DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Peterson, Jane Marie	DOIID	601846	NAIC NPN	7567293

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Administrator	Not Applicable	7/11/2022		7/31/2026
Inactive	Non Resident	Agent	Health	1/26/2005	7/31/2012
Inactive	Non Resident	Agent	Life	1/26/2005	7/31/2012
* 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	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	2/1/2005	7/31/2012
Inactive	Anthem Insurance Companies, Inc.	300941	Agent - Health	2/1/2005	7/31/2012
Inactive	Anthem Life Insurance Company	301209	Agent - Health	1/26/2005	7/31/2012
Inactive	Anthem Life Insurance Company	301209	Agent - Life	1/26/2005	7/31/2012

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Community Insurance Company (TPA)	395826	Administrator - Not Applicable	7/12/2022