DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Siegel, Gregoire B	DOIID	744672	NAIC NPN	6540704

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	12/17/2010	3/31/2018
Inactive	Non Resident	Agent	Health	12/17/2010	3/31/2018
* 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	CompBenefits Dental, Inc.	591692	Agent - Health	9/28/2011	5/17/2016
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	9/28/2011	5/17/2016
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	10/13/2014	5/17/2016
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	10/10/2012	5/17/2016
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	1/14/2011	5/17/2016
Inactive	Humana Insurance Company	301104	Agent - Health	1/14/2011	5/17/2016
Inactive	Humana Insurance Company	301104	Agent - Life	1/14/2011	5/17/2016
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	1/14/2011	5/17/2016
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	1/14/2011	5/17/2016
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	10/13/2014	5/17/2016
Inactive	Kanawha Insurance Company	300127	Agent - Health	9/28/2011	11/12/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	9/28/2011	11/12/2015

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 - Life	2/14/2011	5/17/2016
Inactive	Humana MarketPOINT Inc.	398092	Agent - Health	2/14/2011	5/17/2016