DEPARTMENT OF INSURANCE
Affiliations
NameWiesemann, Michael WayneDOIID629185NAIC NPN7918766
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
InactiveNon ResidentAgentVariable Life and Variable Annuities3/30/20065/31/2016 
InactiveNon ResidentAgentHealth3/30/20065/31/2016 
InactiveNon ResidentAgentLife3/30/20065/31/2016 
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.
Notice: The Department verifies, at the time of application for a Variable Life and Variable Annuity line of authority, that an agent is registered with the Financial Industry Regulatory Authority (FINRA) and the applicant has passed the Series 6 or greater exam. The Department does not verify registration with FINRA after the agent is qualified by the Department to receive the Variable Life and Variable Annuity line of authority. If you have questions about a broker’s FINRA registration status, you should check this status directly with FINRA.

Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveAetna Health Inc. (PA)660717Agent - Health12/8/20115/31/2016
InactiveAetna Health Insurance Company301583Agent - Health8/19/20145/31/2016
InactiveAetna Life Insurance Company301140Agent - Health12/8/20115/31/2016
InactiveAetna Life Insurance Company301140Agent - Life12/8/20115/31/2016
InactiveAmerican Continental Insurance Company643130Agent - Health6/28/201011/12/2014
InactiveAmerican Continental Insurance Company643130Agent - Life6/28/201011/12/2014
InactiveAmerican Equity Investment Life Insurance Company300389Agent - Life12/14/201211/24/2014
InactiveAmerican National Life Insurance Company of Texas300912Agent - Health6/13/20082/11/2010
InactiveAmerican National Life Insurance Company of Texas300912Agent - Life6/13/20082/11/2010
InactiveAmerican Pioneer Life Insurance Company301782Agent - Health10/17/20119/13/2012
InactiveAmerican Pioneer Life Insurance Company301782Agent - Life10/17/20119/13/2012
InactiveAthene Annuity & Life Assurance Company301798Agent - Life1/3/20138/10/2015
InactiveAthene Annuity and Life Company301893Agent - Life2/22/20101/5/2016
InactiveCIGNA Health & Life Insurance Company301783Agent - Health5/12/20145/31/2016
InactiveCIGNA Health & Life Insurance Company301783Agent - Life5/12/20145/31/2016
InactiveCincinnati Life Insurance Company (The)300601Agent - Health10/6/20105/17/2016
InactiveCincinnati Life Insurance Company (The)300601Agent - Life10/6/20105/17/2016
InactiveCompBenefits Dental, Inc.591692Agent - Health3/5/201012/8/2015
InactiveCompBenefits Insurance Company301864Agent - Health3/5/20107/2/2013
InactiveCompBenefits Insurance Company301864Agent - Life3/5/20107/2/2013
InactiveCoventry Health and Life Insurance Company301771Agent - Health9/17/20145/31/2016
InactiveDental Concern Inc. (The)301641Agent - Health3/5/201012/8/2015
InactiveEquiTrust Life Insurance Company502870Agent - Life4/25/20135/31/2016
InactiveFamily Life Insurance Company300356Agent - Health8/13/201212/28/2012
InactiveFirst Health Life & Health Insurance Company301735Agent - Health7/20/20115/31/2016
InactiveGerber Life Insurance Company300529Agent - Health5/5/201012/26/2012
InactiveGerber Life Insurance Company300529Agent - Life5/5/201012/26/2012
InactiveGolden Rule Insurance Company301943Agent - Health5/4/20126/10/2016
InactiveGolden Rule Insurance Company301943Agent - Life5/4/20126/10/2016
InactiveGuarantee Trust Life Insurance Company301043Agent - Health3/21/20125/31/2016
InactiveGuarantee Trust Life Insurance Company301043Agent - Life3/21/20125/31/2016
InactiveHumana Benefit Plan of Illinois, Inc.781543Agent - Health10/13/201412/8/2015
InactiveHumana Health Plan, Inc.300142Agent - Health3/5/201012/8/2015
InactiveHumana Insurance Company301104Agent - Health3/5/20105/31/2016
InactiveHumana Insurance Company301104Agent - Life3/5/20105/31/2016
InactiveHumana Insurance Company of Kentucky300826Agent - Health3/5/201012/8/2015
InactiveHumana Insurance Company of Kentucky300826Agent - Life3/5/201012/8/2015
InactiveHumanaDental Insurance Company301457Agent - Health3/5/20102/23/2012
InactiveHumanaDental Insurance Company301457Agent - Life3/5/20102/23/2012
InactiveIndependent Order of Foresters300743Agent - Life2/12/20105/31/2016
InactiveLincoln National Life Insurance Company (The)301382Agent - Health6/30/20088/16/2011
InactiveLincoln National Life Insurance Company (The)301382Agent - Life6/30/20088/16/2011
InactiveLincoln National Life Insurance Company (The)301382Agent - Variable Life and Variable Annuities6/30/20088/16/2011
InactiveMarquette National Life Insurance Company300117Agent - Health10/17/20119/13/2012
InactiveMarquette National Life Insurance Company300117Agent - Life10/17/20119/13/2012
InactiveMassMutual Ascend Life Insurance Company300320Agent - Life11/2/20127/29/2014
InactiveMedico Insurance Company301559Agent - Health2/18/20127/13/2016
InactiveMedico Insurance Company301559Agent - Life2/18/20127/13/2016
InactiveMutual of Omaha Insurance Company301012Agent - Health4/19/20065/8/2008
InactiveNassau Life Insurance Company of Kansas300667Agent - Health10/17/201112/13/2012
InactiveNassau Life Insurance Company of Kansas300667Agent - Life10/17/201112/13/2012
InactiveUnited World Life Insurance Company300532Agent - Health4/19/20065/8/2008
InactiveUnited of Omaha Life Insurance Company300156Agent - Health4/19/20065/8/2008
InactiveUnited of Omaha Life Insurance Company300156Agent - Life4/19/20065/8/2008
InactiveUnited of Omaha Life Insurance Company300156Agent - Variable Life and Variable Annuities4/19/20065/8/2008
InactiveUnitedHealthcare Insurance Company300946Agent - Health10/30/20117/25/2016
InactiveUnitedHealthcare of Ohio, Inc.300493Agent - Health10/30/20117/25/2016
InactiveUnitedHealthcare of Wisconsin, Inc.871491Agent - Health9/11/20157/25/2016
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveDesignated Agent Company Inc.681257Agent - Life12/9/20135/31/2016
InactiveDesignated Agent Company Inc.681257Agent - Health12/9/20135/31/2016
InactiveFundamental Insurance and Retirement Planning675147Agent - Life12/23/20095/31/2016
InactiveFundamental Insurance and Retirement Planning675147Agent - Health12/23/20095/31/2016

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