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.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	10/15/2025	12/31/2025

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
Inactive	Colonial Penn Life Insurance Company	300491	Agent - Health	9/13/2020	8/13/2024
Inactive	Colonial Penn Life Insurance Company	300491	Agent - Life	6/18/2019	8/13/2024
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