DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Blom, Raymond Arthur	DOIID	1185061	NAIC NPN	8193644

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	1/27/2022	9/30/2024
Inactive	Non Resident	Agent	Life	1/27/2022	9/30/2024
* 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	1/31/2022	9/30/2024
Inactive	Aetna Health of Ohio Inc.	1065035	Agent - Health	1/31/2022	9/30/2024
Inactive	Aetna Life Insurance Company	301140	Agent - Health	1/31/2022	9/30/2024
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	4/4/2022	5/8/2023
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	4/4/2022	5/8/2023
Inactive	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	7/21/2022	9/30/2024
Inactive	SilverScript Insurance Company	663526	Agent - Health	1/31/2022	9/30/2024
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	7/5/2022	9/30/2024
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	7/5/2022	12/22/2022
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	7/5/2022	9/30/2024

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Sutherland Global Services Inc	601788	Agent - Life	2/4/2022	4/4/2022
Inactive	Sutherland Global Services Inc	601788	Agent - Health	2/4/2022	9/30/2024