DEPARTMENT OF INSURANCE

Affiliations

Name	Michalik, Mark Andrew	DOIID	501425	NAIC NPN	2154879

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Health	1/18/2000	6/30/2015
Inactive	Non Resident	Agent	Life	1/18/2000	6/30/2015
* 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	9/15/2010	6/30/2015
Inactive	Aetna Life Insurance Company	301140	Agent - Health	9/15/2010	6/30/2015
Inactive	Aetna Life Insurance Company	301140	Agent - Life	9/15/2010	6/30/2015
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Health	1/18/2000	1/23/2004
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Life	1/18/2000	1/23/2004
Inactive	American General Life Insurance Company	301585	Agent - Health	12/2/2013	6/30/2015
Inactive	American General Life Insurance Company	301585	Agent - Life	12/2/2013	6/30/2015
Inactive	Chesapeake Life Insurance Company (The)	301017	Agent - Health	11/14/2005	3/23/2006
Inactive	Chesapeake Life Insurance Company (The)	301017	Agent - Life	11/14/2005	3/23/2006
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	4/25/2008	6/30/2015
Inactive	CompBenefits Insurance Company	301864	Agent - Health	4/25/2008	7/2/2013
Inactive	CompBenefits Insurance Company	301864	Agent - Life	4/25/2008	7/2/2013
Inactive	Coventry Health and Life Insurance Company	301771	Agent - Health	9/10/2013	6/30/2015
Inactive	Coventry Health and Life Insurance Company	301771	Agent - Life	9/10/2013	6/30/2015
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	9/26/2005	6/30/2015
Inactive	Fidelity Security Life Insurance Company	300466	Agent - Health	3/5/2008	4/6/2015
Inactive	Fidelity Security Life Insurance Company	300466	Agent - Life	3/5/2008	4/6/2015
Inactive	Golden Rule Insurance Company	301943	Agent - Health	1/4/2012	6/30/2015
Inactive	Golden Rule Insurance Company	301943	Agent - Life	1/4/2012	6/30/2015
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	9/24/2007	6/30/2015
Inactive	Humana Insurance Company	301104	Agent - Health	10/3/2005	6/30/2015
Inactive	Humana Insurance Company	301104	Agent - Life	10/3/2005	6/30/2015
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	9/24/2007	6/30/2015
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	9/24/2007	6/30/2015
Inactive	HumanaDental Insurance Company	301457	Agent - Health	11/11/2009	5/13/2013
Inactive	HumanaDental Insurance Company	301457	Agent - Life	11/11/2009	5/13/2013
Inactive	Kanawha Insurance Company	300127	Agent - Health	4/11/2008	6/30/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	4/11/2008	6/30/2015
Inactive	Markel Insurance Company	301475	Agent - Health	2/20/2014	6/30/2015
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Health	9/30/2008	6/30/2015
Inactive	New York Life Insurance Company	300431	Agent - Health	11/26/2013	8/10/2015
Inactive	New York Life Insurance Company	300431	Agent - Life	11/26/2013	8/10/2015
Inactive	Standard Security Life Insurance Company of NY	301487	Agent - Health	9/14/2005	6/30/2015
Inactive	Standard Security Life Insurance Company of NY	301487	Agent - Life	9/14/2005	6/30/2015
Inactive	Starr Indemnity and Liability Company	301685	Agent - Health	9/12/2011	6/30/2015
Inactive	Time Insurance Company	300683	Agent - Health	4/6/2009	12/20/2014
Inactive	Time Insurance Company	300683	Agent - Life	4/6/2009	12/20/2014
Inactive	Transamerica Life Insurance Company	300571	Agent - Health	11/26/2013	7/29/2015
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	11/26/2013	7/29/2015
Inactive	United States Life Insurance Company in the City of New York	301126	Agent - Health	12/2/2013	6/30/2015
Inactive	United States Life Insurance Company in the City of New York	301126	Agent - Life	12/2/2013	6/30/2015
Inactive	Wellpoint Life and Health Insurance Company	300469	Agent - Health	12/8/2010	6/30/2015
Inactive	Wellpoint Life and Health Insurance Company	300469	Agent - Life	12/8/2010	6/30/2015

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	12/10/2013	6/30/2015
Inactive	Designated Agent Company Inc.	681257	Agent - Health	12/10/2013	6/30/2015
Inactive	Mercer Health & Benefits Administration LLC	656414	Agent - Life	1/13/2014	6/30/2015
Inactive	Mercer Health & Benefits Administration LLC	656414	Agent - Health	1/13/2014	6/30/2015
Inactive	Seabury & Smith Inc	394854	Agent - Life	4/1/2002	4/8/2014
Inactive	Seabury & Smith Inc	394854	Agent - Health	4/1/2002	4/8/2014