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
Inactive	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.

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
Inactive	Aetna Health and Life Insurance Company	300523	Agent - Health	10/24/2019	9/2/2025
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
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	10/24/2019	9/2/2025
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