DEPARTMENT OF INSURANCE

Affiliations

Name	Etienne, Marjorie	DOIID	1013271	NAIC NPN	18166854

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Life	10/2/2018	8/31/2024
Active	Non Resident	Agent	Health	10/2/2018	8/31/2024
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	06/15/2024	08/31/2024

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Aetna Health Inc. (PA)	660717	Agent - Health	4/9/2021
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	7/28/2020
Active	Aetna Life Insurance Company	301140	Agent - Health	4/9/2021
Active	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	7/9/2019
Active	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	7/9/2019
Active	Anthem Life Insurance Company	301209	Agent - Health	10/8/2019
Active	Anthem Life Insurance Company	301209	Agent - Life	10/8/2019
Inactive	Colonial Life and Accident Insurance Company	300846	Agent - Health	12/31/2018	4/4/2019
Inactive	Colonial Life and Accident Insurance Company	300846	Agent - Life	12/31/2018	4/4/2019
Inactive	Lumico Life Insurance Company	300354	Agent - Life	4/28/2019	8/18/2020
Active	Provident Life and Accident Insurance Company	301525	Agent - Health	8/24/2021
Active	Provident Life and Accident Insurance Company	301525	Agent - Life	8/24/2021
Active	ReliaStar Life Insurance Company	301712	Agent - Health	8/12/2020
Active	ReliaStar Life Insurance Company	301712	Agent - Life	8/12/2020
Active	SilverScript Insurance Company	663526	Agent - Health	5/18/2020
Inactive	Starmount Life Insurance Company	628031	Agent - Health	8/13/2019	8/14/2023
Active	UNUM Life Insurance Company of America	300817	Agent - Health	8/24/2021
Active	UNUM Life Insurance Company of America	300817	Agent - Life	8/24/2021
Inactive	Unum Insurance Company	301499	Agent - Health	8/13/2019	8/14/2023
Inactive	Unum Insurance Company	301499	Agent - Life	8/13/2019	8/14/2023
Inactive	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	10/16/2019	12/29/2021
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	10/16/2019	12/30/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date
Active	Designated Agent Company Inc.	681257	Agent - Life	10/16/2019
Active	Designated Agent Company Inc.	681257	Agent - Health	10/16/2019
Active	Optavise, LLC	671337	Agent - Life	10/12/2018
Active	Optavise, LLC	671337	Agent - Health	10/12/2018