DEPARTMENT OF INSURANCE
Affiliations
NameBloom, Lisa DawnDOIID728520NAIC NPN1683493
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
InactiveNon ResidentAgentLife5/17/20105/31/2021 
InactiveNon ResidentAgentHealth5/17/20105/31/2021 
* 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
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveAnthem Life Insurance Company301209Agent - Health8/1/201011/3/2016
InactiveAnthem Life Insurance Company301209Agent - Life8/1/201011/3/2016
InactiveHumana Health Plan, Inc.300142Agent - Health2/22/20186/15/2018
InactiveHumana Insurance Company301104Agent - Health2/22/20186/15/2018
InactiveHumana Insurance Company301104Agent - Life2/22/20186/15/2018
InactiveHumana Insurance Company of Kentucky300826Agent - Health2/22/20186/15/2018
InactiveHumana Insurance Company of Kentucky300826Agent - Life2/22/20186/15/2018
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveDesignated Agent Company Inc.681257Agent - Life12/17/201311/2/2016
InactiveDesignated Agent Company Inc.681257Agent - Health12/17/201311/2/2016
InactiveHub International Ins Services Inc609910Agent - Life8/1/201011/3/2016
InactiveHub International Ins Services Inc609910Agent - Health8/1/201011/3/2016

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