DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Przybyla, Mark R	DOIID	983571	NAIC NPN	18688569

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	2/5/2018	12/31/2020
* 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	3/6/2018	8/15/2018
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	5/1/2018	12/31/2020
Inactive	Bankers Fidelity Assurance Company	554627	Agent - Health	2/5/2018	7/18/2018
Inactive	Bankers Fidelity Life Insurance Company	300193	Agent - Health	2/5/2018	7/18/2018
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	3/6/2018	8/15/2018
Inactive	SILAC Insurance Company	300535	Agent - Health	2/14/2018	11/10/2020
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	2/21/2018	7/11/2018
Inactive	UnitedHealthcare Insurance Company of America	301552	Agent - Health	2/21/2018	7/11/2018
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	2/21/2018	7/11/2018

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 - Health	5/2/2018	12/31/2020
Inactive	eHealthInsurance Services Inc.	514105	Agent - Health	4/17/2018	7/9/2018