DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Douglas, Mae S	DOIID	364284	NAIC NPN	7197741

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Health	3/1/2001	11/23/2011
Inactive	Resident	Agent	Health Maintenance Organization	3/2/1990	3/1/2001
* 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	10/2/2009
Inactive	Humana Health Plan, Inc.	300142	Agent - Health Maintenance Organization	3/2/1990	3/1/2001

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 - Health	2/1/2008	4/1/2009