DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Bloom Health Ins Agency LLC	DOIID	754562	NAIC NPN	15722480

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Administrator	Not Applicable	6/4/2015	3/31/2017
Inactive	Non Resident	Agent	Health	5/28/2015	3/31/2017
Inactive	Non Resident	Agent	Life	5/28/2015	3/31/2017
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Ciolko, Marek Paul	754271	Agent - Health	5/18/2011	3/31/2013
Inactive	McAlpin, Peggy Ann	854047	Administrator - Not Applicable	6/4/2015	3/31/2017
Inactive	McAlpin, Peggy Ann	854047	Agent - Health	11/5/2015	3/31/2017
Inactive	McAlpin, Peggy Ann	854047	Agent - Life	11/5/2015	3/31/2017