DEPARTMENT OF INSURANCE

Affiliations

Name	Polonczyk, Teeanna J	DOIID	690026	NAIC NPN	101248

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Life	10/2/2008	2/1/2020
Inactive	Resident	Agent	Property	8/2/2012	2/1/2020
Inactive	Resident	Agent	Casualty	8/2/2012	2/1/2020
Inactive	Resident	Agent	Health	10/2/2008	2/1/2020
* 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	Allstate Indemnity Company	300778	Agent - Casualty	3/25/2014	6/12/2014
Inactive	Allstate Indemnity Company	300778	Agent - Property	3/25/2014	6/12/2014
Inactive	Allstate Insurance Company	300773	Agent - Casualty	3/25/2014	6/12/2014
Inactive	Allstate Insurance Company	300773	Agent - Property	3/25/2014	6/12/2014
Inactive	Allstate Property and Casualty Insurance Company	300593	Agent - Casualty	3/25/2014	6/12/2014
Inactive	Allstate Property and Casualty Insurance Company	300593	Agent - Property	3/25/2014	6/12/2014
Inactive	Allstate Vehicle & Property Insurance Company	301429	Agent - Casualty	3/25/2014	6/12/2014
Inactive	Allstate Vehicle & Property Insurance Company	301429	Agent - Property	3/25/2014	6/12/2014
Inactive	American General Life Insurance Company	301585	Agent - Health	8/20/2015	1/29/2016
Inactive	American General Life Insurance Company	301585	Agent - Life	8/20/2015	1/29/2016
Inactive	American Heritage Life Insurance Company	300272	Agent - Health	10/22/2013	2/1/2020
Inactive	American Heritage Life Insurance Company	300272	Agent - Life	10/22/2013	2/1/2020
Inactive	American United Life Insurance Company	300498	Agent - Health	6/16/2015	12/11/2015
Inactive	American United Life Insurance Company	300498	Agent - Life	6/16/2015	12/11/2015
Inactive	Anthem Life Insurance Company	301209	Agent - Health	3/3/2011	11/2/2016
Inactive	Anthem Life Insurance Company	301209	Agent - Life	3/3/2011	11/2/2016
Inactive	Athene Annuity and Life Company	301893	Agent - Life	3/29/2011	11/11/2015
Inactive	Bankers Life and Casualty Company	300701	Agent - Health	10/2/2008	2/23/2010
Inactive	Bankers Life and Casualty Company	300701	Agent - Life	10/2/2008	2/23/2010
Inactive	Colonial Penn Life Insurance Company	300491	Agent - Health	10/21/2008	2/23/2010
Inactive	Colonial Penn Life Insurance Company	300491	Agent - Life	10/21/2008	2/23/2010
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	4/2/2012	7/10/2013
Denied	Coventry Health and Life Insurance Company	301771	Agent - Health
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	4/2/2012	7/10/2013
Inactive	Everlake Life Insurance Company	300873	Agent - Health	3/25/2014	6/12/2014
Inactive	Everlake Life Insurance Company	300873	Agent - Life	3/25/2014	6/12/2014
Denied	First Health Life & Health Insurance Company	301735	Agent - Health
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	4/2/2012	7/10/2013
Inactive	Humana Insurance Company	301104	Agent - Health	4/2/2012	7/10/2013
Inactive	Humana Insurance Company	301104	Agent - Life	4/2/2012	7/10/2013
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	4/2/2012	7/10/2013
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	4/2/2012	7/10/2013
Inactive	HumanaDental Insurance Company	301457	Agent - Health	7/5/2012	12/19/2012
Inactive	HumanaDental Insurance Company	301457	Agent - Life	7/5/2012	12/19/2012
Inactive	Kanawha Insurance Company	300127	Agent - Health	4/2/2012	7/10/2013
Inactive	Kanawha Insurance Company	300127	Agent - Life	4/2/2012	7/10/2013
Inactive	Lincoln Benefit Life Company	301110	Agent - Health	3/25/2014	6/12/2014
Inactive	Lincoln Benefit Life Company	301110	Agent - Life	3/25/2014	6/12/2014
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	8/31/2012	10/23/2012
Inactive	Omaha Insurance Company	751908	Agent - Health	8/31/2012	10/23/2012
Inactive	Physicians Life Insurance Company	300924	Agent - Life	2/27/2014	1/22/2015
Inactive	Physicians Mutual Insurance Company	301084	Agent - Health	2/27/2014	1/22/2015
Inactive	Pioneer Mutual Life Insurance Company	501695	Agent - Health	6/16/2015	12/11/2015
Inactive	Pioneer Mutual Life Insurance Company	501695	Agent - Life	6/16/2015	12/11/2015
Inactive	State Life Insurance Company	301497	Agent - Health	6/16/2015	12/11/2015
Inactive	State Life Insurance Company	301497	Agent - Life	6/16/2015	12/11/2015
Inactive	Stonebridge Life Insurance Company	301614	Agent - Health	8/10/2012	8/22/2012
Inactive	Stonebridge Life Insurance Company	301614	Agent - Life	8/10/2012	8/22/2012
Inactive	Transamerica Life Insurance Company	300571	Agent - Health	1/28/2011	7/31/2012
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	1/28/2011	7/31/2012
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Health	1/18/2011	7/31/2012
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Life	1/18/2011	7/31/2012
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	2/25/2011	10/23/2012
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	2/25/2011	10/23/2012
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	3/19/2012	11/28/2012
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	3/19/2012	11/29/2012
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	3/19/2012	11/29/2012
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	3/19/2012	11/28/2012
Inactive	Unitrin Auto and Home Insurance Company	301538	Agent - Casualty	8/10/2012	3/26/2013
Inactive	Unitrin Auto and Home Insurance Company	301538	Agent - Property	8/10/2012	3/26/2013
Inactive	Unitrin Preferred Insurance Company	502869	Agent - Casualty	8/10/2012	3/26/2013
Inactive	Unitrin Preferred Insurance Company	502869	Agent - Property	8/10/2012	3/26/2013

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	3/3/2011	11/2/2016
Inactive	Designated Agent Company Inc.	681257	Agent - Life	3/29/2011	11/2/2016
Inactive	Empower Financial Group LLC	760421	Agent - Health	8/16/2012	1/9/2013
Inactive	Empower Financial Group LLC	760421	Agent - Life	8/16/2012	1/9/2013
Inactive	Empower Financial Group LLC	760421	Agent - Property	8/16/2012	1/9/2013
Inactive	Empower Financial Group LLC	760421	Agent - Casualty	8/16/2012	1/9/2013