DEPARTMENT OF INSURANCE

Affiliations

Name	Costa, John M	DOIID	892556	NAIC NPN	17723205

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Life	9/30/2015	8/1/2017
Inactive	Resident	Agent	Health	9/30/2015	8/1/2017
* 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 and Life Insurance Company	300523	Agent - Health	2/23/2016	8/1/2017
Inactive	American Retirement Life Insurance Company	706303	Agent - Health	2/29/2016	8/1/2017
Inactive	American Retirement Life Insurance Company	706303	Agent - Life	2/29/2016	8/1/2017
Inactive	Americo Financial Life and Annuity Insurance Company	300869	Agent - Health	10/21/2015	8/1/2017
Inactive	Americo Financial Life and Annuity Insurance Company	300869	Agent - Life	10/21/2015	8/1/2017
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	5/27/2016	8/1/2017
Inactive	Anthem Life Insurance Company	301209	Agent - Health	5/28/2016	8/1/2017
Inactive	Anthem Life Insurance Company	301209	Agent - Life	5/28/2016	8/1/2017
Inactive	Bankers Fidelity Assurance Company	554627	Agent - Health	3/9/2016	8/1/2017
Inactive	Bankers Fidelity Assurance Company	554627	Agent - Life	3/9/2016	8/1/2017
Inactive	Bankers Fidelity Life Insurance Company	300193	Agent - Health	3/9/2016	8/1/2017
Inactive	Bankers Fidelity Life Insurance Company	300193	Agent - Life	3/9/2016	8/1/2017
Inactive	Baptist Health Plan, Inc.	300157	Agent - Health	10/19/2015	8/1/2017
Inactive	Everly Life Insurance Company	561641	Agent - Life	3/31/2016	8/1/2017
Inactive	Guarantee Trust Life Insurance Company	301043	Agent - Health	7/17/2017	8/1/2017
Inactive	Guarantee Trust Life Insurance Company	301043	Agent - Life	7/17/2017	8/1/2017
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	6/30/2016	8/1/2017
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	6/30/2016	8/1/2017
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	6/30/2016	8/1/2017
Inactive	Humana Insurance Company	301104	Agent - Health	6/30/2016	8/1/2017
Inactive	Humana Insurance Company	301104	Agent - Life	6/30/2016	8/1/2017
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	6/30/2016	8/1/2017
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	6/30/2016	8/1/2017
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	6/30/2016	8/1/2017
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	10/12/2016	8/1/2017
Inactive	SILAC Insurance Company	300535	Agent - Health	2/22/2016	12/13/2016
Inactive	SILAC Insurance Company	300535	Agent - Life	2/22/2016	12/13/2016
Inactive	SilverScript Insurance Company	663526	Agent - Health	12/16/2015	8/1/2017
Inactive	United American Insurance Company	300910	Agent - Health	10/21/2015	12/23/2016
Inactive	United American Insurance Company	300910	Agent - Life	10/21/2015	12/23/2016
Inactive	United Home Life Insurance Company	300421	Agent - Life	4/25/2016	8/1/2017
Inactive	United National Life Insurance Company	844837	Agent - Health	5/23/2016	1/4/2017
Inactive	United National Life Insurance Company	844837	Agent - Life	5/23/2016	1/4/2017

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	6/1/2016	8/1/2017
Inactive	Designated Agent Company Inc.	681257	Agent - Health	6/1/2016	8/1/2017