DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Peterson, Nichole Marie	DOIID	796207	NAIC NPN	16815964

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	9/23/2020		1/31/2027
Inactive	Non Resident	Agent	Personal Lines	10/29/2012	1/31/2019
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	11/15/2026	01/31/2027

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	10/9/2020	4/2/2026
Inactive	Aetna Health of Ohio Inc.	1065035	Agent - Health	10/9/2020	4/2/2026
Inactive	Aetna Life Insurance Company	301140	Agent - Health	10/9/2020	4/2/2026
Inactive	Arcadian Health Plan, Inc.	728196	Agent - Health	10/20/2020	12/13/2022
Inactive	Esurance Insurance Company	301072	Agent - Personal Lines	11/1/2012	2/15/2017
Inactive	Esurance Property and Casualty Insurance Company	613279	Agent - Personal Lines	2/18/2014	2/15/2017
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	10/19/2020	12/13/2022
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	12/7/2020	12/13/2022
Inactive	Humana Insurance Company	301104	Agent - Health	11/9/2020	12/13/2022
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	10/16/2020	12/13/2022
Inactive	SilverScript Insurance Company	663526	Agent - Health	10/9/2020	4/2/2026
Inactive	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	4/15/2021	12/30/2021
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	4/14/2021	12/29/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Esurance Ins Services Inc	709770	Agent - Personal Lines	8/25/2014	2/15/2017