - Health	2/1/2019	4/30/2020
Inactive	Mercer Health & Benefits Administration Llc	656414	Agent - Life	2/1/2019	4/30/2020