DEPARTMENT OF INSURANCE

Affiliations

Name	Petter, Patricia M	DOIID	305340	NAIC NPN	1497403

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Resident	Agent	Health	1/27/2010	1/31/2026
Active	Resident	Agent	Life	1/27/2010	1/31/2026
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	11/15/2025	01/31/2026

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	9/6/2011	12/10/2018
Inactive	CompBenefits Insurance Company	301864	Agent - Health	10/10/2011	6/26/2013
Inactive	CompBenefits Insurance Company	301864	Agent - Life	10/10/2011	6/26/2013
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	12/17/2018	4/9/2019
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	11/17/2014	12/10/2018
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	10/15/2018	4/9/2019
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	9/6/2011	12/10/2018
Inactive	Humana Insurance Company	301104	Agent - Health	9/6/2011	4/9/2019
Inactive	Humana Insurance Company	301104	Agent - Life	9/6/2011	4/9/2019
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	12/17/2018	4/9/2019
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	12/17/2018	4/9/2019
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	11/17/2014	12/10/2018
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	12/5/2016	12/10/2018
Inactive	HumanaDental Insurance Company	301457	Agent - Health	9/6/2011	2/23/2012
Inactive	HumanaDental Insurance Company	301457	Agent - Life	9/6/2011	12/14/2012
Inactive	Kanawha Insurance Company	300127	Agent - Health	9/6/2011	5/4/2017
Inactive	Kanawha Insurance Company	300127	Agent - Life	9/6/2011	5/4/2017
Inactive	Principal Life Insurance Company	300129	Agent - Health	3/6/2000	1/31/2008
Inactive	Principal Life Insurance Company	300129	Agent - Life	3/6/2000	1/31/2008
Inactive	Union Security Insurance Company	301844	Agent - Health	12/20/1994	4/7/1997
Inactive	Union Security Insurance Company	301844	Agent - Life	12/20/1994	4/7/1997
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	8/18/2010	12/1/2016
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	8/18/2010	12/1/2016
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	8/18/2010	12/1/2016
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	8/18/2010	12/1/2016

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Rogers Benefit Group LLC	398725	Agent - Life	4/3/1995	4/7/1997
Inactive	Rogers Benefit Group LLC	398725	Agent - Health	4/3/1995	4/7/1997