DEPARTMENT OF INSURANCE
Affiliations
NamePetri, Mark VernonDOIID620765NAIC NPN1490783
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveNon ResidentAgentHealth11/8/2021 12/31/2024
ActiveNon ResidentAgentLife11/8/2021 12/31/2024
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.
License Renewal Information
ClassInvoice DateResponse Due / Expiration DateResponse Received DatePayment Received DateRenewal Complete
Agent10/15/202412/31/2024   
Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveAmerican Family Life Assurance Company of Columbus (AFLAC)301781Agent - Health7/1/20093/31/2013
InactiveAmerican Family Life Assurance Company of Columbus (AFLAC)301781Agent - Life7/1/20093/31/2013
ActiveAnthem Health Plans of Kentucky, Inc.300999Agent - Health4/16/2023 
ActiveAnthem Life Insurance Company301209Agent - Health4/16/2023 
ActiveAnthem Life Insurance Company301209Agent - Life4/16/2023 
InactiveBerkshire Life Insurance Company of America300983Agent - Health8/26/20113/28/2017
InactiveBerkshire Life Insurance Company of America300983Agent - Life8/26/20113/28/2017
InactiveCIGNA Dental Health of Kentucky, Inc.300904Agent - Health8/26/20115/11/2018
InactiveCIGNA Health & Life Insurance Company301783Agent - Health8/26/20115/11/2018
InactiveCIGNA Health & Life Insurance Company301783Agent - Life8/26/20115/11/2018
ActiveCareSource Kentucky Co.838179Agent - Health11/29/2022 
InactiveConnecticut General Life Insurance Company301333Agent - Health8/26/20116/11/2014
InactiveConnecticut General Life Insurance Company301333Agent - Life8/26/20116/11/2014
ActiveGolden Rule Insurance Company301943Agent - Health11/17/2021 
ActiveGolden Rule Insurance Company301943Agent - Life11/17/2021 
InactiveGuardian Life Insurance Company of America301316Agent - Health8/26/20113/28/2017
InactiveGuardian Life Insurance Company of America301316Agent - Life8/26/20113/28/2017
InactiveHartford Life and Accident Insurance Company300878Agent - Health8/26/201111/23/2012
InactiveHartford Life and Accident Insurance Company300878Agent - Life8/26/201111/23/2012
InactiveMedical Savings Insurance Company301211Agent - Health12/13/20056/15/2009
InactiveMedical Savings Insurance Company301211Agent - Life12/13/20056/15/2009
InactiveMetropolitan Life Insurance Company301948Agent - Health8/26/201112/16/2014
InactiveMetropolitan Life Insurance Company301948Agent - Life8/26/201112/16/2014
ActiveMolina Healthcare of Kentucky, Inc.1035856Agent - Health9/18/2024 
InactiveMutual of Omaha Insurance Company301012Agent - Health4/24/20088/15/2011
ActiveNational Health Insurance Company300554Agent - Health2/9/2024 
ActiveNational Health Insurance Company300554Agent - Life2/9/2024 
InactiveUnited World Life Insurance Company300532Agent - Health4/24/200812/15/2010
InactiveUnited of Omaha Life Insurance Company300156Agent - Health12/16/20088/15/2011
InactiveUnited of Omaha Life Insurance Company300156Agent - Life12/16/20088/15/2011
InactiveUnitedHealthcare Insurance Company300946Agent - Health8/26/201112/1/2016
InactiveUnitedHealthcare Insurance Company300946Agent - Life8/26/201112/1/2016
InactiveUnitedHealthcare of Kentucky, Ltd.301337Agent - Health8/26/201112/1/2016
InactiveUnitedHealthcare of Ohio, Inc.300493Agent - Health8/26/201112/1/2016
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
ActiveHealthMarkets Insurance Agency Inc709727Agent - Health12/29/2021 
ActiveHealthMarkets Insurance Agency Inc709727Agent - Life12/29/2021 
InactivePaychex Insurance Agency Inc509469Agent - Health11/3/20113/29/2017
InactivePaychex Insurance Agency Inc509469Agent - Life11/3/20113/29/2017

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