DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Heleniak, Phyllis Ann	DOIID	318662	NAIC NPN	1013058

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	11/4/1997	2/28/2011
Inactive	Non Resident	Agent	Health	11/4/1997	2/28/2011
* 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	Athene Annuity & Life Assurance Company	301798	Agent - Life	2/6/2008	2/28/2011
Inactive	Chase Insurance Life Company	301287	Agent - Health	11/4/1997	10/20/2005
Inactive	Chase Insurance Life Company	301287	Agent - Life	11/4/1997	10/20/2005
Inactive	Everlake Life Insurance Company	300873	Agent - Life	10/1/2004	8/17/2009
Inactive	Fidelity Life Association, A Legal Reserve Life Insurance Company	300774	Agent - Health	12/11/2000	4/8/2011
Inactive	Fidelity Life Association, A Legal Reserve Life Insurance Company	300774	Agent - Life	12/11/2000	4/8/2011
Inactive	Glenbrook Life and Annuity Company	301384	Agent - Life	10/1/2004	1/1/2005
Inactive	Globe Life and Accident Insurance Company	300639	Agent - Health	5/18/2004	6/8/2005
Inactive	Globe Life and Accident Insurance Company	300639	Agent - Life	5/18/2004	6/8/2005
Inactive	Pruco Life Insurance Company	300954	Agent - Health	11/16/2007	2/28/2011
Inactive	Pruco Life Insurance Company	300954	Agent - Life	11/16/2007	2/28/2011
Inactive	Revol One Insurance Company	300681	Agent - Health	3/5/2008	2/10/2011
Inactive	Revol One Insurance Company	300681	Agent - Life	3/5/2008	2/10/2011
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	9/20/2001	5/25/2004
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	9/20/2001	5/25/2004

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	America Direct Ins Agency Inc	619155	Agent - Life	1/23/2007	3/31/2010
Inactive	America Direct Ins Agency Inc	619155	Agent - Health	1/23/2007	3/31/2010
Inactive	Efinancial LLC	598419	Agent - Life	1/14/2010	12/20/2010
Inactive	Efinancial LLC	598419	Agent - Health	1/14/2010	12/20/2010