DEPARTMENT OF INSURANCE

Affiliations

Name	Sampson, Michael Steven	DOIID	323789	NAIC NPN	1891170

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Life	12/5/2018	7/31/2020
Inactive	Resident	Agent	Casualty	8/22/2002	7/31/2006
Inactive	Resident	Agent	Property	8/22/2002	7/31/2006
Inactive	Resident	Agent	Health	12/5/2018	7/31/2020
* 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	American General Life and Accident Insurance Company	301362	Agent - Health	9/24/1996	4/16/2001
Inactive	American General Life and Accident Insurance Company	301362	Agent - Life	9/24/1996	4/16/2001
Inactive	Assurity Life Insurance Company	301099	Agent - Health	10/30/2005	7/31/2006
Inactive	Assurity Life Insurance Company	301099	Agent - Life	10/30/2005	7/31/2006
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	12/3/2014	4/7/2017
Inactive	Continental General Insurance Company	300691	Agent - Health	7/14/1994	9/10/1996
Inactive	Continental General Insurance Company	300691	Agent - Life	7/14/1994	9/10/1996
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	5/12/2005	7/31/2006
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Life	5/12/2005	7/31/2006
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	12/3/2014	4/7/2017
Inactive	First Colony Life Insurance Company	301179	Agent - Health	2/22/2002	7/1/2002
Inactive	First Colony Life Insurance Company	301179	Agent - Life	2/22/2002	7/1/2002
Inactive	First Penn-Pacific Life Insurance Company	301581	Agent - Health	1/30/2002	7/1/2002
Inactive	First Penn-Pacific Life Insurance Company	301581	Agent - Life	1/30/2002	7/1/2002
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	12/3/2014	4/7/2017
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	12/3/2014	4/7/2017
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	12/3/2014	4/7/2017
Inactive	Humana Insurance Company	301104	Agent - Health	12/3/2014	4/7/2017
Inactive	Humana Insurance Company	301104	Agent - Life	12/3/2014	4/7/2017
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	12/3/2014	4/7/2017
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	12/3/2014	4/7/2017
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	12/3/2014	4/7/2017
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	10/12/2016	4/7/2017
Inactive	Independent Mutual Fire Insurance Company	300851	Agent - Casualty	8/22/2002	2/13/2003
Inactive	Independent Mutual Fire Insurance Company	300851	Agent - Property	8/22/2002	2/13/2003
Inactive	Jackson National Life Insurance Company	300486	Agent - Life	12/5/2018	6/19/2020
Inactive	John Alden Life Insurance Company	300573	Agent - Health	4/19/2002	7/1/2002
Inactive	John Alden Life Insurance Company	300573	Agent - Life	4/19/2002	7/1/2002
Inactive	Kanawha Insurance Company	300127	Agent - Health	12/3/2014	11/12/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	12/3/2014	11/12/2015
Inactive	Life Investors Insurance Company of America	301793	Agent - Health	8/22/2005	1/3/2006
Inactive	Life Investors Insurance Company of America	301793	Agent - Life	8/22/2005	1/3/2006
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	6/30/2006	7/31/2006
Inactive	Nassau Life Insurance Company of Kansas	300667	Agent - Health	6/14/2004	2/17/2006
Inactive	Nassau Life Insurance Company of Kansas	300667	Agent - Life	6/14/2004	2/17/2006
Inactive	Old Line Life Insurance Company of America (The)	301709	Agent - Health	8/25/2000	6/28/2001
Inactive	Old Line Life Insurance Company of America (The)	301709	Agent - Life	8/25/2000	6/28/2001
Inactive	Pennsylvania Life Insurance Company	301321	Agent - Health	6/27/2005	1/20/2006
Inactive	Pennsylvania Life Insurance Company	301321	Agent - Life	6/27/2005	1/20/2006
Inactive	State Life Insurance Company	301497	Agent - Health	2/8/2002	7/1/2002
Inactive	State Life Insurance Company	301497	Agent - Life	2/8/2002	7/1/2002
Inactive	Sterling Life Insurance Company	301947	Agent - Health	2/14/2003	7/2/2004
Inactive	Sterling Life Insurance Company	301947	Agent - Life	2/14/2003	7/2/2004
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	8/29/2001	7/1/2002
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Health	8/22/2002	2/13/2003
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Life	8/22/2002	2/13/2003
Inactive	United Casualty Insurance Company of America	301322	Agent - Casualty	3/8/2001	11/26/2001
Inactive	United Casualty Insurance Company of America	301322	Agent - Property	3/8/2001	11/26/2001
Inactive	United World Life Insurance Company	300532	Agent - Health	6/30/2006	7/31/2006
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	6/30/2006	7/31/2006
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	6/30/2006	7/31/2006
Inactive	Western National Life Insurance Company	300461	Agent - Life	10/19/1999	7/1/2002
Inactive	Western and Southern Life Insurance Company	301744	Agent - Health	2/7/1994	8/22/1996
Inactive	Western and Southern Life Insurance Company	301744	Agent - Life	2/7/1994	8/22/1996
Inactive	Western-Southern Life Assurance Company	301590	Agent - Health	2/7/1994	8/22/1996
Inactive	Western-Southern Life Assurance Company	301590	Agent - Life	2/7/1994	8/22/1996

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Humana MarketPOINT Inc.	398092	Agent - Life	5/14/2007	7/31/2014
Inactive	Humana MarketPOINT Inc.	398092	Agent - Health	4/2/2009	7/31/2014