DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Corpsavers Ins Agency Inc	DOIID	625545	NAIC NPN	7555960

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	5/20/2011	2/15/2012
Inactive	Non Resident	Agent	Health	5/20/2011	2/15/2012
* 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	Humana Insurance Company	301104	Agent - Health	10/5/2011	2/15/2012
Inactive	Humana Insurance Company	301104	Agent - Life	10/5/2011	2/15/2012
Inactive	Medico Insurance Company	301559	Agent - Health	6/2/2011	10/19/2011
Inactive	Medico Insurance Company	301559	Agent - Life	6/2/2011	10/19/2011

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Siewert, Timothy Patrick	624756	Agent - Health	5/20/2011	2/15/2012
Inactive	Siewert, Timothy Patrick	624756	Agent - Life	5/20/2011	2/15/2012