DEPARTMENT OF INSURANCE

Affiliations

Name	Iacometta, Stacey	DOIID	726228	NAIC NPN	12240588

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Health	9/15/2012	5/31/2014
Inactive	Non Resident	Agent	Life	9/15/2012	5/31/2014
* 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	4/9/2012	5/31/2012
Inactive	Aetna Life Insurance Company	301140	Agent - Health	4/9/2012	5/31/2012
Inactive	American Medical and Life Insurance Company	301598	Agent - Health	12/7/2010	6/12/2012
Inactive	Colorado Bankers Life Insurance Company	301845	Agent - Health	9/11/2013	5/31/2014
Inactive	Colorado Bankers Life Insurance Company	301845	Agent - Life	9/11/2013	5/31/2014
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	7/17/2013	5/20/2014
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	7/17/2013	5/20/2014
Inactive	Fidelity Life Association, A Legal Reserve Life Insurance Company	300774	Agent - Life	10/29/2013	12/13/2013
Inactive	Freedom Life Insurance Company of America	300074	Agent - Health	10/29/2013	12/10/2013
Inactive	Freedom Life Insurance Company of America	300074	Agent - Life	10/29/2013	12/10/2013
Inactive	Gerber Life Insurance Company	300529	Agent - Health	5/14/2012	5/31/2012
Inactive	Golden Rule Insurance Company	301943	Agent - Health	3/20/2012	5/31/2012
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	7/17/2013	5/20/2014
Inactive	Humana Insurance Company	301104	Agent - Health	2/23/2012	5/31/2012
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	7/17/2013	5/20/2014
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	7/18/2013	5/20/2014
Inactive	Kanawha Insurance Company	300127	Agent - Health	7/17/2013	5/20/2014
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	11/25/2012	10/22/2013
Inactive	Pan-American Life Insurance Company	301530	Agent - Health	3/28/2013	6/16/2014
Inactive	Pan-American Life Insurance Company	301530	Agent - Life	3/28/2013	6/16/2014
Inactive	Time Insurance Company	300683	Agent - Health	10/24/2013	2/1/2014
Inactive	Time Insurance Company	300683	Agent - Life	10/24/2013	2/1/2014
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	11/25/2012	10/22/2013
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	11/25/2012	10/22/2013

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	AHB Sales LLC	787451	Agent - Health
Denied	AHB Sales LLC	787451	Agent - Life