DEPARTMENT OF INSURANCE

Affiliations

Name	Pichman, Jerry Greg	DOIID	778582	NAIC NPN	7986923

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Health	5/16/2017	2/28/2019
Inactive	Non Resident	Agent	Life	5/16/2017	2/28/2019
* 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	Anthem Life Insurance Company	301209	Agent - Health	10/1/2013	11/2/2016
Inactive	Anthem Life Insurance Company	301209	Agent - Life	10/1/2013	11/2/2016
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	11/17/2014	5/28/2015
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	11/17/2014	5/28/2015
Inactive	Golden Rule Insurance Company	301943	Agent - Health	6/15/2012	3/3/2017
Inactive	Golden Rule Insurance Company	301943	Agent - Life	6/15/2012	3/3/2017
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	12/21/2012	5/20/2014
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	11/17/2014	5/28/2015
Inactive	Humana Insurance Company	301104	Agent - Health	11/17/2014	5/28/2015
Inactive	Humana Insurance Company	301104	Agent - Life	12/21/2012	5/20/2014
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	12/21/2012	5/20/2014
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	12/21/2012	5/20/2014
Inactive	Kanawha Insurance Company	300127	Agent - Health	11/17/2014	5/28/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	11/17/2014	5/28/2015
Inactive	Starr Indemnity and Liability Company	301685	Agent - Health	9/4/2013	2/28/2017
Inactive	Time Insurance Company	300683	Agent - Health	6/12/2012	12/20/2014
Inactive	Time Insurance Company	300683	Agent - Life	6/12/2012	12/20/2014
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Health	11/12/2015	11/4/2016
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Life	11/12/2015	11/4/2016
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	8/18/2015	2/14/2017

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Designated Agent Company Inc.	681257	Agent - Life	10/1/2013	11/2/2016
Inactive	Designated Agent Company Inc.	681257	Agent - Health	10/1/2013	11/2/2016