DEPARTMENT OF INSURANCE

Affiliations

Name	Pelczarski, Brian	DOIID	857958	NAIC NPN	17387807

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Health	9/18/2017	5/31/2025
Active	Non Resident	Agent	Life	9/18/2017	5/31/2025
* 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	03/15/2025	05/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	3/19/2016	8/18/2017
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	3/19/2016	8/18/2017
Inactive	Golden Rule Insurance Company	301943	Agent - Health	8/12/2015	5/22/2017
Inactive	Golden Rule Insurance Company	301943	Agent - Life	8/12/2015	5/22/2017
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	9/9/2015	8/18/2017
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	9/9/2015	8/18/2017
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	9/9/2015	8/18/2017
Inactive	Humana Insurance Company	301104	Agent - Health	9/9/2015	8/18/2017
Inactive	Humana Insurance Company	301104	Agent - Life	9/9/2015	8/18/2017
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	9/9/2015	6/9/2017
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	9/9/2015	6/9/2017
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	9/9/2015	8/18/2017
Inactive	Kanawha Insurance Company	300127	Agent - Health	9/9/2015	10/22/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	9/9/2015	10/22/2015
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	10/6/2015	2/14/2017
Inactive	UnitedHealthcare Insurance Company of America	301552	Agent - Health	9/8/2016	2/14/2017
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Health	8/12/2015	10/20/2016
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Life	8/12/2015	10/20/2016
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	8/12/2015	2/14/2017
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	10/6/2015	12/5/2016
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	10/6/2015	2/14/2017

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Aptia Insurance Services Group LLC	1283785	Agent - Health
Denied	Aptia Insurance Services Group LLC	1283785	Agent - Life