DEPARTMENT OF INSURANCE

Affiliations

Name	Chisholm, Mary	DOIID	855432	NAIC NPN	16459834

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Life	8/3/2017	12/31/2025
Active	Non Resident	Agent	Health	10/7/2014	12/31/2025
* 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	Aetna Health Inc. (PA)	660717	Agent - Health	8/3/2015	4/25/2024
Active	Aetna Health and Life Insurance Company	300523	Agent - Health	8/26/2019
Inactive	Aetna Health of Ohio Inc.	1065035	Agent - Health	9/30/2020	4/25/2024
Inactive	Aetna Life Insurance Company	301140	Agent - Health	8/3/2015	4/25/2024
Inactive	American Continental Insurance Company	643130	Agent - Life	8/26/2019	12/6/2021
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	8/17/2021	5/25/2023
Inactive	Anthem Health Plans of New Hampshire, Inc.	944064	Agent - Health	9/23/2021	5/25/2023
Inactive	Anthem Insurance Companies, Inc.	300941	Agent - Health	9/23/2021	5/25/2023
Inactive	Anthem Life Insurance Company	301209	Agent - Health	9/23/2020	12/10/2020
Inactive	Anthem Life Insurance Company	301209	Agent - Life	9/23/2020	12/10/2020
Inactive	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	7/21/2022	1/9/2024
Active	Colonial Penn Life Insurance Company	300491	Agent - Health	9/13/2020
Active	Colonial Penn Life Insurance Company	300491	Agent - Life	6/18/2019
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	10/9/2014	6/8/2018
Inactive	Compcare Health Services Insurance Corporation	948751	Agent - Health	9/23/2021	5/25/2023
Active	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	8/26/2019
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	10/9/2014	6/8/2018
Active	Fidelity & Guaranty Life Insurance Company	301359	Agent - Life	5/16/2024
Inactive	First Health Life & Health Insurance Company	301735	Agent - Health	8/3/2015	4/25/2024
Inactive	Gerber Life Insurance Company	300529	Agent - Health	4/19/2018	1/7/2019
Inactive	Gerber Life Insurance Company	300529	Agent - Life	4/19/2018	1/7/2019
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	10/19/2015	6/8/2018
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	10/9/2014	2/23/2018
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	10/9/2014	6/8/2018
Inactive	Humana Insurance Company	301104	Agent - Health	10/9/2014	6/8/2018
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	10/9/2014	6/8/2018
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	10/19/2015	6/8/2018
Inactive	Kanawha Insurance Company	300127	Agent - Health	10/9/2014	10/22/2015
Inactive	Massachusetts Mutual Life Insurance Company	300445	Agent - Health	7/19/2018	9/6/2018
Inactive	SilverScript Insurance Company	663526	Agent - Health	9/30/2020	4/25/2024
Active	The Savings Bank Mutual Life Insurance Company of Massachusetts	690290	Agent - Life	5/13/2024
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	9/26/2021	1/9/2024
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	9/26/2021	12/22/2022
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	9/26/2021	12/23/2021
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	9/26/2021	1/9/2024

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Extend Insurance Services, LLC	625753	Agent - Health	8/28/2017	1/31/2018
Denied	Extend Insurance Services, LLC	625753	Agent - Life
Inactive	Usi Insurance Services LLC	669260	Agent - Health	5/10/2017	11/8/2017