DEPARTMENT OF INSURANCE

Affiliations

Name	Poulsen, Royce E	DOIID	718750	NAIC NPN	2600623

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Life	11/24/2009	6/30/2016
Inactive	Non Resident	Agent	Health	11/24/2009	6/30/2016
* 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	Aetna Health Inc. (PA)	660717	Agent - Health	9/8/2010	7/9/2012
Inactive	Aetna Life Insurance Company	301140	Agent - Health	9/8/2010	7/9/2012
Inactive	Aetna Life Insurance Company	301140	Agent - Life	9/8/2010	7/9/2012
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	6/15/2010	12/5/2014
Inactive	Connecticut General Life Insurance Company	301333	Agent - Health	4/9/2010	6/11/2012
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	10/13/2010	12/5/2014
Inactive	Genworth Life Insurance Company	300623	Agent - Health	2/5/2013	6/30/2016
Inactive	Genworth Life Insurance Company	300623	Agent - Life	2/5/2013	6/30/2016
Inactive	Gerber Life Insurance Company	300529	Agent - Health	4/28/2010	12/26/2012
Inactive	Gerber Life Insurance Company	300529	Agent - Life	4/28/2010	12/26/2012
Inactive	Health Net Life Insurance Company	620945	Agent - Health	9/23/2011	11/13/2012
Inactive	Health Net Life Insurance Company	620945	Agent - Life	9/23/2011	11/13/2012
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	10/10/2012	12/5/2014
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	6/15/2010	12/5/2014
Inactive	Humana Insurance Company	301104	Agent - Health	6/15/2010	5/4/2015
Inactive	Humana Insurance Company	301104	Agent - Life	6/15/2010	5/4/2015
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	6/15/2010	12/5/2014
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	6/15/2010	12/5/2014
Inactive	Kanawha Insurance Company	300127	Agent - Health	2/18/2013	12/5/2014
Inactive	Kanawha Insurance Company	300127	Agent - Life	2/18/2013	12/5/2014
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	6/2/2010	12/26/2012
Inactive	Omaha Insurance Company	751908	Agent - Health	4/23/2012	6/24/2013
Inactive	PacifiCare Life and Health Insurance Company	301304	Agent - Health	3/23/2011	11/4/2011
Inactive	Pennsylvania Life Insurance Company	301321	Agent - Health	12/19/2011	1/23/2013
Inactive	SilverScript Insurance Company	663526	Agent - Health	10/23/2011	4/8/2015
Inactive	Transamerica Life Insurance Company	300571	Agent - Health	1/23/2013	6/30/2016
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	6/2/2010	12/26/2012
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	6/2/2010	12/26/2012
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	3/23/2011	6/15/2012
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	3/23/2011	6/15/2012

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Longevity Alliance Inc	658429	Agent - Life	5/14/2010	5/7/2015
Inactive	Longevity Alliance Inc	658429	Agent - Health	5/14/2010	5/7/2015