DEPARTMENT OF INSURANCE
Affiliations
NamePtolomey, Mark IanDOIID955273NAIC NPN524103
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveNon ResidentAgentLife5/24/2017 3/31/2025
ActiveNon ResidentAgentHealth5/24/2017 3/31/2025
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.
License Renewal Information
ClassInvoice DateResponse Due / Expiration DateResponse Received DatePayment Received DateRenewal Complete
Agent01/15/202503/31/2025   
Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveDental Concern Inc. (The)301641Agent - Health6/12/201912/19/2019
InactiveHumana Benefit Plan of Illinois, Inc.781543Agent - Health6/10/201912/19/2019
InactiveHumana Health Plan of Ohio Inc.301565Agent - Health6/10/201912/19/2019
InactiveHumana Health Plan, Inc.300142Agent - Health6/10/201912/19/2019
InactiveHumana Insurance Company301104Agent - Health6/10/201912/19/2019
InactiveHumana Insurance Company301104Agent - Life6/10/201912/19/2019
InactiveHumana Insurance Company of Kentucky300826Agent - Health6/10/201912/19/2019
InactiveHumana Insurance Company of Kentucky300826Agent - Life6/10/201912/19/2019
InactiveHumana Medical Plan, Inc.801568Agent - Health6/10/201912/19/2019
InactiveHumana Wisconsin Health Organization Insurance Corporation830687Agent - Health6/10/201912/19/2019
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveFortune Ins Solutions LLC955554Agent - Life5/26/20171/23/2020
InactiveFortune Ins Solutions LLC955554Agent - Health5/26/20171/23/2020
InactivePaychex Insurance Agency Inc509469Agent - Life6/10/201912/19/2019
InactivePaychex Insurance Agency Inc509469Agent - Health6/10/201912/19/2019

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