DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Coulombe, Mercedes Roman	DOIID	626982	NAIC NPN	809528

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	3/1/2006	11/30/2009
Inactive	Non Resident	Agent	Health	3/1/2006	11/30/2009
* 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 Health Plan, Inc.	300142	Agent - Health	3/28/2006	10/31/2008
Inactive	Humana Insurance Company	301104	Agent - Health	3/28/2006	10/31/2008
Inactive	Humana Insurance Company	301104	Agent - Life	3/28/2006	10/31/2008
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	3/28/2006	10/31/2008
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	3/28/2006	10/31/2008
Inactive	HumanaDental Insurance Company	301457	Agent - Health	7/21/2006	10/31/2008
Inactive	HumanaDental Insurance Company	301457	Agent - Life	7/21/2006	10/31/2008

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Humana MarketPOINT Inc.	398092	Agent - Life	2/1/2008	10/31/2008
Inactive	Humana MarketPOINT Inc.	398092	Agent - Health	2/1/2008	10/31/2008