DEPARTMENT OF INSURANCE

Affiliations

Name	Insurance Services LLC	DOIID	680943	NAIC NPN	7974891

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Health	5/30/2008	3/31/2016
Inactive	Non Resident	Agent	Life	5/30/2008	3/31/2016
* 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 Inc. (PA)	660717	Agent - Health	8/15/2013	3/31/2016
Inactive	Aetna Life Insurance Company	301140	Agent - Health	8/15/2013	3/31/2016
Inactive	Aetna Life Insurance Company	301140	Agent - Life	8/15/2013	3/31/2016
Inactive	American Continental Insurance Company	643130	Agent - Health	6/8/2013	11/12/2014
Inactive	American Continental Insurance Company	643130	Agent - Life	6/8/2013	11/12/2014
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	7/1/2008	3/31/2016
Inactive	Anthem Insurance Companies, Inc.	300941	Agent - Health	7/1/2008	10/16/2012
Inactive	Anthem Life Insurance Company	301209	Agent - Health	7/1/2008	3/31/2016
Inactive	Anthem Life Insurance Company	301209	Agent - Life	7/1/2008	3/31/2016
Inactive	Medico Insurance Company	301559	Agent - Health	12/15/2011	8/18/2015
Inactive	Medico Insurance Company	301559	Agent - Life	12/15/2011	8/18/2015
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	7/13/2009	12/26/2012
Inactive	Omaha Insurance Company	751908	Agent - Health	4/19/2012	6/24/2013
Inactive	PacifiCare Life and Health Insurance Company	301304	Agent - Health	3/16/2011	10/26/2011
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	7/13/2009	12/26/2012
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	7/13/2009	12/26/2012
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	3/16/2011	3/31/2016
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	3/16/2011	3/31/2016
Inactive	Wellpoint Life and Health Insurance Company	300469	Agent - Health	6/9/2008	3/31/2016
Inactive	Wellpoint Life and Health Insurance Company	300469	Agent - Life	6/9/2008	3/31/2016

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Mikolajcik, Lawrence V	679630	Agent - Health	5/30/2008	3/31/2016
Inactive	Mikolajcik, Lawrence V	679630	Agent - Life	5/30/2008	3/31/2016