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DEPARTMENT OF INSURANCE
Affiliations
Name
Petri, Mark Vernon
DOIID
620765
NAIC NPN
1490783
License - Line of Authority Information
Status
Residency
Class
Line of Authority
Active Date
Inactive Date
License Expiration Date
Active
Non Resident
Agent
Health
11/8/2021
12/31/2024
Active
Non Resident
Agent
Life
11/8/2021
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
Class
Invoice Date
Response Due / Expiration Date
Response Received Date
Payment Received Date
Renewal Complete
Agent
10/15/2024
12/31/2024
Appointments with the following Insurers
Status
Affiliation Name
DOI Number
Line of Authority
Active Date
Inactive Date
Inactive
American Family Life Assurance Company of Columbus (AFLAC)
301781
Agent - Health
7/1/2009
3/31/2013
Inactive
American Family Life Assurance Company of Columbus (AFLAC)
301781
Agent - Life
7/1/2009
3/31/2013
Active
Anthem Health Plans of Kentucky, Inc.
300999
Agent - Health
4/16/2023
Active
Anthem Life Insurance Company
301209
Agent - Health
4/16/2023
Active
Anthem Life Insurance Company
301209
Agent - Life
4/16/2023
Inactive
Berkshire Life Insurance Company of America
300983
Agent - Health
8/26/2011
3/28/2017
Inactive
Berkshire Life Insurance Company of America
300983
Agent - Life
8/26/2011
3/28/2017
Inactive
CIGNA Dental Health of Kentucky, Inc.
300904
Agent - Health
8/26/2011
5/11/2018
Inactive
CIGNA Health & Life Insurance Company
301783
Agent - Health
8/26/2011
5/11/2018
Inactive
CIGNA Health & Life Insurance Company
301783
Agent - Life
8/26/2011
5/11/2018
Active
CareSource Kentucky Co.
838179
Agent - Health
11/29/2022
Inactive
Connecticut General Life Insurance Company
301333
Agent - Health
8/26/2011
6/11/2014
Inactive
Connecticut General Life Insurance Company
301333
Agent - Life
8/26/2011
6/11/2014
Active
Golden Rule Insurance Company
301943
Agent - Health
11/17/2021
Active
Golden Rule Insurance Company
301943
Agent - Life
11/17/2021
Inactive
Guardian Life Insurance Company of America
301316
Agent - Health
8/26/2011
3/28/2017
Inactive
Guardian Life Insurance Company of America
301316
Agent - Life
8/26/2011
3/28/2017
Inactive
Hartford Life and Accident Insurance Company
300878
Agent - Health
8/26/2011
11/23/2012
Inactive
Hartford Life and Accident Insurance Company
300878
Agent - Life
8/26/2011
11/23/2012
Inactive
Medical Savings Insurance Company
301211
Agent - Health
12/13/2005
6/15/2009
Inactive
Medical Savings Insurance Company
301211
Agent - Life
12/13/2005
6/15/2009
Inactive
Metropolitan Life Insurance Company
301948
Agent - Health
8/26/2011
12/16/2014
Inactive
Metropolitan Life Insurance Company
301948
Agent - Life
8/26/2011
12/16/2014
Active
Molina Healthcare of Kentucky, Inc.
1035856
Agent - Health
9/18/2024
Inactive
Mutual of Omaha Insurance Company
301012
Agent - Health
4/24/2008
8/15/2011
Active
National Health Insurance Company
300554
Agent - Health
2/9/2024
Active
National Health Insurance Company
300554
Agent - Life
2/9/2024
Inactive
United World Life Insurance Company
300532
Agent - Health
4/24/2008
12/15/2010
Inactive
United of Omaha Life Insurance Company
300156
Agent - Health
12/16/2008
8/15/2011
Inactive
United of Omaha Life Insurance Company
300156
Agent - Life
12/16/2008
8/15/2011
Inactive
UnitedHealthcare Insurance Company
300946
Agent - Health
8/26/2011
12/1/2016
Inactive
UnitedHealthcare Insurance Company
300946
Agent - Life
8/26/2011
12/1/2016
Inactive
UnitedHealthcare of Kentucky, Ltd.
301337
Agent - Health
8/26/2011
12/1/2016
Inactive
UnitedHealthcare of Ohio, Inc.
300493
Agent - Health
8/26/2011
12/1/2016
Designated to act on behalf of the following Business Entities
Status
Affiliation Name
DOI Number
Line of Authority
Active Date
Inactive Date
Active
HealthMarkets Insurance Agency Inc
709727
Agent - Health
12/29/2021
Active
HealthMarkets Insurance Agency Inc
709727
Agent - Life
12/29/2021
Inactive
Paychex Insurance Agency Inc
509469
Agent - Health
11/3/2011
3/29/2017
Inactive
Paychex Insurance Agency Inc
509469
Agent - Life
11/3/2011
3/29/2017
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