DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Mazzoni, Mace Michael	DOIID	763688	NAIC NPN	16361877

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	9/15/2011	11/30/2015
* 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	10/5/2011	11/23/2011
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	10/5/2011	11/23/2011
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	10/5/2011	11/23/2011
Inactive	Humana Insurance Company	301104	Agent - Health	10/5/2011	11/23/2011
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	10/5/2011	11/23/2011
Inactive	Kanawha Insurance Company	300127	Agent - Health	10/5/2011	11/23/2011
Inactive	Tier One Insurance Company	301056	Agent - Health	10/14/2013	11/27/2013
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	7/30/2012	10/12/2013
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	7/30/2012	10/12/2013

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Corporate Call Center, Inc	695480	Agent - Health	10/5/2011	11/23/2011