DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Mathias, Mark	DOIID	547373	NAIC NPN	1596655

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	1/3/2006	9/30/2017
Inactive	Non Resident	Agent	Health	1/3/2006	9/30/2017
* 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	Dental Concern Inc. (The)	301641	Agent - Health	5/13/2003	9/30/2005
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Health	1/26/2010	10/30/2017
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Life	1/26/2010	10/30/2017
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	5/13/2003	9/30/2005
Inactive	Humana Insurance Company	301104	Agent - Health	5/13/2003	9/30/2005
Inactive	Humana Insurance Company	301104	Agent - Life	5/13/2003	9/30/2005
Inactive	Metropolitan Life Insurance Company	301948	Agent - Life	12/12/2002	9/30/2005
Inactive	Symetra Life Insurance Company	301691	Agent - Life	11/12/2002	9/30/2005
Inactive	Wilcac Life Insurance Company	301573	Agent - Life	4/3/2002	8/15/2005

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	CBIZ Benefits & Ins Services Inc	514101	Agent - Life	7/7/2015	3/18/2016
Inactive	CBIZ Benefits & Ins Services Inc	514101	Agent - Health	7/7/2015	3/18/2016