DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Wirzulis, Karen J	DOIID	701185	NAIC NPN	3480388

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	3/9/2009	8/31/2019
Inactive	Non Resident	Agent	Health	3/9/2009	8/31/2019
* 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	Anthem Life Insurance Company	301209	Agent - Health	8/12/2009	11/3/2016
Inactive	Anthem Life Insurance Company	301209	Agent - Life	8/12/2009	11/3/2016

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	11/2/2016
Inactive	Designated Agent Company Inc.	681257	Agent - Life	12/2/2013	11/2/2016
Inactive	Omni Underwriting Managers LLC	630189	Agent - Health	9/9/2009	3/31/2014
Inactive	Omni Underwriting Managers LLC	630189	Agent - Life	9/9/2009	3/31/2014
Denied	Usi Insurance Services LLC	669260	Agent - Health
Denied	Usi Insurance Services LLC	669260	Agent - Life