DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Braidech, Mark	DOIID	745454	NAIC NPN	3238675

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	1/4/2011	12/31/2019
Inactive	Non Resident	Agent	Life	1/4/2011	12/31/2019
* 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	Anthem Life Insurance Company	301209	Agent - Health	7/13/2013	11/3/2016
Inactive	Anthem Life Insurance Company	301209	Agent - Life	7/13/2013	11/3/2016
Inactive	Standard Insurance Company	300185	Agent - Health	2/17/2016	12/31/2019
Inactive	Standard Insurance Company	300185	Agent - Life	2/17/2016	12/31/2019

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 - Life	7/13/2013	11/2/2016
Inactive	Designated Agent Company Inc.	681257	Agent - Health	7/13/2013	11/2/2016
Inactive	Usi Insurance Services LLC	669260	Agent - Life	12/27/2018	9/12/2019
Inactive	Usi Insurance Services LLC	669260	Agent - Health	12/27/2018	9/12/2019