DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Hizy, Michael	DOIID	893649	NAIC NPN	17312212

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	9/30/2015	7/31/2017
Inactive	Non Resident	Agent	Life	9/30/2015	7/31/2017
* 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	CIGNA Health & Life Insurance Company	301783	Agent - Health	10/13/2015	7/12/2016

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Dentalplans Com	894687	Agent - Life
Inactive	Dentalplans Com	894687	Agent - Health	11/5/2015	7/12/2016