DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Bongibault, Brandie Ann	DOIID	536638	NAIC NPN	7219234

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Life	10/8/2001	7/1/2004
Inactive	Resident	Agent	Limited Line Credit	10/26/2005	4/1/2009
Inactive	Resident	Agent	Health	10/1/2001	7/1/2004
* 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	Boston Mutual Life Insurance Company	300143	Agent - Life	11/16/2001	7/1/2004
Inactive	Colonial Life and Accident Insurance Company	300846	Agent - Health	10/1/2001	7/1/2004
Inactive	Colonial Life and Accident Insurance Company	300846	Agent - Life	10/8/2001	7/1/2004
Inactive	DentiCare, Inc.	300655	Agent - Health	4/18/2002	7/1/2004
Inactive	Fidelity Security Life Insurance Company	300466	Agent - Health	2/19/2004	7/1/2004
Inactive	Fidelity Security Life Insurance Company	300466	Agent - Life	2/19/2004	7/1/2004
Inactive	Pavonia Insurance Company of Delaware	602103	Agent - Limited Line Credit	8/3/2006	4/1/2009
Inactive	Protective Life Insurance Company	300638	Agent - Health	4/18/2002	12/22/2003
Inactive	Protective Life Insurance Company	300638	Agent - Life	4/18/2002	12/22/2003
Inactive	Revol One Insurance Company	300681	Agent - Limited Line Credit	10/26/2005	4/1/2009
Inactive	Union Security Insurance Company	301844	Agent - Health	3/14/2002	7/1/2004
Inactive	Union Security Insurance Company	301844	Agent - Life	3/14/2002	7/1/2004
Inactive	Wesco Insurance Company	300534	Agent - Limited Line Credit	10/26/2005	5/10/2007

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Creative Employee Benefits, Inc.	400416	Agent - Life	2/12/2003	7/1/2004
Inactive	Creative Employee Benefits, Inc.	400416	Agent - Health	2/12/2003	7/1/2004
Inactive	Planchoice Inc.	400482	Agent - Life	3/19/2003	7/1/2004
Inactive	Planchoice Inc.	400482	Agent - Health	3/19/2003	7/1/2004