DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Martin, Thomas G	DOIID	1217917	NAIC NPN	18890645

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	7/20/2022		4/30/2025
* 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	02/15/2025	04/30/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Arcadian Health Plan, Inc.	728196	Agent - Health	8/2/2023
Active	CHA HMO, Inc.	300662	Agent - Health	12/19/2023
Inactive	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	7/21/2022	12/16/2022
Active	CompBenefits Insurance Company	301864	Agent - Health	8/2/2023
Active	Dental Concern Inc. (The)	301641	Agent - Health	4/1/2024
Active	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	10/16/2023
Active	Humana Health Plan of Ohio Inc.	301565	Agent - Health	8/18/2023
Active	Humana Health Plan, Inc.	300142	Agent - Health	1/5/2024
Active	Humana Insurance Company	301104	Agent - Health	8/2/2023
Active	Humana Medical Plan, Inc.	801568	Agent - Health	9/1/2023
Active	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	8/18/2023
Inactive	Sierra Health and Life Insurance Company Inc.	300357	Agent - Health	7/21/2022	12/16/2022
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	7/21/2022	12/16/2022
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	7/21/2022	12/16/2022
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	7/21/2022	12/16/2022

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Humana MarketPOINT Inc.	398092	Agent - Health	8/2/2023