DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Dicicco, Michael Ralph	DOIID	775823	NAIC NPN	16094372

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	3/1/2018	4/30/2022
Inactive	Non Resident	Agent	Life	3/1/2018	4/30/2022
* 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	AXIS Insurance Company	301290	Agent - Health	7/11/2018	4/30/2022
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	2/11/2019	7/23/2020
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	2/11/2019	7/23/2020
Inactive	American Financial Security Life Insurance Co.	301635	Agent - Health	5/29/2018	2/12/2019
Inactive	American General Life Insurance Company	301585	Agent - Health	9/29/2012	1/10/2013
Inactive	American General Life Insurance Company	301585	Agent - Life	9/29/2012	1/10/2013
Inactive	Aspen American Insurance Company	301513	Agent - Health	6/7/2019	12/1/2020
Inactive	CareSource Kentucky Co.	838179	Agent - Health	4/13/2021	6/6/2022
Inactive	Federal Insurance Company	301144	Agent - Health	4/19/2018	10/28/2021
Inactive	Golden Rule Insurance Company	301943	Agent - Health	7/24/2019	5/28/2021
Inactive	Golden Rule Insurance Company	301943	Agent - Life	7/24/2019	5/28/2021
Inactive	LifeShield National Insurance Company	737111	Agent - Health	12/11/2018	12/21/2021
Inactive	Time Insurance Company	300683	Agent - Health	10/3/2012	4/30/2014
Inactive	Time Insurance Company	300683	Agent - Life	10/3/2012	4/30/2014

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Health Plan Intermediaries Holdings	786463	Agent - Health	7/25/2018	4/18/2022