DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Lacey, Everett M	DOIID	815909	NAIC NPN	14253437

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	7/30/2013	9/30/2015
* 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	Chesapeake Life Insurance Company (The)	301017	Agent - Health	8/20/2015	9/30/2015
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	7/17/2014	9/30/2015
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	7/17/2014	9/30/2015
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	7/17/2014	9/30/2015
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	7/17/2014	9/30/2015
Inactive	Humana Insurance Company	301104	Agent - Health	7/17/2014	9/30/2015
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	7/17/2014	9/30/2015
Inactive	Kanawha Insurance Company	300127	Agent - Health	7/17/2014	10/22/2015
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	7/30/2013	1/13/2015
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	7/30/2013	1/13/2015

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Alorica Customer Care, Inc.	800938	Agent - Health	10/2/2013	4/11/2014