DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Brancheau, Susan	DOIID	332904	NAIC NPN	1469791

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	5/31/1996	12/31/2010
Inactive	Non Resident	Agent	Health Maintenance Organization	5/31/1996	3/1/2001
Inactive	Non Resident	Agent	Life	5/31/1996	12/31/2010
* 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	Humana Health Plan, Inc.	300142	Agent - Health	3/1/2001	12/31/2010
Inactive	Humana Health Plan, Inc.	300142	Agent - Health Maintenance Organization	5/31/1996	3/1/2001
Inactive	Humana Insurance Company	300118	Agent - Health	5/31/1996	12/31/1998
Inactive	Humana Insurance Company	301104	Agent - Health	4/21/2000	12/31/2010
Inactive	Humana Insurance Company	300118	Agent - Life	5/31/1996	12/31/1998
Inactive	Humana Insurance Company	301104	Agent - Life	4/21/2000	12/31/2010
Inactive	Time Insurance Company	300683	Agent - Health	3/16/2001	12/14/2010
Inactive	Time Insurance Company	300683	Agent - Life	3/16/2001	12/14/2010

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	CBIZ Benefits & Ins Services Inc	514101	Agent - Life	8/28/2000	3/8/2010
Inactive	CBIZ Benefits & Ins Services Inc	514101	Agent - Health	8/28/2000	3/8/2010