DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Weatherby, Susan Lynn	DOIID	389472	NAIC NPN	7208733

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Health	6/1/1999	11/1/2013
Inactive	Resident	Agent	Health Maintenance Organization	11/19/1992	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	First Allmerica Financial Life Insurance Company	301853	Agent - Health	6/1/1999	1/26/2007
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	3/1/2001	12/15/2010
Inactive	Humana Health Plan, Inc.	300142	Agent - Health Maintenance Organization	11/19/1992	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	Charles Taylor TPA, LLC	401233	Agent - Health	9/10/2001	6/23/2009
Inactive	The Underwriters Group, Inc	674720	Agent - Health	3/3/2008	3/19/2009