DEPARTMENT OF INSURANCE

Affiliations

Name	Mervis, Charles Frankel	DOIID	501124	NAIC NPN	1577379

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Life	1/14/2000	7/31/2019
Inactive	Non Resident	Agent	Health	1/14/2000	7/31/2019
* 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	AF&L Insurance Company	301582	Agent - Health	1/13/2003	12/1/2006
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Health	1/14/2000	12/12/2013
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Life	1/14/2000	12/12/2013
Inactive	Arcadian Health Plan, Inc.	728196	Agent - Health	10/18/2017	4/29/2019
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	8/9/2013	6/15/2018
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	8/9/2013	6/15/2018
Inactive	Guarantee Trust Life Insurance Company	301043	Agent - Health	3/1/2000	12/9/2004
Inactive	Guarantee Trust Life Insurance Company	301043	Agent - Life	3/1/2000	12/9/2004
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	10/13/2014	6/15/2018
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	10/10/2012	2/23/2018
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	8/9/2013	6/15/2018
Inactive	Humana Insurance Company	301104	Agent - Health	9/28/2011	6/15/2018
Inactive	Humana Insurance Company	301104	Agent - Life	9/28/2011	6/15/2018
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	8/9/2013	6/15/2018
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	8/9/2013	6/15/2018
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	10/13/2014	6/15/2018
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	10/12/2016	6/15/2018
Inactive	John Hancock Life Insurance Company	300821	Agent - Health	12/21/2002	12/29/2008
Inactive	John Hancock Life Insurance Company	300821	Agent - Life	12/21/2002	12/29/2008
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Health	9/19/2008	12/13/2013
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Life	9/19/2008	12/13/2013
Inactive	Kanawha Insurance Company	300127	Agent - Health	9/24/2013	10/22/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	9/24/2013	10/22/2015
Inactive	Penn Treaty Network America Insurance Company	301297	Agent - Health	10/6/2000	9/1/2006
Inactive	Penn Treaty Network America Insurance Company	301297	Agent - Life	10/6/2000	9/1/2006
Inactive	Standard Life and Accident Insurance Company	301534	Agent - Health	8/31/2000	2/10/2004
Inactive	Standard Life and Accident Insurance Company	301534	Agent - Life	8/31/2000	2/10/2004
Inactive	United Teacher Associates Insurance Company	300747	Agent - Health	6/19/2003	2/18/2011
Inactive	United Teacher Associates Insurance Company	300747	Agent - Life	6/19/2003	2/18/2011

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Cornerstone Senior Services LLC	399590	Agent - Life	10/9/2000	1/5/2004
Inactive	Cornerstone Senior Services LLC	399590	Agent - Health	10/9/2000	1/5/2004
Inactive	Humana MarketPOINT Inc.	398092	Agent - Life	10/19/2011	3/31/2016
Inactive	Humana MarketPOINT Inc.	398092	Agent - Health	10/19/2011	3/31/2016