DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Grisa, Debra	DOIID	889845	NAIC NPN	17659219

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	9/4/2015		11/30/2024
* 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	09/15/2024	11/30/2024

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Arcadian Health Plan, Inc.	728196	Agent - Health	10/11/2017	1/4/2024
Inactive	CHA HMO, Inc.	300662	Agent - Health	12/20/2023	1/4/2024
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	9/8/2015	3/14/2019
Inactive	CompBenefits Insurance Company	301864	Agent - Health	11/12/2019	1/4/2024
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	9/8/2015	1/4/2024
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	9/8/2015	1/4/2024
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	10/22/2018	1/4/2024
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	9/8/2015	1/4/2024
Inactive	Humana Insurance Company	301104	Agent - Health	9/8/2015	1/4/2024
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	9/8/2015	1/4/2024
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	9/8/2015	1/4/2024
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	10/12/2016	1/4/2024
Inactive	Kanawha Insurance Company	300127	Agent - Health	9/8/2015	10/22/2015

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Humana MarketPOINT Inc.	398092	Agent - Health	11/21/2017	1/4/2024