DEPARTMENT OF INSURANCE

Affiliations

Name	Petithomme, Garry	DOIID	733987	NAIC NPN	9153962

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	10/11/2017		7/31/2025
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	05/15/2025	07/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Accendo Insurance Company	300312	Agent - Health	11/4/2021	11/17/2023
Inactive	Aetna Health Inc. (PA)	660717	Agent - Health	11/30/2017	9/30/2024
Inactive	Aetna Health Insurance Company	301583	Agent - Health	9/3/2014	7/31/2015
Active	Aetna Health and Life Insurance Company	300523	Agent - Health	10/24/2019
Inactive	Aetna Health of Ohio Inc.	1065035	Agent - Health	6/3/2021	9/30/2024
Inactive	Aetna Life Insurance Company	301140	Agent - Health	11/26/2017	9/30/2024
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	8/17/2018	11/20/2019
Inactive	Anthem Life Insurance Company	301209	Agent - Health	7/22/2019	12/16/2024
Inactive	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	11/2/2022	1/31/2025
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	2/10/2014	12/5/2014
Inactive	Connecticut General Life Insurance Company	301333	Agent - Health	10/5/2012	6/11/2014
Active	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	10/24/2019
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	2/10/2014	12/5/2014
Inactive	First Health Life & Health Insurance Company	301735	Agent - Health	11/30/2017	9/30/2024
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	10/10/2012	12/4/2013
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	2/10/2014	12/5/2014
Inactive	Humana Insurance Company	301104	Agent - Health	10/8/2010	12/4/2013
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	2/10/2014	12/5/2014
Inactive	Kanawha Insurance Company	300127	Agent - Health	2/10/2014	12/5/2014
Inactive	SilverScript Insurance Company	663526	Agent - Health	10/3/2019	9/30/2024
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	11/2/2022	1/31/2025
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	11/2/2022	12/22/2022
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	11/2/2022	1/31/2025
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	12/11/2018	5/13/2021

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	8/20/2018	11/20/2019