DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Brooks, Michael Thomas	DOIID	381744	NAIC NPN	1486803

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	4/4/1995	10/31/2021
Inactive	Non Resident	Agent	Health Maintenance Organization	6/26/1995	3/1/2001
Inactive	Non Resident	Agent	Health	4/4/1995	10/31/2021
* 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	Aetna Health Inc. (PA)	660717	Agent - Health	3/28/2019	7/9/2021
Inactive	Aetna Health of Ohio Inc.	1065035	Agent - Health	7/24/2020	7/9/2021
Inactive	Aetna Life Insurance Company	301140	Agent - Health	3/28/2019	7/9/2021
Inactive	Aetna Life Insurance Company	301140	Agent - Life	3/28/2019	7/9/2021
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	1/21/2019	12/10/2020
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	1/31/2013	2/6/2018
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	3/1/2001	2/6/2018
Inactive	Humana Health Plan, Inc.	300142	Agent - Health Maintenance Organization	5/27/1997	3/1/2001
Inactive	Humana Insurance Company	301104	Agent - Health	5/27/1997	2/6/2018
Inactive	Humana Insurance Company	301104	Agent - Life	5/27/1997	2/6/2018
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	3/16/2011	2/6/2018
Inactive	Prudential Health Care Plan Inc.	301342	Agent - Health Maintenance Organization	6/26/1995	4/14/1997
Inactive	Prudential Insurance Company of America	300784	Agent - Health	4/4/1995	4/14/1997
Inactive	Prudential Insurance Company of America	300784	Agent - Life	4/4/1995	4/14/1997
Inactive	SilverScript Insurance Company	663526	Agent - Health	8/23/2019	7/9/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Designated Agent Company Inc.	681257	Agent - Life	3/28/2019	12/13/2020
Inactive	Designated Agent Company Inc.	681257	Agent - Health	1/22/2019	12/13/2020
Inactive	Humana MarketPOINT Inc.	398092	Agent - Life	2/1/2008	4/1/2009
Inactive	Humana MarketPOINT Inc.	398092	Agent - Health	2/1/2008	4/1/2009