DEPARTMENT OF INSURANCE

Affiliations

Name	Fc Health Group	DOIID	1040748	NAIC NPN	18836439

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Health	5/16/2019	5/1/2020
Inactive	Non Resident	Agent	Life	5/16/2019	5/1/2020
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Forrest, Michael Benjamin	945922	Agent - Health	5/16/2019	2/29/2020
Inactive	Forrest, Michael Benjamin	945922	Agent - Life	5/16/2019	2/29/2020