DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	High Mark Health Plans Inc	DOIID	720228	NAIC NPN	14159111

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	12/24/2009	4/1/2011
Inactive	Non Resident	Agent	Health	12/24/2009	4/1/2011
Denied	Non Resident	Life & Health Consultant	Not Applicable
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Nieves, Jason Curtis	643078	Agent - Health	12/24/2009	1/31/2011
Inactive	Nieves, Jason Curtis	643078	Agent - Life	12/24/2009	1/31/2011