DEPARTMENT OF INSURANCE

Affiliations

Name	Skidmore, Anthony D	DOIID	337894	NAIC NPN	3102776

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Health	10/6/1987	10/31/2006
Inactive	Resident	Agent	Life	10/26/2001	10/31/2006
AFFIDAVIT ON FILE
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Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Anthem Life Insurance Company	301209	Agent - Health	3/4/1996	12/31/1998
Inactive	Anthem Life Insurance Company	301209	Agent - Life	3/4/1996	12/31/1998
Inactive	C.M. Life Insurance Company	301335	Agent - Health	2/11/1997	12/11/2002
Inactive	C.M. Life Insurance Company	301335	Agent - Life	2/11/1997	12/11/2002
Inactive	Centennial Life Insurance Company (The)	301561	Agent - Health	3/27/1996	3/31/1997
Inactive	Centennial Life Insurance Company (The)	301561	Agent - Life	3/27/1996	3/31/1997
Inactive	Guardian Life Insurance Company of America	301316	Agent - Health	5/13/1988	10/31/2006
Inactive	Guardian Life Insurance Company of America	301316	Agent - Life	5/13/1988	10/31/2006
Inactive	Humana Insurance Company	301104	Agent - Health	1/31/1994	9/13/2002
Inactive	Humana Insurance Company	301104	Agent - Life	1/31/1994	9/13/2002
Inactive	Jackson National Life Insurance Company	300486	Agent - Life	3/8/1995	2/9/1998
Inactive	John Alden Life Insurance Company	300573	Agent - Health	12/22/1993	3/31/1997
Inactive	John Alden Life Insurance Company	300573	Agent - Life	12/22/1993	3/31/1997
Inactive	MML Bay State Life Insurance Company	301198	Agent - Health	6/26/1996	12/9/1996
Inactive	MML Bay State Life Insurance Company	301198	Agent - Life	6/26/1996	12/9/1996
Inactive	Massachusetts Mutual Life Insurance Company	300445	Agent - Health	9/9/1987	12/11/2002
Inactive	Massachusetts Mutual Life Insurance Company	300445	Agent - Life	9/9/1987	12/11/2002
Inactive	Principal Life Insurance Company	300129	Agent - Health	11/6/1995	9/4/1998
Inactive	Principal Life Insurance Company	300129	Agent - Life	11/6/1995	9/4/1998
Inactive	SeeChange Health Insurance Company	301115	Agent - Health	11/28/1988	3/31/1997
Inactive	SeeChange Health Insurance Company	301115	Agent - Life	11/28/1988	3/31/1997
Inactive	Time Insurance Company	300683	Agent - Health	11/19/1987	3/31/1997
Inactive	Time Insurance Company	300683	Agent - Life	11/19/1987	3/31/1997
Inactive	Trustmark Insurance Company	300317	Agent - Health	8/20/1993	3/31/1997
Inactive	Trustmark Insurance Company	300317	Agent - Life	8/20/1993	3/31/1997

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Healthplan Services, Inc.	401230	Agent - Health	8/31/1995	3/31/1997