DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Timmerman, Ethan	DOIID	1013173	NAIC NPN	18923934

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	10/2/2018	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	Arcadian Health Plan, Inc.	728196	Agent - Health	2/15/2019	10/17/2019
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	12/5/2018	10/17/2019
Inactive	Humana Insurance Company	301104	Agent - Health	10/17/2018	10/17/2019
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	6/21/2019	10/17/2019

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Trubridge Inc	717747	Agent - Health	5/17/2019	10/17/2019