DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Haczyk, Piotr	DOIID	1152118	NAIC NPN	17894023

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	8/17/2021		8/31/2026
* 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	Aetna Health Inc. (PA)	660717	Agent - Health	9/4/2024	2/10/2025
Inactive	Aetna Health of Ohio Inc.	1065035	Agent - Health	9/4/2024	2/10/2025
Inactive	Aetna Life Insurance Company	301140	Agent - Health	9/4/2024	2/10/2025
Inactive	Arcadian Health Plan, Inc.	728196	Agent - Health	10/24/2024	1/28/2025
Inactive	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	8/15/2024	1/29/2025
Inactive	Devoted Health Insurance Company of Kentucky, Inc.	1306593	Agent - Health	8/29/2024	2/7/2025
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	4/6/2022	1/10/2024
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	10/21/2022	1/10/2024
Inactive	Humana Insurance Company	301104	Agent - Health	12/3/2024	1/28/2025
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	6/9/2023	1/10/2024
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	6/7/2022	1/10/2024
Inactive	SilverScript Insurance Company	663526	Agent - Health	9/4/2024	2/10/2025
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	8/15/2024	1/29/2025
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	8/15/2024	1/29/2025

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	2/14/2022	1/10/2024