DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Lasley Payne, Janice Elizabeth	DOIID	804792	NAIC NPN	4930491

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	3/1/2013	11/30/2016
Inactive	Non Resident	Agent	Life	3/1/2013	11/30/2016
* 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	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	9/2/2015	12/13/2016
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	9/2/2015	12/13/2016
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	9/2/2015	12/13/2016
Inactive	Humana Insurance Company	301104	Agent - Health	9/2/2015	12/13/2016
Inactive	Humana Insurance Company	301104	Agent - Life	9/2/2015	12/13/2016
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	9/2/2015	12/13/2016
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	9/2/2015	12/13/2016
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	9/2/2015	12/13/2016
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Health	11/8/2013	1/21/2017
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Life	11/8/2013	1/21/2017

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	L T C I Partners L L C	540090	Agent - Health	11/8/2013	6/10/2015
Inactive	L T C I Partners L L C	540090	Agent - Life	11/8/2013	6/10/2015