DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Smith, Michael John	DOIID	878163	NAIC NPN	14865274

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	5/15/2015	4/30/2018
Inactive	Non Resident	Agent	Life	5/15/2015	4/30/2018
* 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	Anthem Life Insurance Company	301209	Agent - Health	10/9/2015	11/3/2016
Inactive	Anthem Life Insurance Company	301209	Agent - Life	10/9/2015	11/3/2016
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	5/27/2015	12/1/2016
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	5/27/2015	12/1/2016
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	5/27/2015	4/30/2018
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	5/27/2015	4/30/2018

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Designated Agent Company Inc.	681257	Agent - Life	10/9/2015	11/2/2016
Inactive	Designated Agent Company Inc.	681257	Agent - Health	10/9/2015	11/2/2016
Inactive	Paychex Insurance Agency Inc	509469	Agent - Life	5/28/2015	12/1/2016
Inactive	Paychex Insurance Agency Inc	509469	Agent - Health	5/28/2015	3/8/2018