DEPARTMENT OF INSURANCE

Affiliations

Name	Bayside Benefit Solutions LLC	DOIID	773032	NAIC NPN	16502648

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Health	1/19/2012	6/4/2013
Inactive	Non Resident	Agent	Life	1/19/2012	6/4/2013
* 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	Ferguson, Shawn	770064	Agent - Health	1/19/2012	3/6/2013
Inactive	Ferguson, Shawn	770064	Agent - Life	1/19/2012	3/6/2013