DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Martin, Dominique A	DOIID	737709	NAIC NPN	15945391

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Pending Replacement	Non Resident	Agent	Health	9/21/2010		5/31/2024
* 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
Pending Replacement	Arcadian Health Plan, Inc.	728196	Agent - Health	10/13/2017
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	10/1/2010	3/14/2019
Pending Replacement	CompBenefits Insurance Company	301864	Agent - Health	11/12/2019
Pending Replacement	Dental Concern Inc. (The)	301641	Agent - Health	10/1/2010
Pending Replacement	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	10/13/2014
Pending Replacement	Humana Health Plan of Ohio Inc.	301565	Agent - Health	10/3/2018
Pending Replacement	Humana Health Plan, Inc.	300142	Agent - Health	10/1/2010
Pending Replacement	Humana Insurance Company	301104	Agent - Health	10/1/2010
Pending Replacement	Humana Insurance Company of Kentucky	300826	Agent - Health	10/1/2010
Pending Replacement	Humana Medical Plan, Inc.	801568	Agent - Health	10/13/2014
Pending Replacement	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	10/12/2016
Inactive	HumanaDental Insurance Company	301457	Agent - Health	10/1/2010	2/22/2012
Inactive	Kanawha Insurance Company	300127	Agent - Health	10/1/2010	10/22/2015

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Humana MarketPOINT Inc.	398092	Agent - Health	10/26/2010	7/21/2023