DEPARTMENT OF INSURANCE

Affiliations

Name	Peterson, Petagay Archibald	DOIID	1227190	NAIC NPN	20434729

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	9/2/2022		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	Aetna Health Inc. (PA)	660717	Agent - Health	9/14/2022
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	9/14/2022
Active	Aetna Life Insurance Company	301140	Agent - Health	9/14/2022
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	1/22/2023
Active	Anthem Health Plans of New Hampshire, Inc.	944064	Agent - Health	1/22/2023
Active	Anthem Insurance Companies, Inc.	300941	Agent - Health	1/22/2023
Active	Arcadian Health Plan, Inc.	728196	Agent - Health	9/13/2024
Active	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	9/6/2022
Active	CompBenefits Insurance Company	301864	Agent - Health	9/13/2024
Active	Compcare Health Services Insurance Corporation	948751	Agent - Health	1/22/2023
Active	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	9/8/2022
Active	Dental Concern Inc. (The)	301641	Agent - Health	9/19/2024
Active	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	10/28/2024
Active	Humana Health Plan of Ohio Inc.	301565	Agent - Health	10/14/2024
Active	Humana Insurance Company	301104	Agent - Health	9/13/2024
Active	Humana Medical Plan, Inc.	801568	Agent - Health	9/29/2024
Active	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	10/14/2024
Active	SilverScript Insurance Company	663526	Agent - Health	9/14/2022
Active	UnitedHealthcare Insurance Company	300946	Agent - Health	9/6/2022
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	9/6/2022	12/22/2022
Active	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	9/6/2022
Inactive	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	12/6/2022	7/22/2024

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	8/27/2024