DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Acosta, Michelle L	DOIID	766146	NAIC NPN	7619222

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	10/8/2011	1/31/2016
Inactive	Non Resident	Agent	Health	10/8/2011	1/31/2016
* 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	Aetna Health Inc. (PA)	660717	Agent - Health	11/9/2011	1/31/2016
Inactive	Aetna Life Insurance Company	301140	Agent - Health	11/9/2011	1/31/2016
Inactive	Aetna Life Insurance Company	301140	Agent - Life	11/9/2011	1/31/2016
Inactive	Anthem Life Insurance Company	301209	Agent - Health	11/17/2011	12/1/2012
Inactive	Anthem Life Insurance Company	301209	Agent - Life	11/17/2011	12/1/2012
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	10/21/2011	7/24/2013
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	10/21/2011	7/24/2013
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	11/26/2013	12/17/2014
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	11/26/2013	12/17/2014
Inactive	Humana Insurance Company	301104	Agent - Health	11/26/2013	12/17/2014
Inactive	Humana Insurance Company	301104	Agent - Life	11/26/2013	12/17/2014
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	11/26/2013	12/17/2014
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	11/26/2013	12/17/2014
Inactive	Kanawha Insurance Company	300127	Agent - Health	12/5/2013	1/31/2016
Inactive	Kanawha Insurance Company	300127	Agent - Life	12/5/2013	1/31/2016
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	11/9/2011	6/25/2012
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	11/9/2011	6/25/2012
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	11/9/2011	6/25/2012

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	AmWINS Group Benefits, LLC	521331	Agent - Health	12/2/2013	2/17/2014
Inactive	AmWINS Group Benefits, LLC	521331	Agent - Life	12/2/2013	2/17/2014
Inactive	Designated Agent Company Inc.	681257	Agent - Health	11/17/2011	1/31/2016
Inactive	Designated Agent Company Inc.	681257	Agent - Life	11/17/2011	1/31/2016