DEPARTMENT OF INSURANCE

Affiliations

Name	Martin, Mary A	DOIID	386530	NAIC NPN	3316244

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Health	7/2/1998		1/31/2025
Active	Resident	Agent	Life	7/2/1998		1/31/2025
Inactive	Resident	Agent	Health Maintenance Organization	8/28/1991	3/31/1997
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	11/15/2024	01/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Aetna Health Inc. (PA)	660717	Agent - Health	10/3/2019
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	8/6/2020
Active	Aetna Life Insurance Company	301140	Agent - Health	10/3/2019
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Health	9/30/1998	8/22/2003
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Life	9/30/1998	8/22/2003
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	3/26/2009	12/7/2016
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	3/26/2009	12/7/2016
Inactive	American Retirement Life Insurance Company	706303	Agent - Health	5/6/2016	12/21/2018
Inactive	American Retirement Life Insurance Company	706303	Agent - Life	5/6/2016	12/21/2018
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health Maintenance Organization	8/28/1991	3/31/1997
Active	Anthem Health Plans of New Hampshire, Inc.	944064	Agent - Health	9/26/2021
Active	Anthem Insurance Companies, Inc.	300941	Agent - Health	6/12/2021
Active	Anthem Life Insurance Company	301209	Agent - Health	7/2/1998
Active	Anthem Life Insurance Company	301209	Agent - Life	7/2/1998
Active	Arcadian Health Plan, Inc.	728196	Agent - Health	10/12/2017
Inactive	CIGNA Health & Life Insurance Company	301783	Agent - Health	6/1/2017	12/22/2020
Inactive	CIGNA Health & Life Insurance Company	301783	Agent - Life	6/1/2017	12/22/2020
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	1/12/2016	12/13/2016
Inactive	CompBenefits Insurance Company	301864	Agent - Health	8/17/2012	7/2/2013
Inactive	CompBenefits Insurance Company	301864	Agent - Life	8/17/2012	7/2/2013
Active	Compcare Health Services Insurance Corporation	948751	Agent - Health	9/26/2021
Active	Dental Concern Inc. (The)	301641	Agent - Health	5/23/2022
Inactive	First Colony Life Insurance Company	301179	Agent - Life	12/31/1998	7/14/2004
Active	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	10/13/2014
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	7/9/2019	12/13/2022
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	1/12/2006	12/10/2018
Active	Humana Insurance Company	301104	Agent - Health	1/12/2006
Active	Humana Insurance Company	301104	Agent - Life	1/12/2006
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	12/17/2014	12/13/2022
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	1/12/2006	12/5/2014
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	6/13/2018	12/13/2022
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	10/12/2016	12/13/2022
Inactive	HumanaDental Insurance Company	301457	Agent - Health	8/17/2012	5/13/2013
Inactive	HumanaDental Insurance Company	301457	Agent - Life	8/17/2012	5/13/2013
Inactive	Kanawha Insurance Company	300127	Agent - Health	4/10/2008	12/5/2014
Inactive	Kanawha Insurance Company	300127	Agent - Life	4/10/2008	12/5/2014
Inactive	LifeUSA Insurance Company	300386	Agent - Health	9/30/1998	8/2/2002
Inactive	LifeUSA Insurance Company	300386	Agent - Life	9/30/1998	8/2/2002
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	5/20/2010	12/26/2012
Inactive	North American Company for Life and Health Insurance	300291	Agent - Life	12/15/1998	10/18/2005
Inactive	Omaha Insurance Company	751908	Agent - Health	2/15/2017	2/22/2018
Inactive	PacifiCare Life and Health Insurance Company	301304	Agent - Health	1/26/2009	11/3/2011
Inactive	PacifiCare Life and Health Insurance Company	301304	Agent - Life	1/26/2009	7/17/2012
Inactive	Principal Life Insurance Company	300129	Agent - Health	10/19/1998	12/7/2000
Inactive	Principal Life Insurance Company	300129	Agent - Life	10/19/1998	12/7/2000
Active	SilverScript Insurance Company	663526	Agent - Health	10/3/2019
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	5/20/2010	12/26/2012
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	5/20/2010	12/26/2012
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	7/17/2016	1/24/2018
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	1/26/2009	6/7/2021
Inactive	UnitedHealthcare Insurance Company of America	301552	Agent - Health	9/8/2016	1/24/2018
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	7/17/2016	1/24/2018

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Arison Insurance Services, Inc.	401001	Agent - Life	8/3/1998	6/23/2008
Inactive	Arison Insurance Services, Inc.	401001	Agent - Health	8/3/1998	6/23/2008
Active	Designated Agent Company Inc.	681257	Agent - Life	6/30/2008
Active	Designated Agent Company Inc.	681257	Agent - Health	6/30/2008