DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Payne, Thomas	DOIID	653895	NAIC NPN	9193645

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Administrator	Not Applicable	4/19/2007	5/31/2018
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	CHA Health (TPA)	397883	Administrator - Not Applicable	3/6/2008	3/31/2010
Inactive	Humana Behavioral Health, Inc.	576042	Administrator - Not Applicable	7/11/2013	5/31/2018
Inactive	Humana Health Plan Inc.	630298	Administrator - Not Applicable	10/13/2010	4/27/2018
Inactive	Humana Ins Co (TPA)	533960	Administrator - Not Applicable	10/13/2010	10/13/2010
Inactive	HumanaDental Insurance Company (TPA)	533962	Administrator - Not Applicable	8/27/2010	4/27/2018
Inactive	Kanawha Ins Co	831774	Administrator - Not Applicable	8/14/2017	4/27/2018