DEPARTMENT OF INSURANCE

Affiliations

Name	Mikolajcik, Lawrence V	DOIID	679630	NAIC NPN	1019432

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Life	5/5/2008	12/31/2026
Active	Non Resident	Agent	Health	5/5/2008	12/31/2026
* 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	Accendo Insurance Company	300312	Agent - Health	12/1/2022	11/17/2023
Active	Accendo Insurance Company	300312	Agent - Life	6/10/2020
Active	Aetna Health Inc. (PA)	660717	Agent - Health	8/15/2013
Active	Aetna Health and Life Insurance Company	300523	Agent - Health	8/19/2020
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	7/24/2020
Active	Aetna Life Insurance Company	301140	Agent - Health	8/15/2013
Active	Aetna Life Insurance Company	301140	Agent - Life	8/15/2013
Active	Allianz Life Insurance Company of North America	301791	Agent - Life	3/28/2021
Inactive	American Continental Insurance Company	643130	Agent - Health	6/8/2013	11/11/2014
Inactive	American Continental Insurance Company	643130	Agent - Life	8/19/2020	8/11/2021
Active	Baltimore Life Insurance Company	300286	Agent - Life	12/31/2024
Active	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	2/27/2023
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	2/10/2012	3/14/2019
Active	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	6/8/2013
Active	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Life	12/1/2022
Active	Coventry Health and Life Insurance Company	301771	Agent - Health	9/11/2014
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	2/10/2012	12/19/2019
Active	First Health Life & Health Insurance Company	301735	Agent - Health	8/10/2014
Active	Forethought Life Insurance Company	301407	Agent - Life	5/24/2008
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	10/13/2014	12/19/2019
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	10/14/2011	12/19/2019
Inactive	Humana Insurance Company	301104	Agent - Health	11/10/2010	12/19/2019
Inactive	Humana Insurance Company	301104	Agent - Life	11/10/2010	12/19/2019
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	10/14/2011	12/19/2019
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	2/10/2012	12/19/2019
Inactive	Medico Insurance Company	301559	Agent - Health	12/15/2011	12/17/2014
Inactive	Medico Insurance Company	301559	Agent - Life	12/15/2011	12/17/2014
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	7/16/2009	12/26/2012
Inactive	Omaha Insurance Company	751908	Agent - Health	4/19/2012	6/24/2013
Inactive	PacifiCare Life and Health Insurance Company	301304	Agent - Health	5/20/2008	11/3/2011
Inactive	PacifiCare Life and Health Insurance Company	301304	Agent - Life	5/20/2008	7/17/2012
Pending Replacement	Paramount Care Inc.	1260849	Agent - Health	12/3/2024
Inactive	Philadelphia American Life Insurance Company	300178	Agent - Health	9/7/2021	11/5/2024
Inactive	Philadelphia American Life Insurance Company	300178	Agent - Life	9/7/2021	11/5/2024
Inactive	Reserve National Insurance Company	301073	Agent - Health	8/14/2017	3/13/2018
Inactive	Reserve National Insurance Company	301073	Agent - Life	8/14/2017	3/13/2018
Inactive	SILAC Insurance Company	300535	Agent - Health	8/7/2013	12/29/2015
Inactive	SILAC Insurance Company	300535	Agent - Life	8/7/2013	12/29/2015
Active	SilverScript Insurance Company	663526	Agent - Health	10/19/2019
Active	Tier One Insurance Company	301056	Agent - Health	5/22/2025
Active	Tier One Insurance Company	301056	Agent - Life	5/22/2025
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	7/16/2009	12/26/2012
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	7/16/2009	12/26/2012
Active	UnitedHealthcare Insurance Company	300946	Agent - Health	2/27/2023
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	5/20/2008	6/7/2021
Inactive	UnitedHealthcare Insurance Company of America	301552	Agent - Health	9/9/2016	12/21/2018
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	8/6/2019	1/28/2020
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	7/15/2018	1/28/2020
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	4/25/2011	12/5/2016
Active	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	2/27/2023
Inactive	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	10/26/2019	12/29/2021
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	10/26/2019	12/29/2021
Inactive	Wellpoint Life and Health Insurance Company	300469	Agent - Health	6/9/2008	11/1/2012
Inactive	Wellpoint Life and Health Insurance Company	300469	Agent - Life	6/9/2008	11/1/2012

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Designated Agent Company Inc.	681257	Agent - Health	12/2/2013	2/10/2025
Inactive	Designated Agent Company Inc.	681257	Agent - Life	12/2/2013	2/10/2025
Active	Infinity Life Ins Group LLC	846809	Agent - Health	7/31/2014
Active	Infinity Life Ins Group LLC	846809	Agent - Life	7/31/2014
Active	Ins Services LLC	873078	Agent - Health	3/27/2015
Active	Ins Services LLC	873078	Agent - Life	3/27/2015
Inactive	Insurance Services LLC	680943	Agent - Health	5/30/2008	3/31/2016
Inactive	Insurance Services LLC	680943	Agent - Life	5/30/2008	3/31/2016
Inactive	Medi-Solutions Insurance Agency LLC	816356	Agent - Health	8/6/2013	3/31/2015
Inactive	Medi-Solutions Insurance Agency LLC	816356	Agent - Life	8/6/2013	3/31/2015