DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Tremblay, Donna Marie	DOIID	680226	NAIC NPN	9417630

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	5/12/2008		5/31/2027
Active	Non Resident	Agent	Life	5/12/2008		5/31/2027
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	03/15/2025	05/31/2025	04/10/2025	04/10/2025	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Hartford Life and Accident Insurance Company	300878	Agent - Health	9/10/2008
Active	Hartford Life and Accident Insurance Company	300878	Agent - Life	9/10/2008

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	CBIZ Benefits & Ins Services Inc	514101	Agent - Life	9/10/2008
Active	CBIZ Benefits & Ins Services Inc	514101	Agent - Health	9/10/2008