DEPARTMENT OF INSURANCE

Affiliations

Name	Bloom Insurance Agency LLC	DOIID	664017	NAIC NPN	9567860

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Life	4/1/2009	3/31/2027
Active	Non Resident	Agent	Health	4/1/2008	3/31/2027
* 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
Active	Aetna Health Inc. (PA)	660717	Agent - Health	9/12/2012
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	7/20/2020
Active	Aetna Life Insurance Company	301140	Agent - Health	9/12/2012
Active	Aetna Life Insurance Company	301140	Agent - Life	9/12/2012
Inactive	American Pioneer Life Insurance Company	301782	Agent - Health	12/28/2010	9/13/2012
Inactive	American Pioneer Life Insurance Company	301782	Agent - Life	12/28/2010	9/13/2012
Active	Ameritas Life Insurance Corporation	300126	Agent - Health	5/27/2021
Inactive	Ameritas Life Insurance Corporation	300126	Agent - Life	12/31/2016	5/18/2021
Inactive	Arcadian Health Plan, Inc.	728196	Agent - Health	1/18/2018	9/12/2022
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	8/5/2010	3/14/2019
Inactive	CompBenefits Insurance Company	301864	Agent - Health	8/5/2010	8/20/2014
Inactive	CompBenefits Insurance Company	301864	Agent - Life	8/5/2010	8/20/2014
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	8/5/2010	9/12/2022
Active	Essence Healthcare, Inc.	657425	Agent - Health	11/1/2023
Inactive	Golden Rule Insurance Company	301943	Agent - Health	4/28/2008	6/29/2009
Inactive	Golden Rule Insurance Company	301943	Agent - Life	4/28/2008	6/29/2009
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	10/22/2019	9/12/2022
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	8/5/2010	9/12/2022
Inactive	Humana Insurance Company	301104	Agent - Health	8/5/2010	9/12/2022
Inactive	Humana Insurance Company	301104	Agent - Life	8/5/2010	9/12/2022
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	8/5/2010	9/12/2022
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	8/5/2010	9/12/2022
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	1/31/2022	9/12/2022
Inactive	HumanaDental Insurance Company	301457	Agent - Health	8/5/2010	5/13/2013
Inactive	HumanaDental Insurance Company	301457	Agent - Life	8/5/2010	5/13/2013
Inactive	Kanawha Insurance Company	300127	Agent - Health	8/5/2010	10/22/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	8/5/2010	10/22/2015
Inactive	Marquette National Life Insurance Company	300117	Agent - Health	3/4/2011	9/13/2012
Inactive	Marquette National Life Insurance Company	300117	Agent - Life	5/19/2008	6/29/2009
Inactive	Nassau Life Insurance Company of Kansas	300667	Agent - Health	10/9/2012	1/6/2014
Inactive	Nassau Life Insurance Company of Texas	300872	Agent - Health	12/28/2010	9/13/2012
Inactive	Nassau Life Insurance Company of Texas	300872	Agent - Life	12/28/2010	9/13/2012
Pending Replacement	Paramount Care Inc.	1260849	Agent - Health	9/25/2024
Inactive	Pennsylvania Life Insurance Company	301321	Agent - Health	12/1/2009	1/29/2014
Inactive	Pennsylvania Life Insurance Company	301321	Agent - Life	5/8/2010	1/29/2014
Inactive	Renaissance Life & Health Insurance Company of America	301447	Agent - Health	6/6/2011	6/15/2023
Inactive	Renaissance Life & Health Insurance Company of America	301447	Agent - Life	6/6/2011	6/15/2023
Inactive	Security Life Insurance Company of America	300936	Agent - Health	11/22/2011	12/31/2016
Inactive	Security Life Insurance Company of America	300936	Agent - Life	11/22/2011	12/31/2016
Active	SilverScript Insurance Company	663526	Agent - Health	3/9/2020
Inactive	Standard Security Life Insurance Company of NY	301487	Agent - Health	3/31/2010	12/26/2018
Inactive	Standard Security Life Insurance Company of NY	301487	Agent - Life	3/31/2010	12/26/2018
Inactive	Stonebridge Life Insurance Company	301614	Agent - Health	6/4/2014	10/1/2015
Inactive	Stonebridge Life Insurance Company	301614	Agent - Life	6/4/2014	10/1/2015
Inactive	Transamerica Life Insurance Company	300571	Agent - Health	6/4/2014	7/19/2016
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	6/4/2014	7/19/2016
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	12/11/2018	12/29/2021

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Ivey, Brooke Buice	707951	Agent - Health	4/13/2012	10/22/2012
Inactive	Ivey, Brooke Buice	707951	Agent - Life	4/13/2012	10/22/2012
Inactive	Keeven, Bryan M	977652	Agent - Health	2/14/2018	2/4/2019
Inactive	Keeven, Bryan M	977652	Agent - Life	2/14/2018	2/4/2019
Inactive	Mayo, Douglas P	785508	Agent - Health	10/22/2012	4/11/2014
Inactive	Mayo, Douglas P	785508	Agent - Life	10/22/2012	4/11/2014
Inactive	Pearce, Catherine Louise	837300	Agent - Health	4/11/2014	1/22/2018
Inactive	Pearce, Catherine Louise	837300	Agent - Life	4/11/2014	1/22/2018
Active	Rogers, Meredith	1026592	Agent - Health	2/27/2019
Active	Rogers, Meredith	1026592	Agent - Life	2/27/2019
Inactive	Thomas, Eugene Robert	664392	Agent - Health	5/12/2008	6/29/2009
Inactive	Thomas, Eugene Robert	664392	Agent - Life	5/12/2008	6/29/2009
Inactive	Wielgos, Wayne Robert	662884	Agent - Health	4/1/2008	9/25/2008
Inactive	Wielgos, Wayne Robert	662884	Agent - Life	4/1/2008	9/25/2008